Major Restorative Services Sample Clauses
The 'Major Restorative Services' clause defines which significant dental procedures are covered under a dental insurance plan. Typically, this includes treatments such as crowns, bridges, dentures, and sometimes root canals, which are necessary to restore the function and appearance of teeth after substantial damage or decay. The clause outlines the extent of coverage, any waiting periods, and applicable cost-sharing requirements for these services. Its core function is to clarify the insurer’s obligations regarding expensive dental treatments, helping policyholders understand their benefits and financial responsibilities for major dental work.
Major Restorative Services. Crowns and Onlays Oral Surgery Services General Anesthesia or Intravenous Sedation (IV) Surgical Periodontal Services
Major Restorative Services. Onlays and crowns when the teeth cannot be restored with another filling material.
Major Restorative Services. Inlays, onlays and gold foils will be covered only when other materials cannot be used satisfactorily.
Major Restorative Services. Effective May 1, 2007, 100% co-insurance to a maximum of $1,500 per person per calendar year. Major restorative services will be extended to include repair or recementing of bridgework on natural teeth and standard bridges, including pontics, abutment retainers/crowns on natural teeth.
Major Restorative Services. Gold foil restorations. ‐ Inlays and onlays. ‐ Crowns Effective January 1, 1993, for all of the above Eligible Expenses, excluding Orthodontia, the Plan will pay the amount charged by the Dentist or the amount in the 1992 Ontario Dental Association Fee Guide, General Practice, whichever is the lesser, up to a Maximum Benefit of one thousand six hundred dollars ($1,600.00) per employee and one thousand six hundred dollars ($1,600.00) per insured dependent. For Orthodontia, the Plan will pay fifty percent (50%) of the amount charged, up to the aforementioned Fee Guide, to a Maximum Lifetime Benefit of one thousand five hundred dollars ($1,500.00) per person. The maximum benefit will be one thousand and seven hundred dollars ($1,700.00). ODA schedule to remain one year behind current contract year.
Major Restorative Services maximum per year • Level 4 .......Orthodontic Services $2,000 lifetime Recall exams (and bitewings and cleanings) once every 9 months. Fluoride treatment, once every 12 months, for Children up to the age of 21 only. Orthodontic Services for Dependent Children up to the age of 19. Oral hygiene instruction is not a covered expense. Missing tooth limitation for Major dental services (dentures, bridges/implants). Pit and Fissure Sealants for Dependent Children under age 14. Periodontic scaling, root planing and occlusal adjustment and equilibration: maximum 8 time units for each service per year. Termination age: Employee’s 75TH birthday To be eligible to participate in this plan you must be: • actively working on a regular permanent basis, for the minimum number of hours per week as indicated in the schedule of benefits, • insured under a government health insurance plan and reside in Canada, • under age 65, and • have been employed for 90 consecutive days. Your coverage will not take effect until the first day of the month following the waiting period.
Major Restorative Services. The dentist or member will be reimbursed 80% of eligible expenses incurred under Plan B of the Dental Coverage Eligible expenses include the following services required for replacement of missing teeth or the major reconstruction of decayed teeth where basic restorative methods cannot be used satisfactorily; ◼ Partial dentures ◼ Complete upper and lower dentures ◼ Veneers, crowns and bridges Limitations: Only one Plan B services on the same tooth will be covered in a five year period No benefit is payable for the replacement of lost, broken or stolen dentures Veneers, crowns and bridges will be paid only when decay is evident on pre-treatment x-rays.