AISH Program Policy

Published Date: March 01, 2014
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Benefits

Health Benefits

Dental Services

AUTHORITY

Assured Income for the Severely Handicapped Act, section 3
Assured Income for the Severely Handicapped General Regulation, section 7

INTENT

To provide basic dental coverage for eligible clients, cohabiting partners and dependent children to ensure their dental health and well-being.

POLICY

AISH provides basic dental coverage through the Health Benefits Card (HBC). AISH covers dental treatment and services that are provided by dentists, denturists and dental hygienists within Alberta. These services are provided according to fee schedules in a Memorandum of Understanding with the Alberta Dental Association and College, and in agreements with the College of Alberta Denturists and the College of Registered Dental Hygienists of Alberta. Pre-authorization by the Alberta Dental Service Corporation (ADSC) is required for all dental procedures.

Basic dental coverage includes complete, recall and emergency examinations, teeth cleaning, x-rays, restorations (fillings), extractions, dentures as well as other dental services. Dental service providers should confirm the basic dental services available with the Health Benefits Card with the ADSC.

If a dental service provider accepts anyone covered for dental service through the AISH program, they may not bill for or request additional fees (i.e. balance bill or extra bill) above what is defined in the fee schedules from the AISH program or the AISH client for the dental services.

In situations where the client, cohabiting partner or dependent child has coverage under another dental plan, the dental service provider first applies for this coverage before accessing coverage through the AISH program.

Dental coverage is not provided outside of Alberta, and any costs incurred while traveling or vacationing outside of Alberta are not covered. Prior to leaving the province, the client should contact their AISH worker to discuss available options.

If dental treatments or services are denied, the client may request a review through the AISH program.