Benefit enhancements for the Public Service Dental Care Plan
As of , participants and their eligible dependants will have improved coverage under the Public Service Dental Care Plan. The purpose of this notice is to provide an overview of the benefit enhancements and other changes that will be coming into effect.
Changes coming in effect :
- 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
- $2,250 per year starting on
- $2,500 per year starting on
- 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.
Assistant Deputy Minister
Pensions and Benefits Sector
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