Retirees Dental Plan FAQ

Dear Retiree,

Thank you for your interest in the above plan.

Plan Features include:

  1. Pricing is not based on age.
  2. World-wide coverage while traveling. (Snowbirds take note.)
  3. No loss of benefits if you move between provinces.
  4. No annual deductible.
  5. No dollar limit on basic dental services covered.
  6. Reimbursement based on current provincial dental fee guides.
  7. No limit on scaling.
  8. Standard root canal therapy.
  9. Enhanced benefits in the second year. (e.g. crowns and bridges)
  10. No waiting period before benefits begin.

You may choose to be covered under this plan starting on the first day of any future month. You will find an enrollment form and bank authorization form by clicking Enrollment Forms in the menu above. The benefits outline can be found by clicking Plan Details. Below is a list of commonly asked questions about the plan.

Sincerely,
Jane Guild
Plan Administrator

Note: The above information is intended to be general in nature. In all cases the provisions of the contract will apply.


WHO IS ELIGIBLE FOR THIS PLAN?

To qualify for this dental plan you must (A) be receiving or about to receive a pension (eg. OAS, CPP, or former employer), and (B) be a resident of Canada. You may still be actively employed.

WHEN MAY I ENROLL?

You may choose to be covered under this plan starting on the first day of any future month.

IS THIS PLAN SPONSORED BY TREASURY OR YOUR FORMER EMPLOYER?

No. It is a private, strictly voluntary plan.

WHO MANAGES THIS PLAN?

The plan in administered by RMS Retirement Management Services Ltd. in Victoria, BC, Canada.

WHO PAYS THE CLAIMS?

Green Shield Canada handles the claims part of the plan. They are a not for profit corporation which began in 1957 in Windsor, ON.

WHO DO I CONTACT ABOUT THIS PLAN?

For enrollment, banking, address and plan changes, contact the plan administrator, RMS Retirement Management Services Ltd. Because of the overwhelming response to this plan PLEASE DO NOT CONTACT Green Shield Canada until you are a member of the plan. They will be unable to answer your questions until that time.

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HOW DO I PAY FOR THIS PLAN?

Fees are paid monthly by pre-authorized cheque from your bank account. Plan pricing and coverage are reviewed each year and may be changed June 1st for all members, regardless of how long they have been on the plan.

CAN I PAY ANNUALLY?

Annual payments are not possible at this time due to administrative reasons. You will be notified if annual payments become possible.

ARE MY FEES TAX DEDUCTIBLE?

The fees for this plan are an eligible medical expense on your income tax. You may be able to claim them.

HOW DO I CLAIM FOR MY DENTAL BILLS?

You pay your dentist directly and claim from Green Shield Canada or have Green Shield pay him/her directly and then pay the difference. The dentist will provide the Standard Dental Claim Form needed.

HOW MUCH DOES THIS PLAN PAY?

The plan pays 70% in the first year and 80% thereafter for the services covered according to the current provincial dental fee guide. If your dental provider charges above this rate, you are responsible for the difference.

WHAT DOES PREDETERMINATION MEAN?

When the cost of your dental work is expected to exceed $300.00 on one claim you must have your dentist ask for pre-approval from Green Shield Canada before work begins. Please refer to the plan benefits for details. This does not mean your coverage is limited to $300.00. There is no overall limit on the total amount you may claim for the services covered.

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IS MAJOR DENTAL WORK SUCH AS CROWNS, BRIDGES, NEW DENTURES, ORTHODONTICS ETC INCLUDED?

There is coverage after 12 months on the plan for crowns, bridges and new dentures at 50% up to $600.00 per person over a 12 month period. Orthodontics are not covered.

DOES THIS PLAN COVER DENTURISTS?

Yes, but not all services provided by denturists. Please check the plan benefits for details.

CAN MY SPOUSE BE THE ONLY ONE ON THE PLAN?

Yes, as long as the pensioner has coverage under another plan such as current employment, DVA etc.

CAN I COVER MY COMMON LAW SPOUSE?

Yes, as long as you have been living together for at least 12 months.

CAN MY DEPENDANT CHILDREN BE COVERED?

Yes, to the end of the year following their 21st birthday, or to the end of the year following their 25th birthday if enrolled in full-time attendance at a college, university or institute of higher learning.

I AM THE PENSIONER. CAN I BE ON THE PLAN MYSELF WITHOUT COVERING MY SPOUSE OR DEPENDANTS?

Yes.

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CAN I ADD MY SPOUSE OR DEPENDANTS LATER?

You may add them when they lose coverage under their present plan or at the next anniversary date of the plan.

I AM RECEIVING A SURVIVORS PENSION. AM I ELIGIBLE?

Yes.

HOW LONG DO I HAVE TO BE ON THE PLAN?

You are making a minimum commitment of one year.

WHEN DOES COVERAGE START?

Coverage begins on the first of the month you request but is subject to written confirmation from Green Shield Canada.

IS THERE A DEDUCTIBLE?

No. A deductible is a basic yearly charge that you pay before you may make a claim. This plan does not have such a charge. This is different from co-insurance which is 70% in year one and 80% in year two.

ARE THERE ANY ADDITIONAL VALUE-ADDED SERVICES?

Yes. Preferred Provider Vision Network Arrangement

As a Green Shield plan member, you have access to our national preferred provider vision network arrangement where all Green Shield plan members are eligible to receive a discount on eyewear and laser eye surgery.

Features of this great value-added service for either eyewear or laser eye surgery include:

1. Offer applies to any Green Shield plan member, regardless of whether you have Green Shield vision benefits or not;

2. The vision provider may bill Green Shield directly; the plan member just pays any portion of the expense not covered under their vision benefit;

3. Trustworthy retail chains with convenient locations;

4. The discount offer applies to everything such as all extra coatings, upgrades and accessories;

5. Hundreds of the latest frame styles to choose from plus the latest lens and coating technology;

6. Professional opticians to assist in selecting products;

7. For some vendors, this offer applies to non-disposable contact lenses only (excludes disposable contact lenses).

Visit our website at greenshield.ca or call our Customer Service Centre at 1.888.711.1119 for information on the vision providers.

How to Submit Your Vision Claim

1. Present your Green Shield Identification Card as proof of being a Green Shield plan member.

2. The vision provider will apply the appropriate discount(s) to your claim and may submit the claim directly to Green Shield for payment. You pay your vision provider any balance not covered under your vision benefit.

3. If no vision benefit exists, you pay your provider the full balance owing after the applicable discounts have been applied.

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E. & O. E.