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COVERED SERVICES →
ELIGIBLE EXPENSES →
Snapshot of Your Dental Coverage
Dental coverage through the Flexible Benefits Program can help pay for a broad range of dental care services. Here's a snapshot of the Dental coverage offered through the Flexible Benefits Program.
- Two coverage options, Basic Dental and Enhanced Dental (see the side-by-side comparison). You can also opt out of coverage.
- One carrier, GreenShield. GreenShield’s Benefits Booklet provides more details about your coverage. Access your GreenShield Benefits Booklet from the Resource Library on MyBenefits Online, or from:
- GreenShield+: Once you log in, go to your name at the top, select Account Settings, select the Coverage tile, and then select Benefits Booklets. You’ll see a link to download your GreenShield Benefits Booklet.
- GreenShield+ Plan Member: Once you're logged into your account from the app, select Coverage, select Benefits Booklet, and select View Policy. A PDF of your GreenShield Benefits Booklet will launch.
- What to consider. When deciding whether to elect the Basic Dental or Enhanced Dental coverage option, consider the following:
- Does a member of your family suffer from a condition that requires regular dental treatments?
- How much money have you spent on your and/or your dependent’s dental services in the last two or three years?
- Do you also have coverage through your spouse’s program (you may want to consider the coverage offered through your spouse’s program against the coverage offered through the Flexible Benefits Program)?
- What’s on the horizon—orthodontic services for your children, denture adjustments, crowns, etc.?
You don’t have to enrol for Health coverage to elect Dental coverage under the Flexible Benefits Program.
Go to MyBenefits Online to see your current coverage elections (if you’re currently enrolled), and for additional coverage and carrier-related details.
CONTACT INFO & APPS
GreenShield
- GreenShield+ Website
- GreenShield+ Plan Member App
- Main Phone: 1-888-711-1119
- GreenShield+ Plan Member Mobile App: APPLE APP STORE | GOOGLE PLAY
Remember …
If you enrol and then decide to opt out of either the Basic Dental or Enhanced Dental coverage option during the year due to a qualified life event, you won’t have coverage for the remainder of the calendar year. If you decide to opt out during Annual Enrolment, you won’t have coverage for yourself or your eligible dependents for the following year. If you want to re-join, you’ll need to re-elect a Dental coverage option during the next Annual Enrolment (or earlier if you experience a qualified life event).
ABOUT COVERED SERVICES
The Flexible Benefits Program pays benefits for covered services based on your provincial dental association’s current fee guide. Note that this guide periodically changes, which can impact a covered service that’s described here. If such a change takes place, the provincial dental association’s fee guide will govern.
A service is considered covered by the Flexible Benefits Program provided the treatment is:
- Performed by a dentist (or under a dentist’s supervision) or denturist;
- Recognized by the Canadian Dental Association;
- Proven to be effective; and
- Of a form, intensity, frequency, and duration that’s essential to the management of your dental health.
See your GreenShield Benefits Booklet for services that are excluded from coverage under the Flexible Benefits Program.
Looking for more details?
Access more Dental coverage details by visiting GreenShield+ Plan Member.
ABOUT ELIGIBLE EXPENSES
The Flexible Benefits Program pays benefits for eligible expenses. An eligible expense is based on the Reasonable and Customary (R&C) limit for a covered service.
To determine the R&C limit for a covered service:
- GreenShield analyzes the costs that are customarily charged for a particular covered service or supply in your area to treat a dental condition; and
- Based on that analysis, GreenShield determines the R&C limit for the covered service.
BENEFIT MAXIMUMS
The Flexible Benefits Program pays benefits—up to a combined maximum per covered individual each year—for covered:
- Basic services;
- Comprehensive basic services, and
- Major services.
The annual benefit maximum amount depends on whether you elect the Basic Dental or Enhanced Dental coverage option.
If you’re enrolled in the Enhanced Dental coverage option, a lifetime benefit maximum applies for covered orthodontic services for each covered person. This lifetime benefit maximum doesn’t apply under the Basic Dental coverage option (this option doesn’t cover orthodontic services).
PROPOSED DENTAL TREATMENT
Your dentist’s proposed treatment and what the Flexible Benefits Program reimburses may or may not be the same.
When several treatment alternatives exist, the Flexible Benefits Program pays benefits based on the maximum eligible expense for the least expensive covered service. Remember, the treatment you choose to receive is a decision between you and your dentists. Here are some additional tips:
- Avoid painful surprises! Before you begin a treatment with your dentist, check to make sure the Flexible Benefits Program covers the proposed service—and to what extent.
- Ask your dentist for a treatment plan—a written description of your required treatment and its cost.
- Submit the treatment plan to GreenShield to determine what your out-of-pocket costs will be before your treatment begins. This is called a pre-treatment estimate. You can submit it electronically via the GreenShield+ Plan Member app or the GreenShield+ Plan Member website. Or, your provider can submit it electronically through their Provider portal.
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