Dental care benefits

Find information about dental benefits under the Non-Insured Health Benefits (NIHB) Program.

On this page

• About dental care benefits
• How to access dental care benefits
• For more information

About dental care benefits

The program covers many different dental services that are described in the Dental Benefits Guide, including:

• diagnostic services, such as:
  • examinations
  • radiographs (X-rays)
• preventive services, such as:
  • polishing
  • painting sealants
  • applying fluorides
  • removing plaque (scaling)
•  adjunctive services, such as:
  • sedation
  • general anaesthesia
• restorative services, such as:
  • fillings
  • crowns
• orthodontic services, such as:
  • braces
  • retainers
• prosthodontic services, including dentures
• oral surgery services, including extractions
• periodontal services, including deep scaling
• endodontic services, including root canal treatments

This program provides eligible clients with coverage for benefits not available under other federal, provincial, territorial or private health insurance.

How to access dental care benefits

Dental services must be provided by a licensed dental professional, such as a:

• dentist
• denturist
• dental hygienist
• dental specialist

Service providers who are enrolled with the program can send in claims to bill the program directly. This means that you should not have to pay when receiving your dental services. You will need to show client identification in order for providers to bill the program directly for your benefits.

Certain procedures are covered without prior approval, which is also called predetermination. For these procedures, the dental professional can provide the service and send the bill directly to the program.

For procedures that do require prior approval, the dental professional must contact the program before you receive services. This is done to make sure the service is covered under the program.

Express Scripts Canada administers claims for providers on behalf of the program. Information can be found on their website, including:

• forms
• newsletters
• a claims submission kit
• a provider enrolment form
• regional dental benefit grids