The Plan does not cover injuries associated with normal acts such as cleaning, chewing and eating. The Plan covers the services of a dental surgeon and charges for dental prosthesis when required for the treatment of a fractured jaw or accidental injuries to natural teeth if the fracture or injury was caused by an external, violent and accidental injury or blow. Eligible expenses Expenses for treatment of accidental injury You should submit your claims for accidental injury expenses to the PSHCP first. Any amount not covered by your dental plan may then be submitted to the PSHCP. If you are covered under the Public Service Dental Care Plan, the Dependants Dental Care Plan, the CF Dependants Dental Care Plan or the Pensioners’ Dental Services Plan, you must submit your claims for oral surgery to that plan first. If you choose to have the more expensive treatment, the Plan will only reimburse you up to the amount quoted for the less expensive treatment, as long as the treatment you choose is not excluded under the Plan. When two or more courses of treatment for oral procedure or accidental injury are considered appropriate, the Plan will pay for the treatment that is least expensive. Eligible expenses under the Dental Benefit are the reasonable and customary charges for these services and procedures when performed by a dentist or dental surgeon. The Dental Benefit provides coverage for certain oral surgical procedures and courses of treatment following accidental injury.
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