After recent arbitration from our siblings at PSAC with the Public Service Dental Care Plan, it was ruled that there be significant improvements made which will come into effect on January 1, 2025. CAPE joins PSAC in applauding the arbitration panel’s decision that will benefit more than 185,000 federal public sector workers.
The significant improvements to the plan include:
- An increase to the annual maximum for routine and major services from $2,500 to $3,000 as of January 1, 2025, and to $3,250 as of January 1, 2027;
- An increase to the lifetime orthodontic maximum from $2,500 to $3,000 effective January 1, 2025, and $3,250 as of January 1, 2027;
- An increase from 50% to 65% coverage for major services such as bridge, implant or dentures;
- New coverage for tomography, pit and fissure sealants regardless of age, and procedures and assessments related to Temporomandibular joint disorders (TMJ);
- Contributions to the plan for those on extended parental leave will be paid by the employer for up to 18 months of leave;
- More flexible language for exceptions for replacing appliances such as crowns or bridges and on time limits to submit a claim where unavoidable circumstances are at play;
- New anesthesia coverage for any member or dependent who has a disorder which puts the safety of the patient or dentist at risk;
- More flexible coverage when there is damage to a tooth that would not usually be covered if the damage is such that it may require major coverage in the future;
- Coverage for members or their dependents with a congenitally missing tooth until the age of 22.
If you encounter any issues once the new updates are implemented in January, contact your HR department or communicate directly with the provider. If there’s a denial of coverage that you think contravenes the policy, you are able to appeal the decision through the Dental Care Board of Management so please contact your labour relations officer should it get to this point.
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