We all know that dental and medical expenses are handled very different in Canada, but did you know that your children might be eligible to have the costs of their oral care covered by Medical Services Insurance (MSI) in Nova Scotia?
Nova Scotia’s Health Insurance Programs are designed to provide eligible residents with coverage for medically required hospital, medical, dental and optometric services with some restrictions. The Medical Services Insurance Programs are administered by Medavie Blue Cross on behalf of the Nova Scotian government.
Q. Who is eligible for the Nova Scotia Children’s Oral Health Program?
A. All children 14 years of age and under with a valid MSI health card number are eligible for the Nova Scotia Children’s Oral Health Program.
Q. What does MSI cover for children’s dental care?
A. MSI currently covers some basic dental care services for children from birth up to the end of the month in which they turn 15. Once a year, the program covers:
- One routine dental exam
- Two routine x-rays
- One preventative service – for example, brushing and flossing instruction, and/or cleaning
Fillings, necessary extractions and nutritional counseling are also covered by the program.
In some cases, MSI also covers fluoride treatments. Check with your dental office to see if your child qualifies for a fluoride treatment paid for by MSI.
Q. If my family has private insurance, is my child still covered under the program?
A. Yes. The Children’s Oral Health Program is a universal program that covers certain dental services provided in Nova Scotia. All children, age 14 and younger who have a valid MSI health card number are covered under the program.
Q. How does it work if I have private insurance?
A. The program is the payer of last resort. This means that your private insurance will be used first and MSI will cover the difference up to the regulated fee amount.
If your private insurance covers the regulated fee, then MSI will not provide any additional top up.
Under the program, your dentist cannot charge you any ‘out of pocket’ expenses for any additional amounts.
Q. Under the program, am I responsible for paying the difference above what MSI covers?
A. No. If your child is eligible for the program, your dentist should not charge you any additional expense for those services that are covered. Your dentist should bill MSI directly and they will receive payment based on the regulated fee. You are not responsible for the difference for costs that are covered under the program.
Q. My dentist asked me to pay the office for my child’s dental visit. How do I get reimbursed for services covered by the Children’s Oral Health Program?
A. Mail your invoice with your child’s MSI health card number to Green Shield Canada:
Children’s Oral Health Program
PO Box 1671
Windsor, ON N9A 0C6
You will be reimbursed for services covered by the program up to the regulated fee.
Q. What is a regulated fee?
A. A regulated fee is what MSI covers for a specific service under the program. A list of regulated fees is available at https://novascotia.ca/Just/regulations/regs/hsidental.htm.
Q. What if my child visits the dentist more than once a year?
A. Your child is eligible for one routine exam, one preventative service, and two routine x-rays per year, as well as fillings, which are not limited. If any additional services are received throughout the year, the dentist may charge you up to their own private rate.