Student Coverage Staging
Dental Coverage for Students
Dental care is an important part of maintaining your overall health, but the cost of treatment can sometimes be a concern for students. Many students have access to dental benefits through a student health and dental plan, while others may have coverage through a parent or government program.
Understanding what your plan covers can help you make informed decisions about your dental care and avoid unexpected costs.
What Does Student Dental Coverage Include?
Coverage depends on your school, insurance provider, and the details of your plan. Many student plans include routine and preventive dental care, while some also provide coverage for restorative treatments and other services.
Depending on your plan, covered services may include:
Dental Examinations
Routine exams help assess the health of your teeth, gums, and mouth.
Cleanings
X-rays
Fillings
Other Treatments
Your plan may also have annual limits, deductibles, frequency restrictions, or different levels of coverage for specific treatments.
Local University & College Dental Plans
McMaster University
MCMASTER UNIVERSITY STUDENTS
The MSU Dental Insurance plan covers full-time undergraduate students at McMaster University enrolled in 18 units or more. Coverage runs from September 1st to August 31st.
Through contractual agreements, the following McMaster students are also covered:
- Midwifery Students
- MBA Students
- Commerce Internship Students
- Undergraduate Medical Students
Part-time Students may opt into the MSU plan.
Graduate Students are NOT covered by this plan. Please see GSA section for graduate students’ coverage.
McMaster Undergraduate Student Dental Plans
$600 Maximum
Basic & Preventative Services
- 80% of one examination and consultation, including any necessary x-rays and diagnostic services at time of exam, during each policy year. (100% at Gore Park Dentistry)
- 80% of one cleaning and one unit of polishing; includes up to 4 units of scaling (above the gum line) (100% at Gore Park Dentistry
- Fluoride treatments will be limited to one per policy year.
Minor Restorative
- 50% of the cost of amalgam, silicate, composite or tooth-coloured fillings and space maintainers. (75% at Gore Park Dentistry)
Extractions and Oral Surgery
- 50% coverage of extractions and residual root removal including wisdom teeth (limit of two per policy year). (75% at Gore Park Dentistry)
Other
- Endodontics, Periodontics, and Major Restorative are covered at 10%. (35% at Gore Park Dentistry)
McMaster GSA Dental Plan Coverage Chart
| Dental Services | Insured Portion1 | Studentcare Dental Network Savings | Total Coverage |
|---|---|---|---|
Preventive Services
|
70% | 30% | 100% |
Basic Services
|
70% | 20% | 90% |
Major Restorative
|
Not Covered | 20% | 20% |
Note: Services performed by an orthodontist aren’t covered by the Dental Plan.
Mohawk College
MSA Dental Plan Coverage Chart
| Dental Services | Insured Portion1 | Studentcare Dental Network Savings | Total Coverage |
|---|---|---|---|
Preventive Services
|
70% | 30% | 100% |
Preventive/Basic Services
|
50% | 20% | 70% |
Basic Services
|
70% | 20% | 90% |
Basic Services
|
20% | 20% | 40% |
Major Restorative
|
Not Covered | 20% | 20% |
You have access to preventive care with a Plan that offers up to $750 in coverage for dental visits per policy year.
The policy year is from Sept. 1 – Aug. 31.
Your Plan covers 20% to 70% of your dental costs and by visiting a Studentcare Dental Network member, you’ll receive an additional 20% to 30% off dental services. This enables you to have up to 100% of your dental costs covered by the Dental Plan. The maximum paid by Sun Life Financial per policy year on the insured portion of the Dental Plan is $750.
- Percentage of Provincial Dental Fee Guide Cost for General Practitioners (in the province where service was performed).
- Recall exams, cleaning/polishing, bitewing x-rays, oral hygiene instruction, and the application of fluoride are covered once per 12 months. Scaling is covered up to 2 units per policy year. A complete exam (sometimes called a new patient exam) is only covered once per 36 months. A complete set of x-rays or panorex x-rays is covered once per 36 months.
