Individual plan members | Dental benefits
If you have a Personal Choice or Seniors Plus individual health plan, your dental claims are paid according to the Alberta Blue Cross Dental Schedule. Dental benefits for more than 370,000 Albertans are paid according to the Alberta Blue Cross Dental Schedule.
What is the Dental Schedule?
The Alberta Blue Cross Dental Schedule is a basis of payment for dental claims. Every year, the schedule is updated with new rates so that it continues to provide a fair and consistent basis of payment of your dental claims. Increases are based on the results of a review undertaken annually by Alberta Blue Cross. Through the review process, the rate for each and every dental procedure is assessed to ensure the Dental Schedule continues to meet the needs of all concerned—including plan members and dental providers.
What is the Dental Schedule based on?
The Dental Schedule takes into account the costs associated with operating a dental practice as well as economic indicators, and remains comparable to rates for similar procedures in current provincial suggested dental fee guides published in British Columbia, Saskatchewan and Manitoba. View the Alberta Blue Cross Dental Schedule Handbook.
How much will you be charged?
There is no standard for billing of dental services in Alberta, which means dental offices may charge widely varying prices for dental services. If your dental office charges more than Alberta Blue Cross Dental Schedule rates, you will be billed the difference regardless of the level of coverage provided by your Personal Choice or Seniors Plus plan.
All Alberta dental offices have copies of the Dental Schedule as well as quick and easy access to information about dental coverage through CDAnet™ .
If your plan pays according to the Alberta Blue Cross Dental Schedule and you are asked to pay more than your plan pays, you will be responsible for the difference. In such cases, it is your choice to negotiate a better rate with the dental provider, agree to pay the amount, or access services from another dental provider who may not charge more.
If your plan pays according to the Dental Schedule, you should have already received a copy of the Alberta Blue Cross Dental Schedule information sheet or handbook. The reference material contains updated rates, examples of rates paid for common services, and tips to help you be an informed consumer of dental services
I have 100% coverage for dental check-ups and cleanings but I still end up with out-of-pocket expenses. Why?
There is no single standard for dental services billing in Alberta today. That means dental offices can, and do, charge varying prices for dental services—a situation that can lead to the question you've asked. Dental services covered under Personal Choice or Seniors Plus individual health plans are paid according to the Alberta Blue Cross Dental Schedule which provides a consistent and fair basis of payment.