Dental Plan Overview 

All students enrolled in a full-time program at Ryerson are automatically enrolled in the Ryerson Students' Union Members' Dental Plan.

The benefit year is from September 1 to August 31 (for students starting in the Fall term) or January 1 to August 31 (for students starting in the Winter term). This means you will be covered by the Ryerson Students' Union Members' Dental Plan for a full twelve months.

If you are a first year student, or a new member to the Plan, your coverage will commence November 1st, retroactive to September 1st. However, you will need to retain all of your original receipts for September and October. As of November 1st you will be able to file a manual claim for these receipts and receive reimbursement from Green Shield Canada 

Claim forms, and assistance with filling them out, are available at the Health & Dental Plan benefit office, located in the Student Centre Lobby 55 Gould St. Additional information on filing claims is also available in the sections below.

Filing A Claim Under The Dental Plan:

When you visit the dentist, they will need the following information from you:

The insurance provider is Green Shield Canada .For more info please visit: https://www.mystudentplan.ca/rsu/en/home
Green Shield Identification Number is : RSU (your 9 digit Ryerson Student ID #) -00
Green Shield Customer Service Centre 1-888-711-1119
Please show the RSU Care Card for electronic billing purposes. 

Many dentists will be able to process your insurance claim for you electronically. If your dentist does not provide this service ask them to fill out a Standard Dental Claim Form detailing your visit, and submit the claim form to Green Shield for reimbursement. You will have to pay at the end of your appointment.

Some major restorative procedures and other complex treatments will require a pre-claim application to ensure coverage. Contact the Members' Health and Dental Plan Administrator for more details on pre-claim requirements.

Once your benefits claim has been approved, a reimbursement cheque will be issued directly to you. You will usually receive your cheque in 2-3 weeks at your home address.

Please be advised that different dentists have different policies regarding payment for services covered by an insurance plan. Your dentist may require you to pay by cash, cheque, or credit card for services at the time or your appointment. In this case, reimbursement will be made directly to you through the mail.

Other dentists may accept payments directly from Green Shield and will therefore only bill you for the difference between your benefits coverage and the full amount. Be sure to ask your dentist ahead of time whether you will be expected to make payment at the time of your visit.

Dental Plan Benefits

Green Shield bases its reimbursement for covered dental services on the Ontario Dental Association recommended rates. This practice is common amongst most insurance companies. Your dentist may or may not charge the same rates for these services - but the difference will likely be very small.

The benefits shown below will be eligible, if they are based on the licensed dental practitioner's reasonable and customary charge in accordance with the Fee Guide. 

Please note that two units of scaling are covered under the annual exam. Basic services of "Diagnostic and Preventive" is covered at 80% and the second unit is covered under Comprehensive Basic Services as "Endodontics and Periodontics".

Basic Services

Diagnostic & Preventive

• Recalls include exams, bitewing X-rays and cleanings (up to 1 unit of polishing plus up to 1 unit of scaling) once per benefit year beginning September 1.
• Fluoride treatments twice per benefit year beginning September 1 (19 years and under only)
• Complete, general or comprehensive oral exams, full mouth x-rays and panoramic x-rays, once every 3 years

Restorative & Extractions

• Basic restorations, fillings and inlays.
• Extractions and surgical services. General anaesthetics and intravenous sedation only when done in conjunction with eligible extraction(s) and/or oral surgery.
• Standard denture services once every 12 months, including relining and rebasing of dentures plus denture adjustments after 3 months from installation.

In provinces with more than one fee guide, Green Shield will reimburse according to the least expensive standard fee (or fee range).


Comprehensive Basic Services

Endodontics & Periodontics

• Endodontic treatment including standard root canal therapy.
• Occlusal equilibration - selective grinding of tooth surfaces to adjust a bite, 4 time units per benefit year.
• Periodontal treatment including scaling or root planning, 1 time unit per benefit year inclusive

Comprehensive oral surgery

• Surgical exposure, repositioning, transplantation or enucleation of teeth
• Remodeling and recontouring - shaping or restructuring of bone or gum
  
  

Major Services

Bridges, Crowns and Dentures

• Standard onlays or crown restorations to restore diseased or accidentally injured natural teeth.
• Standard bridges, including pontics, abutment retainers/crowns on natural teeth.
• Standard dentures including complete, immediate, transitional, and partial dentures once every 5 years.
• Standard repair or recementing of crowns, onlays and bridge work on natural teeth.

Alternate Treatment

The benefit plan will reimburse the amount shown in the Fee Guide for the least expensive service or supply, provided that both courses of treatment are a benefit under the plan.

Predetermination

For all proposed treatment for crowns, onlays and bridges, an estimate completed by your dental practitioner, must be submitted for assessment. Our assessment of the proposed treatment, may result in a lesser benefit being payable or may result in benefits being denied. Failure to submit an estimate prior to beginning your treatment will result in the delay of the assessment.

If the total cost of any other proposed treatment is expected to exceed $300, it is recommended that you submit an estimate completed by your dental practitioner.

Limitations

Laboratory charges must be completed in conjunction with other services and will be limited to the Co-pay of such services. Laboratory charges that are in excess of 40% of the dentist's fee in the current General Practitioners Fee Guide will be reduced accordingly; co-insurance is then applied.

