The Public Service Dental Plan
The Public Service Dental Care Plan (DCP) is a private health service plan for federal public service employees and their eligible dependents. It covers, up to certain limits, specific dental services and supplies not covered under provincial and territorial health or dental care plans. For example, services such as x-rays, cleaning, fillings, treatment of gums, surgical extractions and repairs and adjustments to dentures are reimbursed at 90% of cost, based on the previous year’s provincial/territorial dental fee schedule (or its equivalent). Other services such as crowns, dentures, fixed bridges and orthodontics are reimbursed at 50% of cost.
Each calendar year, there is an annual deductible amount per person or per family which you must pay. Expenses in excess of this amount are eligible for reimbursement from the Plan. The current annual deductibles are $25.00 per person and $50.00 per family. In addition, there are annual maximum reimbursement limits which will progressively increase from $2,000 in 2019 to $2,500 in 2021 and the frequency of some procedures, such as cleanings, is limited. Members who join the plan after July 1st in any calendar year are subject to an annual maximum benefit of half the regular maximum. Further note that orthodontic services are subject to a separate lifetime limit of $2,500 for each covered person.
DCP coverage is arranged according to specific group of public service employees. PIPSC members fall under Plan 55555 – Employees of Public Service Departments and Eligible Agencies (also known as the National Joint Council, or NJC, plan).
Filing a Claim
You can complete the claim form either online or download a copy and submit it to the address indicated. Your dentist will provide you with the correct service and procedure codes. Note: some dental offices have the ability to submit your claim directly to Great West Life, the Plan Administrator, so you will only have to pay your share of the cost upfront. Ask your dentist for details.