Explore your coverage
Here are some of your covered dental benefits as a member of IHN-CCO. These services are covered when given by an in-network provider. If you think you need a service that is not listed below, you or your provider should contact your dental plan before you get the service. If you cannot reach your dental plan, contact us.
The services listed below are subject to the Prioritized List of Health Services. Benefits are subject to change.
| Service | Your Cost* | Approval/Referral | Limits to Care |
|---|---|---|---|
| Basic restorative care such as a filling | $0 | Not required | No limit |
| Dentures | $0 | Approval required | Full: Once every 10 years if dentally appropriate Partial: Once every 5 years if dentally appropriate |
| Emergency dental care | $0 | Not required | No limit |
| Exams, cleanings, and x-rays | $0 | Not required | Once annual exam for adults; two for children under 18. Follow-up care allowed |
| Extractions (removing teeth) | $0 | Approval required for wisdom teeth | Wisdom teeth are a limited benefit not covered for orthodontics. No limit for other services |
| Periodontal maintenance | $0 | Not required | Covered once every six months |
| Specialist care | $0 | Referral required | Approval may be required for certain services. Contact your assigned dental plan for details. |
* This cost only applies when services are given by an in-network provider. Any services with an out-of-network provider must have prior authorization or approval, unless it is an emergency. If you do not get approval, you may have to pay.
The information on this page is a summary of your IHN-CCO benefits. For a full description of the benefits and services available to you, read your IHN-CCO Member Handbook.
2018 Member Handbook - Medical/Mental/Dental 491.71 KB2018 Member Handbook - Mental/Dental only 483.72 KB