What’s Not Covered

The following are a number of products and services not covered under the plan. Note that this list isn’t exhaustive.

• Appliances which have been lost, stolen or broken because of an incident that did not involve accidental bodily injury
• Charges for broken or missed appointments
• Correction of temporomandibular joint (TMJ) dysfunction
• Cosmetic treatment, such as teeth bleaching or diastema (gap) closure, unless necessitated by an accidental injury
• Dietary planning, plaque control or oral hygiene instructions
• Full mouth reconstructions and vertical dimension correction
• Mouth guards worn for safety protection for sports, work or other related activities
• Services or supplies that weren’t provided by a dentist or other dental professional (e.g. services or supplies provided by an online or kiosk distributor)
• Treatment that’s experimental, educational or for the purpose of research
• Treatment where expenses aren’t considered necessary for the prevention of dental disease or correction of a dental defect
• Treatment provided free of charge
• Services provided by a family member if the family member has been given a discount. If you or your dependant is required to pay a portion of the cost of the services, you must pay for that portion or have your entire claim deemed ineligible (for example, if a dentist bills $300, we pay $180 (60 percent) and you pay the remaining $120 (40 percent). If the dentist doesn’t require you or your dependant to pay your portion, we won’t pay either)
• Expenses covered through a government program, whether or not you or your dependants choose to participate in the program
• Where charging for services or supplies is prohibited under legislation
• Expenses incurred while on active duty in any military or peacekeeping force
• All expenses incurred as a result of conduct that would constitute an indictable offence within Canada