General Exclusions
The Plans will not pay for the following:
- Any services and supplies received unless the person is a resident of a Province or Territory in Canada and registered with and entitled to benefits under their respective provincial government health plan.
- Services and supplies you are entitled to without charge by law, or for which a charge is made only because you have coverage under the Plans.
- Services or supplies not listed as covered expenses.
- Services related to the treatment of Temporo-Mandibular Joint dysfunction.
- Dental implants.
- Charges for completing claim forms or for missed appointments.
- Services covered or provided by Worker’s Compensation, any government agency or a liable third party.
- Charges for services provided prior to the effective date of coverage.
- Expenses for services and supplies rendered or prescribed by a person who is ordinarily a resident in the patient’s home or who is a close relative of the patient.
- Retired employees who no longer meet the eligibility requirements under the Plan(s) (including all eligible family members).
