Mohawk Students' Association

Mohawk Students' Association (MSA)

Dental Plan Coverage Chart


 

 Insured Portion1

Dental Network

Savings

Total Coverage

  Preventive Services

   recall exam2, cleanings2

 70% 30% 100%

  Preventive Services

   extraction of impacted

   teeth

 50% 20% 70%

  Basic Services

   fillings3

 70% 20% 90%

  Basic Services

  oral surgery, endodontics

  (root canal), periodontics

  (gum treatment)

  20%20% 40%

  Major Restorative

   crowns, bridges, posts

Not Covered
 20% 20%

   

The maximum paid by Sun Life per policy year on the insured portion of the Dental Plan is $750.

1 Percentage of Provincial dental Fee Guide Cost for General Practitioners (province where service would be performed).

2 Recall exams, cleaning/polishing, bitewing x-rays, oral hygiene


 

 

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