Effective January 1, 2019. The major and minor changes to the plans are as follows:
The annual maximum coverage for routine and major services will increase 47%. The increase will be phased in from the current maximum of $1,700 per year to:
• $2,000 per year starting January 1, 2019;
• $2,250 per year starting January 1, 2020;
• $2,500 per year starting January 1, 2021.
• Dental implants will be covered in their own right. (Currently, implants are partially covered by deeming them to be another procedure, i.e., a bridge or dentures. This has often led to gaps in, or problems with, coverage.)
• Coverage for replacement fillings for children will be possible 12 months after the initial filling is done (instead of 24 months).
• Congenitally missing teeth will be covered until age 21 (up from age 19).
• Coverage during suspensions is improved.
• An allowable break in service to become eligible for the plan is extended from 5 to 7 days.
• The new plan allows coverage for extra scaling to be approved retroactively. (Currently, this may only be approved in advance.)
• Charges for oral hygiene instructions will now be limited to once per lifetime per adult (and remain once per year for children).
• Coverage is eliminated for minor issues such as:
• The assistance of a second oral surgeon.
• Dental professional peer consultation.
• Trauma control if done at the same time as treatment for caries or pain control.
• Enlargement of the canal or pulp chamber as a part of dental treatment separate from doing a root canal.
For further information: