Dental Coverage in the U.S. How does it work?

All dental care for spouses and children of the CAF member must be arranged with a local provider with direct billing to either the member or to Canada Life (FKA Great West Life), if the dentist will bill directly. Members are to claim through Canada Life, as they do in Canada. The process is exactly the same, other than noting payment needs to be made in US dollars (USD).

There will likely be a portion of the bill that is the member’s responsibility, as it is in Canada. This dollar amount is the:
  1. co-payment obligation
  2. billing over the maximum entitlement under the policy for certain services and/or
  3. the yearly deductible
You may notice on your statements a section that is called Excess Dental. This is cost over the comparison cost between the two countries – which is completed by Canada Life. Excess Dental is reimbursable through the Orderly Room.

It is strongly recommended that members obtain a treatment plan, including a quote for the cost, for any significant dental work and submit it to Canada Life to find out what the reimbursement will be as well as what the member’s responsibility will be. This would apply to treatments such as orthodontic work.

2020 Dental Brief by CDLS(W) Medical Staff

Navigating Dental in the U.S. - FAQ Document

Dental Plan Booklet

Canada Life Claim Form