GSA Dental Plan Coverage Chart
| Insured Portion1 | Studentcare Dental Network Savings | Total Coverage | |
|---|---|---|---|
| Preventive Services - recall exams2 - cleanings2 - extraction of impacted teeth3 |
70% | 30% | 100% |
| Basic Services - fillings4 - oral surgery - endodontics (root canal) - periodontics5 (gum treatment) - scaling2 |
70% | 20% | 90% |
| Major Restorative - crowns - bridges - posts |
Not Covered | 20% | 20% |
The maximum paid by Sun Life Financial per policy year on the insured portion of the Dental Plan is $550.
1 Percentage of Provincial Dental Fee Guide Cost for General Practitioners (province where service was performed).
2 Recall exams, cleaning/polishing, bitewing x-rays, oral hygiene instruction and the application of fluoride are covered once per 12 months. Scaling is covered up to 2 units per policy year. A complete exam (sometimes called a new patient exam) is covered once per 36 months.
3 The extraction of impacted teeth is considered to be part of preventive services by Sun Life. The Studentcare Dental Network reduction, however, will be 20%, as this is considered oral surgery in the Provincial Dental Fee Guide for General Practitioners.
4 Fillings in amalgam (metal) are covered for all teeth. Composite (white) fillings are covered for front teeth and pre-molars only. If you choose to have your back (posterior) teeth filled in composite, your claim will be reimbursed according to the amalgam fee.
5 Certain maximums exist. Contact Studentcare for more details.
Certain exclusions and limitations may apply. Prior to dental treatment for work that is expected to cost $300 or more, students should submit a treatment plan (obtained from your dentist) to Sun Life Assurance Company of Canada for approval.
Note: Services performed by an orthodontist aren't covered by the Dental Plan.