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Diagnosis and Prevention

The reimbursement for basic dental care (diagnosis, prevention, and minor treatments) for all insureds with this coverage is limited to a maximum of $600 per person (insured person, spouse, or dependent child aged under 21 years) per insurance period for all plans (basic, supplementary, or retirees’ plan). To find out the refundable amount for different treatments, especially if their cost is over $500, it is recommended that you submit a treatment plan (cost estimate) to MÉDIC Construction. The amounts are limited according to the rates set in the “Guide des tarifs et nomenclature des actes buccodentaires” published by the Association des chirurgiens dentistes du Québec.

Coverage for dental care includes the following:

  • Complete oral examination (once every 36 months*)
  • Recall oral exam, including x-ray and cleaning performed during the examination (maximum once every 9 months*)
  • Certain special examinations (maximum once every 12 months*)
  • Emergency examination with specific diagnosis
  • Interproximal x-rays (maximum once every 12 months*)
  • Panoramic x-rays (maximum once every 60 months*)
  • Fluoride application (patient aged under 16 years; maximum once every 9 months*)
  • Installation of space maintainers following premature loss of primary teeth (baby teeth) and installation of apparatuses to correct harmful habits
  • Polishing of the tooth crown (prophylaxis) (maximum once every 9 months*)
  • Consultations required by the attending dental surgeon
  • Certain examinations, lab tests, and x-rays for diagnostic purposes (except during complete or recall oral exams)
  • Bacteriological test (maximum once every 12 months*)
  • Diagnostic waxing (except for cosmetic purposes)
  • Application of sealing material to pits and fissures on permanent teeth (patient aged under 16 years; maximum once per tooth)

* Example of calculation of treatment frequency:

  • If the treatment frequency is 9 months, the person must not have received the same treatment over the 9 preceding months to have the right to a reimbursement. For example, to obtain a reimbursement for a dental exam received on August 15, 2016 the person must not have had such an exam since November 15, 2015.

The Bulletin MÉDIC Construction for each plan gives the reimbursable amounts.

Specific conditions, limitations, and exclusions other than those mentioned above may apply to the reimbursement of certain types of coverage; only the Règlement sur les régimes complémentaires d'avantages sociaux dans l'industrie de la construction has legal value.

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