Pre-authorization is required for treatment that will cost $500 or more.
“Dental Care” due to an accident means the treatment resulting from a breakage of a tooth or teeth by a direct accidental blow to the mouth and not by an object placed in the mouth, deterioration of the teeth or by any other cause.
Some Expenses Require Prior Pre-Authorization
If your dentist recommends dental work that will cost more than $500 or includes procedures such as crowns, bridgework, veneers, implants, onlays or inlays, you must have your expense pre-authorized by AFBS. Your dentist must provide AFBS with specific information, including x-rays, study moulds or casts.
Pre-authorization is not required if treatment is the result of an emergency. If the emergency treatment is for a crown or bridge, you must submit x-rays with your claim. Pre-authorization is not necessary for a crown if a root canal has been performed on the tooth. The dentist needs to indicate this on the claim form.
Through the pre-authorization process, you will have confirmation of the amount eligible for reimbursement through the Program before treatment starts.
Dental Injury/Accident
If you require Dental Care as a result of an accident, you will be insured for any expenses not paid by your provincial health care plan up to the available annual maximum. Payment will be made under the Extended Health Care plan and will not affect your Dental Care annual maximums.
Program Handbook > Dental Care
