Our Calgary dentist office accepts the vast majority of dental insurance plans, including group dental insurance plans, private dental insurance plans and government dental insurance plans. Some of the dental insurers we direct bill to include:

• • Canada Life     
  • Sun Life Canada
  • Alberta Blue Cross
  • Pacific Blue Cross
  • Industrial Alliance
  • Claim Secure
  • The Co-Operators
  • Desjardins Insurance
  • Empire Life Insurance
    
    

If you’re wondering whether our Calgary dentist can direct bill your dental insurance plan, please call our dental office and one of our friendly and knowledgeable team members would be happy to answer any question you may have.

Most dental insurance plans require that patients pay a certain portion of their Calgary dentist fees after payment by their dental insurance plan. This amount is often referred to as a “co-payment”. The amount of the co-payment will depend upon a variety of factors, including the fee schedule adopted by the particular dental insurance plan, the Calgary’s dentist’s fee charged for the particular treatment and the percentage of that fee that is covered by the dental insurance plan. The amount of the co-payment a patient must pay for their dental treatment is a percentage of their dental insurer’s stated fee guide which may differ from your Calgary dentist’s fee guide. 

It is important to note that the percentage at which a particular dental treatment will be covered by an insurer varies depending upon the insurance company, the type of plan you or your company has with that insurance company and the type of dental procedure.

For instance, for a typical dental hygiene visit with a Calgary dentist, most dental insurers will cover dental treatment such as scaling, polishing and dental x-rays at a rate of 70-100% of the dental insurer’s fee guide. After payment by the dental insurer of that 70 to 100%, the patient is contractually obligated to their insurer to pay to their Calgary dentist the balance of the dentist’s fee, which is known as their co-payment. Similarly, the Calgary dentist is also contractually obligated to collect the co-payment from their patient.

Another important aspect of some dental insurance plans to be aware of is annual policy limits. Although not all dental insurance plans have an annual policy limit, it is a common feature of many dental insurance plans. If your policy has an annual limit, this means that, after reaching a certain dental benefit amount, the dental insurer will not pay any further benefits for your Calgary dentist treatment during that benefit year.

Although our Calgary dentist does not recommend that your oral health choices be guided solely by your dental benefit coverage, it is certainly understandable that you would want to maximize your dental insurance benefits and minimize the amount of treatment done with no benefits at all. A good way to do this is to speak with our NW Calgary dentist (located in Kensington / Hillhurst / Sunnyside area) about your recommended treatment and, if you are approaching your annual policy limit, determine whether certain dental procedures can be safely delayed so you can take advantage of the following year’s dental benefits. Approaching your dental treatment in this manner is often a possibility, particularly if you are not dealing with a dental emergency and the end of your dental policy’s benefit year is approaching.

Yes, of course! Asking our Calgary dentist for a pre-determination of your proposed dental work can be a very useful tool in planning for your dental treatment. 

A dental insurance pre-determination is a request to your dental insurer prior to treatment to confirm the amount of existing insurance coverage for the proposed dental treatment. Often our Calgary dentist can make this request of your dental insurer on the day of your visit, with the response being communicated through our computer system, or if that is not possible with your plan, a phone call. If the dental treatment involves major dental work such as crowns, veneers, bridges, sedation dentistry, dental implants or other extensive dental treatment, a request for a pre-determination must be made several weeks in advance of your appointment date to allow your dental insurer time to review x-rays and assess your potential claim.  

Dental insurance plans vary widely amongst dental insurance providers and the amount of dental insurance coverage available to a patient varies widely amongst the myriad of plans underwritten by dental insurance companies. Most dental insurance plans will only cover a percentage of the total cost of each dental procedure and the percentage often varies depending upon the type of procedure. Many plans cover a higher percentage (often at the rate of 70-80%) for basic dental treatment such as dental hygiene cleanings, check-ups, fillings and tooth extractions and a lower percentage (such as 50%) for major dental treatment such as dental crowns and bridges. For procedures such as dental implants and cosmetic dentistry, including such dental treatments as veneers and whitening, it is not uncommon for dental insurance plans to not cover these procedures at all. However, this does vary amongst dental plans and dental insurance providers.

In addition to limiting payment of dental insurance claims to a certain percentage of the cost of the dental treatment, many dental insurance plans also have maximum annual limits of what the dental insurer will pay. Some dental plans also limit the amount of certain procedures per year, such as scaling (dental cleanings), which are usually limited to a certain number of units per calendar year (for example, 12 units per calendar year).

If you have two dental insurance plans (often referred to as “dual insurance”), then your primary insurance company will pay its portion of your dental treatment first, after which the secondary dental insurance will pay all or part of the balance, depending upon the policy of the dental insurer and your dental insurance plan.

It is responsibility of the patient to pay the patient balance owing after payment by the dental insurance company(ies).

To ensure that our patients are fully informed of the cost of their dental treatment, including their our-of-pocket expenses, we are always more than happy to request a pre-determination from the insurance company. A pre-determination is a statement from the insurer advising what portions of the proposed dental treatment will be paid by the insurer. We are also pleased to provide our patients with written estimates and, where possible, treatment options, to allow you to make an informed choice regarding your dental treatment.  

If you have any questions about what treatment procedures your dental insurance covers, or if you have any questions about your dental insurance generally, please call our Calgary dentist and our friendly and knowledgeable team members would be happy to answer your questions and provide any assistance necessary to help you understand your dental insurance coverage. 

If you are at our office for a dental emergency, if time allows given the nature of the emergency, at your request our Calgary dentist office will most certainly make every effort to pre-determine any proposed dental emergency treatment.

Yes, of course! If you have a copy of your insurance policy, send it to us by email or bring it along to your appointment and our Calgary dental team members would be happy to review your dental insurance policy with you and answer to the best of our ability any questions you may have. You can also submit a request for a review of your insurance below.

Please see the Government of Canada website for more information about the Canada Dental Benefit.