Dental Coverage

The Health Association’s Dental plan covers dental services based on reasonable and customary charges, up to the amounts specified in the Nova Scotia Dental Association Fee Schedule for general practitioner dentists. The reimbursement you receive depends on the category of dental services:

  • 100% coverage for Basic services
  • 80% coverage for Major services
  • 50% coverage for Orthodontic services

There is a maximum of $1,500 per person in each calendar year for Basic and Major services combined.  There is a lifetime maximum of $2,000 for Orthodontic services.

Basic Dental Services 

The Plan provides 100% coverage to an annual maximum of $1,500 per person for all Basic and Major services combined.

  • Complete Oral Examination: Extensive exam including patient history, clinical examination and diagnosis of oral conditions. Limited to one in any 24 consecutive months.
     
  • Recall Examination: Periodic examination to maintain oral health and diagnose oral conditions. Limited to one in any 12 consecutive months for adults and two in any 12 consecutive months for dependent children.
     
  • Complete Mouth X-rays or Panographic X-rays: Limited to one in any 24 consecutive months.
     
  • Bite-Wing X-rays: Limited to one (2 films) in any 12 consecutive months for adults, and two in any 12 consecutive months for dependent children.
     
  • Polishing and Fluoride Treatments: Limited to one in any 12 consecutive months for adults, and twice in any 12 consecutive months for dependent children.
     
  • Scaling: Limited to two units (a unit of time is based on increments of 15 minutes) in any 12 consecutive months for adults, and two units twice in any 12 months for dependent children.
     
  • Pit and Fissure Sealants: Dependent children only.
     
  • Oral Surgery: Includes simple extractions and surgical extractions of teeth, removal of roots, surgical incision or excision and other oral surgical procedures including pre-operative and post-operative care.
     
  • Minor Restorative: Includes sedative dressings, temporary restorations, amalgam acrylic, composite resin, silicate restorations and retentive pins.
     
  • Adjunctive Dental Services: Includes emergency treatment not classified elsewhere in the Dental Fee Guide, conscious sedation (includes intravenous or nitrous oxide) and professional consultation.
     
  • The Plan does not cover separate charges for local anaesthesia administered in conjunction with procedures, general anaesthesia unless the patient’s medical condition prevents conscious sedation, electronic anaesthesia, hypnosis and acupuncture.
     
  • Mouth guards: Includes one mouth guard in a calendar year.


Major Dental Services  

The Plan provides 80% coverage to an annual maximum of $1,500 per person for all Basic and Major services combined.

  • Periodontal Scaling, Preventive Scaling and Root Planing: Limited to 8 time units in 12 consecutive months. More frequent service may be considered on a case-by-case basis for severe periodontal conditions. A treatment plan (pre-determination) should be filled in and approved by Manulife before you have these services carried out.
     
  • Relining or Rebasing of Dentures: Limited to once in any 36 consecutive months.
     
  • Repair of Partial or Complete Dentures and Re-cementing of Crowns, Inlays and Onlays, and Bridgework: Covered.
     
  • Major Restorative: Includes crowns and veneers, inlay and onlay restorations or gold fillings when teeth cannot be treated with other material. Replacements are covered only after five years from the initial placement, and the existing restoration cannot be made serviceable.
     
  • Prosthodontics: Includes fixed bridgework, partial and complete dentures and surgical services associated with placement of prosthodontics listed in the dental fee schedule.
     
  • Replacement of a Denture or Bridge: Covered after five years from the initial placement and the existing prosthodontic appliance cannot be made serviceable.
     
  • Endodontic Services: Includes treatment of pulp chamber, root canal therapy, and periapical services.


Orthodontic Dental Services   

The plan provides 50% coverage to a lifetime maximum of $2,000 per person.

  • Orthodontic appliances, orthodontic observations and adjustments.