Dental

Dentist and patient in the medical chair getting an examination

Predeterminations 

Note: It is highly advisable to get predeterminations for significant extended health or dental expenses to be aware of the costs you may incur. A predetermination is an estimate of what your benefit plan will cover and what it will not. 

Explore the Predeterminations of Coverage section below for more information. 
 

Dental benefits will be eligible if they are necessary for the prevention of dental disease or treatment of dental disease or injury and reimbursement will be limited to the amount stated in the Provincial Dental Association Fee Guide.

Coverage is divided into four categories: 

  1. Basic services*. 
  2. Comprehensive basic services 
  3. Major services*; and 
  4. Orthodontic services*. 

*Please refer to the Annual Benefit Maximum for more details or the GreenShield benefit booklet, which can be found through your GreenShield+ account.  

Alternate Benefit Clause  

This benefit plan will reimburse the amount shown in the Fee Guide for the least expensive service or supply where two or more professionally accepted courses of treatment are a benefit under the plan. The covered person can choose to have a more expensive treatment performed; however, reimbursement will be limited to the cost of the least expensive alternative. 

Predetermination of Coverage

In the event that you expect any significant extended health or dental expenses, it is advisable to submit a cost estimate/predetermination to GreenShield to confirm how much you can expect to be reimbursed.

To determine if a specific medication/treatment will be covered by our plan, we advise you to:

  • contact GreenShield directly about your coverage 
  • ask your practitioner to submit a predetermination*, or
  • check your coverage online

*  Procedure coverage and reimbursement amounts will be communicated by GreenShield directly to the member.

Contacting GreenShield:

Phone (Mon to Fri, 8:30 a.m. - 8:30 p.m. ET):

  • 1-888-525-7587, select "Option 1", or 
  • 1-888-711-1119 

Online: 

Inquiry support:

Experiencing problems with a benefit claim?

The following steps of the GreenShield Inquiry Support Model can help to resolve the problem.