Dental Care Program - Major Restorative

Major Restorative and Orthodontic Services

Major Restorative

Major Restoratives include a 70% reimbursement level to a combined maximum with Basic of $2,500 per calendar year.

Dental benefits are based on the usual and customary charges up to the current Dental Society Fee Guide for general practitioners in effect in the prescriber's province of residence. The policy does not cover charges for specialist fees for any dental procedure.

Predetermination of Benefits:

When the total cost of any proposed dental treatment is expected to exceed $500, ask your dentist to complete and submit the predetermination section of the claim form to Medavie Blue Cross before the start of the treatment. You will know, beforehand, the exact amount of reimbursement. If you change dentists in the course of treatment, you will be required to submit a new treatment plan.

Extensive restoratives:

• Major repairs and restorations, including inlays, onlays, and crowns

Prosthedontic Services:

• Complete dentures-limited to one complete upper and one complete lower denture in five calendar years
• Partial dentures-limited to one partial upper and one partial lower denture in five calendar years
• Transitional dentures-limited to one complete upper transitional and one complete lower transitional denture in five calendar years and/or one partial upper transitional and one partial lower transitional denture in five calendar year
• Pontics
• Abutments
• Crowns
• Fixed bridges

Implants and restoration over implants to a maximum of one tooth every 10 consecutive calendar years.

This program excludes replacement of the denture unless it is at least five years old and cannot be made serviceable, and, the replacement of dentures that may have been lost, mislaid or stolen.

Orthodontic Services

Payment is at 50% of the Eligible Expenses up to the current Dental Society Fee guide for general practitioners in effect in the Subscriber's provice of residence.

The maximum payment id $2,000 per lifetime per participant under age 19.