How the Dental Plan works

The deductible is essentially the amount that you pay each benefit year before the plan starts to reimburse eligible dental expenses up to certain limits.

The current annual deductible is $50 per insured person, to a maximum of $100 per family.

The Dental Plan reimburses eligible expenses incurred for the following 3 types of services, subject to a maximum reimbursement:

Please refer to the Eligible expenses section for a list of various covered expenses under each type of service as well as the Exclusions and limitations section. Coverage is subject to change.

Reimbursement is based on the charges in the dental fee guide for general practitioners of the province of residence of the insured person that is in effect on the date of the treatment.

Payment will be made for dental treatments rendered while travelling outside Canada, but only to the extent that payment would have been made under the Dental Plan if such service had been rendered in the normal province of residence of the insured person and provided that such treatment was for emergency purposes only.

Eligible expense incurred for dental services outside Quebec or outside Canada will be reimbursed based on the Canadian dollar amounts stated in the Quebec dental fee guide.

The maximum reimbursement is currently:

• $1,750 per covered individual, for all services (except orthodontics) rendered in a benefit year; and
• $2,500 per covered individual, for all orthodontic services rendered in a lifetime

If you are unsure of the amount that will be reimbursed by the plan, or if the total cost of any proposed dental treatment is expected to exceed $500, you should ask your dentist for a treatment plan, which you can submit to the insurer before treatment begins.

A treatment plan describes the dental treatment required as well as the expected cost. It is not intended to limit your choice of dentist, or to impose a given treatment or fee. Rather, it is designed to let you know in advance how much the plan will pay and how much you may have to pay.

Also, an alternate course of treatment that will give a professionally adequate result may be proposed by the insurer.

In such cases, the alternate course of treatment will serve as the basis for reimbursement by the plan even if you elect to proceed with the initial course of treatment proposed by your dentist.

You should discuss this proposal with your dentist to see if it would be equally appropriate in your case.