Dental Claims

Dental Claims

Dental claims under the Active and 60+ Plans provide coverage for a wide range of dental services, including preventive care, restorative procedures, and orthodontics (if applicable). These benefits ensure that members and their eligible dependents have access to essential oral health care.

How to Make a Claim

Using the Pay Direct Option

• Most dental offices can bill the plan directly using your Canada Life benefits information.

• Present your plan details to the dental office, and they will handle the claim submission.

• You pay only the uncovered portion or co-pay at the time of service.

Manual Submission for Dental Claims

If the dentist does not submit claims directly, follow these steps:

Collect Required Documentation:

Obtain an itemized receipt from the dental provider showing:

• Date of service.

• Description of the procedure (e.g., cleaning, filling).

• Total cost and proof of payment.

• Dentist’s license number and contact information.

Complete the Dental Claim Form

• Download the form from www.benefitsoffilm.com or request it from the Benefits Office.

• Fill in your details, including plan number and member ID.

Submit the Claim

• Online:

  • Log into the My Canada Life at Work portal.

  • Upload scanned copies of the claim form and receipts.

• Mail

  • Attach the completed claim form and original receipts to Canada Life at the address listed on the form.

Pre-Approval for Major Procedures

Request Pre-Treatment Authorization

• For crowns, bridges, dentures, or other major restorative work, submit a treatment plan to Canada Life before proceeding.

• The plan will provide a cost estimate and confirmation of coverage.

  
  

Submit the Treatment Plan

• Obtain the treatment plan from your dentist, including X-rays or other supporting documentation.

• Send it to Canada Life via mail or through the portal for approval.

  
  

Deadlines

• Submit claims within 12 months of the service date.

• For orthodontic claims (if applicable), ongoing expenses should be submitted periodically as treatment progresses.

  
  

Reimbursement

Pay Direct Option

The plan pays the covered portion directly to the dentist, and you pay the balance.

Manual Claims

Reimbursement is deposited directly into your bank account (for online submissions) or mailed via cheque (for mailed submissions).

Key Tips for Filing Dental Claims

Verify Coverage

• Confirm the procedure is covered under your plan before treatment.

  
  

Keep Receipts

• Retain all receipts for personal records and potential audit requests.

Submit on Time

• Late submissions may be denied unless valid reasons are provided.

  
  

Coordination of Benefits

• If you have dual coverage (e.g., through a spouse’s plan), submit claims first to the primary plan and then to the secondary plan for the remaining balance.

  
  

Additional Support

• For questions about the claims process or coverage details, contact Canada Life or the Benefits Office.

• Use the My Canada Life at Work portal to track submitted claims and remaining coverage limits.