Pensioners’ Dental Services Plan summary
This is a summary of the Pensioners' Dental Services Plan (PDSP), which is offered to eligible pensioners (retired members) of the public service including the Royal Canadian Mounted Police and the Canadian Armed Forces or of a participating agency or entity. It does not contain all details or describe all limits, restrictions or exclusions. For additional information, please refer to the PDSP member booklet or the PDSP rules or contact the Government of Canada Pension Centre.
The PDSP is designed to cover specific dental services and supplies that are not covered under your provincial/territorial health care or dental care plan. It is contributory voluntary plan and completely separate from the dental care plan for public service employees
Eligibility
Optional coverage for:
- Pensioners (including eligible surviving dependants) receiving an ongoing recognized monthly public service pension – some exceptions apply
- Eligible spouse or common-law partner and eligible dependant children
For definitions of terms used, consult the PDSP Rules.
Enrolment and effective date
To apply for coverage, submit a signed application form, available from the Government of Canada Pension Centre.
- If your completed application is received within 60 days of your pension’s effective date, coverage begins on that date.
- If your completed application is received more than 60 days after your pension’s effective date, coverage takes effect on the first day of the second month following receipt of your application.
Note: By applying, you and your dependants agree to participate in the PDSP for a minimum of three complete calendar years (some exceptions apply).
Positive enrolment
Once your application is approved, you will be issued a certificate number which you’ll need to complete positive enrolment with the plan administrator, Canada Life. Positive enrolment is mandatory and must be completed and maintained separately on all benefit plans. It’s your responsibility to keep your personal information up to date.
Positive enrolment involves giving Canada Life information about yourself, your spouse or common-law partner and each eligible dependant child, including:
- full names
- addresses
- ages
- banking information (for direct deposit)
You will also be asked whether you or any of your dependants have coverage under another group health or dental plan. You may be eligible to coordinate benefits between plans.
Note: There is no coordination of benefits between members of the PDSP.
Once you complete positive enrolment, you will have access to your PDSP benefit card. Claims will not be paid if you don’t complete this step.
Annual deductible
For complete information, consult the PDSP member booklet
- $25 for one covered person or $50 for more than one covered person (family) deducted from your first claim(s) each calendar year
Co-payment percentage (after deductible)
- Preventive and basic dental services: 90%
- Major restorative and orthodontic dental services: 50%
Reasonable and customary charges
- Reimbursement is based on the previous year's dental fee guide for the province or territory where the services are rendered
Note: Provisions for dental services received outside of Canada
Maximum amounts
- Annual maximum for combined preventive, basic and major restorative
- $1,500 per calendar year per covered person
- $750 during first year if coverage takes effect on or after July 1
- Lifetime maximum for orthodontic
- $2,500 per covered person
Eligible expenses, exclusions and limitations
For complete information, consult the PDSP Rules
- list of eligible dental services
- list of exclusions and limitations
- specific limitations for major restorative dental services
Preventive dental services (90%)
For complete information, consult the PDSP Rules
- oral examinations (some frequency limitations apply)
- x-rays (some frequency limitations apply)
- dental cleaning, polishing and fluoride application limited to once every 9 months
- oral hygiene instruction limited to once per calendar year
- other services
Basic dental services (90%)
For complete information, consult the PDSP Rules
- fillings (replacement fillings for the same tooth and surface once every 24 months)
- root canal and other endodontic services
- scaling and root planing (6 units every calendar year; up to 6 additional time units if pre-approved by Canada Life)
- repair or adjustment of dentures
- rebasing and relining of removable dentures (once every 36 months)
- oral surgery and related anaesthesia
Major dental services (50%)
For complete information, consult the PDSP Rules
- crowns and inlays (every 60 months)
- complete or partial dentures, fixed bridges (existing appliance must be at least 5 years old and not serviceable)
Note: Implants are not covered under the PDSP. The Alternate Benefit Clause may apply.
Orthodontic services
For complete information, consult the PDSP Rules
- examinations, x-rays and diagnostic casts (90%)
- Fixed or removable appliances (50%)
Cost-sharing and contributions
- You and the Government of Canada equally share the cost of this coverage
- Monthly contributions are deducted from the member’s pension
Note: Provisions for pensioners who have Veterans' Coverage
Coordination of benefits with other plans
For complete information, consult the PDSP Rules
- If you and a family member are covered under more than one group dental plan, you may coordinate benefits up to 100% of the actual eligible expenses.
- There is no coordination of benefits between members of the PDSP.
Coverage ends automatically
- When the member and/or dependant dies or is no longer eligible.
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