Dental Insurance in BC
Most BC residents are not covered through their MSP services for dental treatment, except for a few groups of people (Low income residents and their children). More often than not however, many obtain extended health and dental benefits through insurance coverage offered by school or work.
These dental insurances can be difficult to understand in terms of their coverage. If you have trouble understanding your coverage, you've come to the right place!
Most dental clinics, including ours, follow the suggested dental fee guide exactly. This fee guide is published online and can be viewed by the public as well!
In the eyes of insurance companies, dental treatment can be split up into four main categories (or more!):
1) Preventive (Usually includes exams and cleanings on most plans)
2) Basic (Usually includes work such as fillings, root canals and dentures)
3) Major (Usually includes work such as crowns, bridges and implants)
4) Orthodontic (Usually includes any orthodontic treatment)
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Every insurance plan is different and offers different coverage. The most common plans in BC pay Preventive and Basic work at 80% and Major work at 50%. Even though insurance companies say they will pay for treatment at a certain percentage, this often comes with strict guidelines and frequencies.
Most insurance companies have frequency limits for the following procedures amongst others:
Complete Exam - Usually once per 2-3 years
Panoramic Xray - Usually once per 2-3 years
Recall Exam - Usually once per 6 or 9 months
Polishing - Usually once per 6 or 9 months
Fluoride - Usually once per 6 or 9 months
Bitewing Xrays - Usually once per 6 or 9 months
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Another limitation implemented by most insurance companies have to do with cleaning. Cleaning in BC is billed by units of time. 1 unit of time = 15 minutes of cleaning. Most insurance companies allocate a maximum number of units for the entire policy year. For example: Maximum 8 units of Scaling or Root Planing for 1 year.
Once again, every insurance plan is different and often come with different restrictions and limitations. When you come in to see us, do give us your insurance information so we can get a detailed breakdown of what your plan covers. If you are unsure, our receptionists are always on hand to explain your coverage details to you!
