Dental
Dental coverage helps pay for eligible dental expenses. Plans may include coverage for basic services such as fillings and check-ups, major services such as crowns and dentures, and orthodontic services such as braces.
Payment of Benefits
- The benefits provider will pay benefits based on dental services, financial limits and treatment frequencies in the fee schedule. The benefits provider will apply reasonable and customary limits to fee items as applicable.
- The benefits provider applies the reimbursement percentage shown in the summary of benefits to the fees shown in the fee schedule/fee guide as follows:
- for services performed in British Columbia or outside Canada, if your province of residence is British Columbia, the fees in the Fee schedule
- for services performed in Canada but outside British Columbia, the fees in the Fee guide in the province/territory of service
- for services performed outside Canada, if your province/territory of residence is not British Columbia, the fees in the fee guide in your province/territory of residence.
- You will be responsible for fees in excess of the amount shown in the applicable Fee schedule/Fee Guide.
Emergency Treatment Outside Your Province/Territory of Residence
You are entitled to the services of a dentist if, while travelling or on vacation outside your province/territory of residence, you require emergency dental care. You will be reimbursed according to the benefit provider’s fee schedule. This will not apply to the services of a dental hygienist.
Exclusions
The following are not eligible expenses under your dental plan unless otherwise stated in the summary of benefits:
- items not listed in the benefit provider’s fee schedule and fees in excess of those listed in the fee schedule
- charges for broken appointments, oral hygiene or nutritional instruction, completion of forms, written reports, communication costs, or charges for translating documents into English
- procedures performed for congenital malformations or for purely cosmetic reasons
- charges for drugs, pantographic tracings, and grafts
- charges for implants and/or services performed in conjunction with implants, except as indicated in the benefit provider’s fee schedule
- anesthesia not done in conjunction with surgery, and charges for facilities, equipment and supplies
- charges for services related to the functioning or structure of the jaw, jaw muscles, or temporomandibular joint
- incomplete or temporary procedures
- recent duplication of services by the same or different dentist
- any extra procedure which would normally be included in the basic service performed
- services or items which would not normally be provided or for which no charge would be made in the absence of dental benefits
- any item not specifically included as a benefit
- travel expenses incurred to obtain dental treatment.
Disclaimer:
The information contained on this website is provided for general information purposes only. Every effort has been made to ensure that this information is accurate, but this site is not a substitute for the official Plan documents, nor is it an employment contract. In the event there is a discrepancy between this website and the official Plan documents, the official Plan documents will prevail. For more information, or if you have questions about the information provided on this website please contact your School District Benefits Administrator.