Charges for dental treatment when sound, natural teeth have been damaged by a direct accidental blow to the mouth, or a fractured or dislocated jaw requires setting. Such treatment must be rendered or reported and approved for payment within 180 days of the accident and all dental work must be completed within 6 months from the date of accident. Eligible expense will be the dentists’ usual, reasonable and customary fee up to the general practitioners’ dental fee guide in effect where services are rendered.
When such dental treatment must be deferred because of the age of the patient or other factors which are justified in the opinion of MBC, the claim may be approved for later payment. The patient must have been covered by the Plan at the time the accident occurred and must still be covered at the time the services are rendered. The member must submit complete details of the required services and reason for deferment within 180 days of the accident. All deferred treatment must be completed and approved for payment no later than the last day of the month in which the person turns 21 years of age.