Reimbursement will be made according to standard and/or basic services, supplies or treatment. Related expenses beyond the standard and/or basic services, supplies or treatment will remain your responsibility.

When more than one surgical procedure is performed during the same appointment in the same area of the mouth, only the most comprehensive procedure will be eligible for reimbursement.

Reimbursement will be pro-rated and reduced accordingly, when time spent by the dentist is less than the average time assigned to a dental service procedure code in the General Practitioners Fee Guide.

Reimbursement for root canal therapy will be limited to payment once.  The total fee for root canal includes all pulpotomies and pulpectomies performed on the same tooth.

Common surfaces on the same tooth/same day will be assessed as one surface. If individual surfaces are restored on the same tooth/same day, payment will be assessed according to the procedure code representing the combined surface.  Payment will be limited to a maximum of 5 surfaces in any 36 month period.

The benefits payable for multiple restorative services in the same quadrant performed at one appointment may be reduced by 20% for all but the most costly service in the quadrant.

Core build-ups are eligible only for the purpose of retention and preservation of a tooth when performed with crown treatment. Necessity must be evident on mounted pre-treatment x-rays. Core build-ups to facilitate impression taking and/or block out undercuts are considered included in the cost of a crown.

Root planing is not eligible if done at the same time as gingival curettage.

In the event of a dental accident, claims should be submitted under the health benefits plan before submitting them under the dental plan.

Diagnostic & Preventive Procedures

The Ryerson Students' Union Members' Dental Plan covers up to 80% of the cost an annual exam, which may include the following diagnostic and preventative procedures:

• Examination, 1 per benefit year
• Complete series of x-rays (not eligible for dependants under 12) and periapical, up to 16 films including bitewings in any period of 36 months
• Bitewings, not more than 4 films per benefit year
• Panoramic, 1 in any period of 36 months
• Polishing, 1 unit per benefit year
• Scaling, 1 unit per benefit year
• Fluoride, under 19 years of age, 2 treatments per benefit year
• Oral hygiene instruction, 1 treatment per lifetime
• Pit and fissure sealants, under 19 years of age, 1 per molar in any period of 36 months
• Anaesthesia, eligible when done in conjunction with a covered dental procedure

Minor Restorative Procedures (fillings)

The Plan covers up to 75% of the cost of the following minor restorative procedures:

• Space maintainers and maintenance, under 15 years of age
• Amalgam and tooth coloured fillings, 1 per tooth in any period of 24 months
• Stainless steel and plastic full coverage restorations, under 15 years of age, 1 per tooth in any period of 36 months
• Denture adjustments and repairs
• Relining, rebasing and tissue conditioning, one treatment in any period of 36 months
• Bridge repairs

Extractions (WISDOM TEETH)

The Plan covers up to 75% of the cost of extraction for up to 4 wisdom teeth per benefit year.

Endodontic Procedures (Root canals)

The Plan covers up to 10% of the cost of root canal therapy.

Periodontic Procedures (occlusal adjustments & applicances)

The Plan covers up to 10% of the cost of the following periodontic procedures:

• Occlusal equilibration, not more than 4 units per benefit year
• Periodontal appliances, not more than 1 appliance per arch in any period of 24 months
• Periodontal appliance repairs, maintenance and adjustments, not more than 4 adjustments per benefit year
• Major surgical procedures

Major Restorative Procedures (crowns, bridges, onlays & dentures)

Some major restorative procedures and other complex treatments will require a pre-claim application to ensure coverage. Contact the RSU's Health and Dental Plan Administrator for more details on pre-claim requirements.

The Plan covers up to 10% of the cost of the following periodontic procedures:

• Inlays, onlays
• Crowns
• Veneers, other than for cosmetic purposes
• Bridges
• Dentures

Replacement of an existing inlay, onlay, crown, veneer, bridge or denture is an eligible expense if the replacement is required to replace an existing inlay, onlay, crown, veneer, bridge or denture which was installed 5 years before the replacement.

Dental Specialist

Coverage is provided for the specialty services of an oral surgeon, endodontist, or periodontist when such specialty services are identified as eligible (based on plan design).

For services provided by a dental specialist, payment is based upon the General Practitioners Dental Association suggested fee guide in the province where the services are rendered.

Pre-determination / Pre-authorization

Please submit a pre-claim application to the insurance carrier prior to treatment of specialist services and any treatment plan exceeding $500. This process will determine the portion of the claim payable by the insurance carrier and the dollar amount that the student will be responsible for.

The insurance carrier will provide a written response to the student and dentist/specialist outlining eligible benefits. Pre-determinations are valid for a period of 12 months from date of issue.

Dental Accident Coverage

Dental treatment, services, or care necessary due to an accident, will be covered under the Ryerson Students' Union Members' Health Plan, NOT the Dental Plan. The health plan's dental accident provision will pay benefits before the dental plan. All treatment for dental accidents must commence within 6 months of the accident, and completed within one year of the date of the accident.

Dentist Surrounding Ryerson

There are several dentists in the downtown area that you can access. Please note the RSU does not recommend any preferred dentist. The downloadable list, click on the word "download", supplies offices that surround Ryerson and are easily accessible for students.

Questions? Contact RSU's Members Health & Dental Plan Administrator at 416-979-5255 x2311 or email at: health@rsuonline.ca