What Every Insured Patient Needs To Know

The name of the insurance carrier and the telephone number.

The name of the person in your company who is in charge of employee benefits.

Regarding the Policy:

  • What is the anniversary date of the policy?
  • Is there an annual deductible? If yes, how much is it?
  • What is the annual maximum allowed per patient?
  • Dental benefits are paid on which year’s Ontario Dental Association fee schedule?
  • How many units of scaling and/or root planning are covered per year?
  • Which codes are allowed for these services?
  • How many Recall appointments are allowed annually? Eg. every 3,6, or 9 months.
  • What percentage of coverage is allowed for the following:
    Diagnostic services
    Preventive services
    Restorative services
    Endodontic services
    Periodontal services
    Major Treatment eg. crowns, bridges, dentures
  • What is the annual maximum for major treatment?
  • Is Endodontic and/or Periodontal treatment classified as basic or major treatment?

The following information is required when patients call their insurance company.

  • Name of subscriber.
  • Employee’s date of birth.
  • SIN number.
  • Employer.
  • Policy number.
  • Division number.
  • Certificate number.