ACCIDENTAL DENTAL. Dental care for natural teeth necessitated by a direct accidental blow to the mouth and not by an object wittingly or unwittingly placed in the mouth. The accident and treatment must occur while coverage is in force. Payment will be made up to the fees set out in the Ontario Dental Association suggested Fee Guide for General Practitioners in effect on the date of treatment. The replacement of natural teeth will be limited to $500 per accident. Predetermination of Benefits and Alternate Benefit Provision - Prior to beginning dental treatment which will involve the use of crowns, bridges and/or dentures and which is expected to cost $300 or more, you must obtain from your dentist and submit to Manulife Financial a treatment plan outlining the details of the accident, any relevant x-rays, pre- accident condition of the teeth, planned treatment and cost. Approval of the treatment plan must be obtained from Manulife Financial prior to commencement of treatment (except for emergency treatment required to alleviate pain). After reviewing the treatment plan, you will be advised of the amount payable by Manulife Financial. Where a range of fees, individual consideration or laboratory charges are included, Manulife Financial will determine the amount payable. There are many ways to treat a particular dental problem or condition and the cost of different procedures, services, courses of treatment and materials may vary considerably. Manulife Financial may determine that payment for a less expensive procedure, which will provide satisfactory results, may be made towards the cost of a procedure selected by you and your dentist. The difference between the amount payable by Manulife Financial and the dentist's charge is your responsibility.
ACCIDENTAL DENTAL. Services by a licensed dental practitioner for the following dental treatment resulting from directly and independently of all other causes, from bodily injury caused by accidental means which occurred while coverage was in force, and received within 3 years of an accident for: ▪ dental treatment for injuries to natural teeth ▪ replacement of natural teeth to a maximum of $500.00 per accident, ie. dentures, bridge, crowns Reimbursement will be made up to the fees set out in the General Practitioners Fee Guide in effect on the date of treatment. A Dental Accident Report Form and your dental x-rays must be submitted to Green Shield for prior approval. Failure to comply may result in non-payment. AMBULANCE TRANSPORTATION When required as the result of an accident or acute physical disability by professional land ambulance, or in acute emergency, by air ambulance. HOSPITAL ACCOMMODATION Eligible benefits will be paid at 100% based on usual, reasonable and customary charges in the area where they were received, provided your provincial government health plan has accepted or agreed to pay the xxxx or standard rate. SEMI-PRIVATE COVERAGE ▪ Reimbursement for the difference in cost between standard xxxx charges and semi-private accommodation in a public general hospital when you have occupied an active treatment bed, or alternative level of care bed. ▪ Reimbursement up to a maximum of $3.00 per day for 120 days per calendar year for the difference in cost between standard xxxx charges and semi-private accommodation in a public chronic hospital or chronic wing facility of a public general hospital when you have occupied a chronic treatment bed or in a public general hospital when you have occupied an alternate level of care semi-private bed. ▪ Reimbursement for the difference in cost between standard xxxx charges and semi-private accommodation in a convalescent or rehabilitation hospital or a convalescent or rehabilitation wing in a public general hospital when you have occupied an active convalescent or rehabilitation bed.
ACCIDENTAL DENTAL. Charges for the treatment of accidental injuries to natural teeth or jaw, provided the treatment is rendered within 6 months of the accident, excluding injuries due to biting or chewing. Medical Equipment and Supplies: Rental or, where deemed necessary, purchase of a hospital bed, wheelchair, respiratory equipment, oxygen and oxygen equipment, and purchase of braces, crutches other durable medical equipment and supplies including: - Diabetic equipment: $500 every 60 consecutive months. - External breast prosthesis: one per 12-month period. - Surgical brassiere: two per 12-month period. - Transcutaneous nerve stimulator: rental for up to 6 months. Orthopedic Shoes/Orthotics which have been specifically designed and constructed, subject to a maximum of $150 per calendar year for orthopedic shoes. Laboratory Tests and X-rays, when not covered under the provincial government plan. Hearing Aids, excluding batteries and repairs, subject to a maximum of $600 in any period of 60 consecutive months.
ACCIDENTAL DENTAL. Dental care necessitated by a direct accidental blow to the mouth and not by an object wittingly or unwittingly placed in the mouth. The accident and treatment must occur while coverage is in force. Treatment must begin within days of the accident, and must be completed within one year. Liberty Health must be notified immediately. Payment will be based on the monetary rates shown in the Ontario Dental Association Fee Guide for General Practitioners in effect at the time of treatment.
ACCIDENTAL DENTAL. Charges for treatment for injury to natural, sound teeth resulting from a direct blow to the mouth while insured within one year following the date of the accident. The tooth must not be diseased, prior to the accident, to the extent that it was predisposed to pathological fracture or imminent loss.
ACCIDENTAL DENTAL. Dental care to repair or replace natural teeth as a result of a direct accidental blow to the mouth and not by an object wittingly or unwittingly placed in the mouth. The accident and treatment must occur while coverage is in force. Treatment must begin within 90 days of the accident, and must be completed within three years. Manulife Financial must be notified immediately. Payment will be based on the monetary rates shown in the Ontario Dental Association Fee Guide for General Practitioners in effect at the time of treatment. Where the patient is less than 18 years of age at the time of the accident, treatment must be completed prior to attainment of age 19. The replacement of natural teeth is subject to a limit of $500 per accident.
ACCIDENTAL DENTAL. Up to a maximum of $2,000 for the repair, extraction, replacement and treatment to a Covered Person’s natural or permanently attached artificial teeth damaged by a direct accidental external blow to the mouth. A Covered Person must see a physician or dentist immediately following the Accident. Treatment must begin within the Period of Coverage and be completed within 182 days of the date of the accidental injury. An accident report is required from the treating physician or dentist.
ACCIDENTAL DENTAL. Dental care for natural teeth necessitated by a direct accidental blow to the mouth and not by an object wittingly or unwittingly placed in the mouth. The accident and treatment must occur while coverage is in force. Payment will be made up to the fees set out in the Ontario Dental Association Suggested Fee Guide for General Practitioners in effect on the date of treatment. The replacement of natural teeth will be limited to $5,500 per accident.
ACCIDENTAL DENTAL. The insurer agrees to reimburse reasonable and customary costs up to $3,000 for emergency treatment or services to whole or sound natural teeth (including capped or crowned teeth) caused by an accidental direct blow to the face. Treatment relating to any dental claim must begin and end within 90 days from the onset of the accident and prior to your return to your country of origin.
ACCIDENTAL DENTAL. Dental care for natural teeth, necessitated by a direct accidental low to the mouth and not by an object wittingly or unwittingly placed in the mouth. The accident and treatment must occur while coverage is in force. Payment will be made up to the fees set out in the Ontario Dental Association suggested Fee Guide for General Practitioners in effect on the date of treatment. The replacement of natural teeth will be limited to $500 per accident. Predetermination of Benefits and Alternate Benefit Provision – Prior to beginning dental treatment which will involve the use of crowns, bridges and/or dentures and which is expected to cost $300 or more, you must obtain from your dentist and submit to RWAM a treatment plan outlining the details of the accident, any relevant x-rays, pre-accident condition of the teeth, planned treatment and cost. Approval of the treatment plan must be obtained from RWAM prior to commencement of treatment (except for emergency treatment required to alleviate pain). After reviewing the treatment plan, you will be advised of the amount payable by RWAM. Where a range of fees, individual consideration or laboratory charges are included, RWAM will determine the amount payable.