- Fillings in amalgam (metal) are covered for all teeth. Composite (white) fillings are covered for the front teeth and pre-molars only. If you choose to have your back (posterior) teeth filled in composite, your claim would be reimbursed according to the amalgam fee.
Certain exclusions and limitations may apply. Prior to dental treatment for work that is expected to cost $300 or more, students should submit a treatment plan (obtained from your dentist) to Sun Life Assurance Company of Canada for approval.
Note: Services performed by an orthodontist aren’t covered by the Dental Plan.
CUP 3906
CUPE 3906 provides dental coverage for Classification A Unit 1 members (excluding TAs and RAs in lieu who do not hold an undergraduate degree) who have a TAship or RAship in lieu of a TAship within the current academic year.
Unit 1 consists of Teaching Assistants, Demonstrators, Tutors and Super Tutors, Markers and Research Assistants who have an RAship in lieu of a TAship. Please note that if you are eligible for the CUPE Dental Plan, you are not eligible for the Graduate Students’ Association Dental Plan (unless otherwise specified by the GSA). You cannot enroll in GSA dental coverage and opt-out of CUPE 3906 coverage.
Eligibility for the Dental plan runs by academic year (i.e., Sept 1st to Aug 31st). The eligible amount for reimbursement (i.e., the money that is available to you) runs by calendar year. This means that if you are only employed for one academic year your coverage will be terminated at the end of that academic year (i.e., August 31st). If you are returning as a TA (or an eligible Sessional Faculty or Postdoctoral Fellow member) in the subsequent academic year, your reimbursement funds will not be renewed until January 1st of that academic year.
*IMPORTANT! *Please note that the Employer will ONLY collect your individual dental premium contributions from your TA/employment pay (NOT your academic funding). The Employer will deduct the entire year’s single premium costs from the first pay of the year.
*IMPORTANT! BLACKOUT PERIOD *Please note that claims that are submitted in September may be initially rejected by the insurance company even if you are eligible for dental benefits. This is likely due to a payroll processing delay and benefit enrollment period and has nothing to do with your eligibility.
Alternatively, if you are not receiving employment payment as TA/RA in lieu in the fall term you will not appear on Equitable Life’s eligibility list [and will have to submit your claims in the winter and/or spring/summer term(s)].
If you meet the eligibility criteria and your claim is rejected, please contact [email protected]. All eligible members may experience a delay in their receipt of reimbursement cheques for claims made in September.
*Members who qualify for the CUPE plan are automatically enrolled in single coverage. Members wishing to enroll in family coverage must fill out a family coverage enrollment form.
Dental Insurance and Dental Benefits
It’s worth understanding the difference between dental insurance and dental benefits, as the two terms are often used interchangeably. Dental insurance typically refers to a policy you or your school pays a premium for, which then covers a percentage of your treatment costs up to a set annual maximum. Dental benefits is a broader term that can include insurance as well as other forms of coverage, such as employer or government-sponsored programs.
Most student plans work on a cost-sharing basis, covering a percentage of the treatment cost rather than the full amount. Preventive services like exams and cleanings are often reimbursed at a higher percentage, while more involved treatments may be covered at a lower rate or subject to annual maximums.
Whichever type of plan you have, reviewing your policy details can help you understand your deductibles, annual maximums, waiting periods, and which treatments are eligible for reimbursement before you begin treatment.
FAQs for Students
How can I check my coverage?
What if my treatment isn't fully covered?
When should students visit the dentist?
Do I need to pay upfront and get reimbursed, or is it billed directly?
Make the Most of Your Student Benefits
Your student dental coverage can help make routine and necessary dental care more manageable. Take the time to understand your benefits, including coverage limits and exclusions, before starting treatment.
At Gore Park Dentistry, students can discuss their dental needs with our care team and learn more about their treatment options. Contact the dental clinic to schedule an appointment and discuss your dental care needs.