A guide to your dental benefits
Being as informed as possible before having dental work completed can help you reduce the amount you will pay out-of-pocket.
Here are some actions you can take that will help you make informed decisions about your dental benefits.
Dental landscape
The dental landscape across Canada varies significantly when it comes to dental fees. At this time, each province has their own provincial basis of payment for dental services. Outside of Alberta, the vast majority of dental providers charge according to the rates contained in the provincial fee guides. Currently in Alberta, approximately half of general dentists charge according to the current Alberta Dental Association (ADA) dental fee guide.
This means that Alberta dentists charge varying prices for dental services.
Identify your coverage
Majority of our plans pay according to the current provincial fee guides, but for dental claims incurred in Alberta, three of the most common bases of payment referenced by our plans that include dental coverage are the Alberta Blue Cross Dental Schedule® (ABCDS), the Usual and Customary (U&C) dental fees and the Individual Products Usual and Customary Dental Fee List. We have information available for all three bases of payment including information on how much is covered for the most commonly claimed procedures.
The first step in helping you find out more about your dental coverage is to identify which base of payment your plan uses.
How to view your coverage
- Sign in to our member site (or register to use it if you haven't already done so).
- Under the Benefits tab, click Dental Coverage.
- Under Benefits overview there will be confirmation of which base of payment your plan uses. Clicking on the link will provide you with some additional information about that base of payment and how much is covered for some common dental procedures.
Get to know your coverage
Now that you know which base of payment your plan uses, we want to provide you with some information about your specific base of payment and take a quick look at your plan's rates for some common dental procedures.
We recommend you familiarize yourself with your plan's rates before visiting your dentist and consider printing off some of the info below so that you can show your dental office what your plan pays.
Note: To confirm which fee guide applies to you, please sign in to the member site for your detailed benefit booklet.
| Resource | Description | Download |
|---|---|---|
| 2024 Alberta Blue Cross® Usual and Customary dental fee resources* | Intro and common procedures The 2024 Usual and Customary Dental fees are currently aligned with the 2024 ADA fee guide |
View/download |
| 2024 Alberta Blue Cross Dental Schedule® resources* | Intro and common procedures | View/download |
| Alberta Blue Cross® Individual Health Plan dental basis of payment* | Intro and common procedures | View/download |
Learn how to reduce out-of-pocket dental expenses
Contact your dental office to let them know you have coverage with Alberta Blue Cross® and be prepared to ask the right questions.
If they answer yes, then you could find yourself paying less out-of-pocket as the fees in that guide are, on average, lower.
While dentists can charge varying fees for dental services, our most recent data shows that approximately half of Alberta dentists were charging according to the current Alberta Dental Association (ADA) fee guide.
If you are unable to determine if the dentist charges according to the ADA fee guide, here are the fees of a few common procedures you can ask about specifically.
| Procedure | Procedure # | ADA Fee |
|---|---|---|
| Complete examination | 01103 | $116.66 |
| Recall exam | 01202 | $73.85 |
| Two bitewing images | 02142 | $54.60 |
| Scaling | 11111 | $80.30 |
| Polishing | 11101 | $71.54 |
| Fluoride | 12111 | $34.66 |
This will help you determine what is covered by your plan and what you will pay out-of-pocket prior to receiving treatment.
Predeterminations are sent electronically and most are processed instantly.
This will help determine how much if anything, you'll have to pay up front and if they submit your claim on your behalf.
If they direct bill your insurance, you only have to pay the amount that wasn't covered.
If you have to pay up front, make sure you ask if they will submit the claim on your behalf.