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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.

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Universal Ave Dental
203 Lester St.
Waterloo, ON N2L 3W4

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Monday to Friday: 8:00am - 5:00pm
Saturday: 8:00am - 5:00pm
Sunday: Closed

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universal.avenue.dental.clinic@gmail.com
+1 519 992 9123
+1 519 992 9123