Benefit enhancements for the Public Service Dental Care Plan

Changes coming in effect January 1, 2019:

• The current yearly maximum reimbursement for dental services of $1,700 will gradually be increased over a three year period as follows:
  • $2,000 per year starting on January 1, 2019
  • $2,250 per year starting on January 1, 2020
  • $2,500 per year starting on January 1, 2021
• Eligible dental implants will be covered.
• Replacement fillings for the same tooth and surface will be covered for eligible children only every 12 months after the initial filling was done, instead of once every 24 months.
• Services and supplies needed to treat congenital or developmental malformation will be covered for children until age 21, instead of age 19.
• The allowable break in service to become eligible for the plan is extended to 7 days, instead of 5 days.
• Reimbursement for up to two units of extra scaling and/or root planning may be approved retroactively, if the application is made within 3 months of the service.
• Oral hygiene instructions will be eligible for reimbursement once per calendar year for children and remains eligible once per lifetime for an adult.
• Participants under suspension can keep their coverage if they pay the required contributions quarterly in advance.
• To reduce unnecessary costs while ensuring plan participants do not experience a reduction in services, duplicative charging (i.e. charging twice) for the following services will no longer be allowed:
  • Trauma control when it is done during a treatment for caries or pain control (note: traumatic dental injury remains covered);
  • Enlargement of the canal or pulp chamber billed separately from a root canal treatment;
  • Dental professional peer consultation costs as these are already included in the original examination fee covered by the Public Service Dental Care Plan;
  • The assistance of a second oral surgeon invoiced in surplus of the charges already billed for a procedure.

To learn more about the Public Service Dental Care Plan, visit Canada.ca/pension-benefits.