Dental Coverage | Active Plan

Basic Dental Coverage

Includes diagnostics, preventative care, minor restorations, and maintenance services:

Diagnostic Services:

• Complete Oral Exam: Every 36 months.

• Limited Oral Exams: Two per calendar year.

• Periodontal & Specific Exams: Two per calendar year each.

• Emergency Exams: As needed.

• X-Rays: Complete series (36 months), Intra-oral (15 films/36 months), Panoramic (24 months).

• Casts & Consultations: One cast per calendar year, two consultations per calendar year.

  
  

Preventative Services:

• Polishing & Fluoride: Twice per calendar year.

• Scaling: Covered.

• Sealants: Once every 24 months (bicuspids & permanent molars).

• Space Maintainers: Includes appliances for harmful habits.

• Other Services: Finishing restorations, interproximal disking, recontouring of teeth.

Minor Restorations:

• Caries, Trauma & Pain Control: Covered.

• Retentive Pins & Posts: For fillings.

• Prefabricated Crowns: One per tooth every 2 years.

• Inlays & Onlays: Covered; replacements after 5 years if unserviceable.

• Gold Foils: For repairing existing gold restorations.

• Fillings: Amalgam and tooth-colored; replacements after 2 years or if not previously covered.

Endodontic Services Coverage

• Root Canal Treatment: One course per permanent tooth every 5 years.

Periodontal (Gum) Services Coverage

• Root Planing: Covered.

• Periodontal Surgery: One per sextant every 5 years (gingival curettage, osseous surgery).

• Occlusal Adjustment & Equilibration: Up to 4 time units (15 min each) per year.

  
  

Denture Maintenance:

• Relines: Once every 24 months (for dentures at least 6 months old).

• Rebases: Once every 24 months (for dentures at least 2 years old).

• Resilient Liners: Once every 36 months (post 3-month care period).

• Repairs & Additions: Covered after the 3-month care period.

• Adjustments: Once every 12 months (post 3-month care period).

• Tissue Conditioning: Twice every 60 months (post 3-month care period).

• Bridgework Repairs: Covered, including removal and re-cementation.
  

Adjunctive Services:

• Emergency Pain Relief: Minor remedies for dental pain.

• Therapeutic Injections: Covered.

• Anesthesia: For covered dental services.

Oral Surgery Coverage

• Tissue Remodelling & Recontouring: Covered services.

Major Dental Coverage

Covers restorative work like crowns, dentures, and veneers:

Crowns

• When Covered: For teeth with extensive structural loss.

• Crowns on Molars: Limited to the cost of metal crowns.

• Complicated Crowns: Limited to standard crown costs.

• Replacement Crowns: Covered after 5 years if existing crown cannot be repaired.

Dentures

• Types Covered: Standard complete dentures, cast/acrylic partial dentures, complete overdentures, or bridgework (if dentures are not viable).

• Material Limits: Tooth-colored retainers/pontics on molars are covered at metal costs.

• Replacement Appliances: Covered if:

  • Existing appliance is temporary.

  • Existing appliance is 5+ years old and irreparable.

  • Less than 5 years old but unserviceable due to new opposing appliance or additional extractions (limited to replacing added teeth if repairable).

• Additional Coverage:

  • Denture-related surgery for tissue remodelling/recontouring.

  • Denture remakes once every 36 months (post 3-month insertion period).

Denture Maintenance

• Includes adjustments, relines, and repairs of dentures.

Veneers

• When Covered: For extensive structural tooth loss.

• Replacement Veneers: Covered after 5 years if irreparable.

Orthodontic Coverage

• Eligibility: Available for individuals aged 6 and older.

*Note: Refer to the booklets for detailed information, exceptions, and conditions for availing these benefits.