The Dental Care plan covers you and your eligible dependents for services that maintain or restore healthy teeth and gums.
The University dental coverage is provided through Sun Life. Claims for reimbursement of expenses are typically submitted in the following two ways:
- Completing a paper form or;
- Online submission of claims through Sun Life Member Services
Visit the Making a Claim page to learn more.
Reimbursement of eligible expenses are based on the current year Sun Life Dental Fee Guide for Alberta and is adjusted yearly for cost of living. Check with your dentist before your dental work begins to see if he or she charges according to the current dental fee guide. If your dentist charges more than the current fee guide, you will have to pay the additional amount.
Treatment Plan Pre-determination
If the proposed treatment is orthodontic or for services over $500, it is recommended you submit a treatment plan to Sun Life in order to establish what expenses will be covered by the Plan. This allows both you and your dentist to know in advance what amounts will be considered eligible under your group coverage. Generally, the Dental claim form is used for obtaining pre-determination and can be submitted electronically or by paper.
Least Cost Alternative
When two or more covered dental procedures are separately suitable for the dental care of a specific condition, and both are consistent with good dental care, the Plan will provide benefits for the least expensive service.
Co-ordination of Benefits
There are certain rules that govern the reimbursement of claims when both you and your spouse have benefit coverage with your respective employers. Visit the Co-ordination of Benefits page to learn more.
There are additional considerations when you or your spouse begin coverage under the Alberta Blue Cross Seniors Program. Upon 65th birthday of you or your spouse Alberta Blue Cross Senior’s program may pay limited dental benefits. Your dentist will be aware which services are covered through Alberta Blue Cross Senior’s Program. After expenses have been adjudicated by Alberta Blue Cross, you are then in a position to submit any residual amount to Sun Life for reimbursement.
Making the Most of Your Dental Benefits
It is recommended that you discuss fees with your dentist before you receive treatment, and have your dental office send Sun Life a pre-determination (fee estimate) so they can let you and your dentist know in advance how much will be covered. That way, if you do have to pay any additional charges, you will be prepared ahead of time and can choose to negotiate a better price, get a cost estimate from another dentist, or agree to pay your dentist’s extra fees.