Dental Insurance

The reimbursement for basic dental care (diagnosis, prevention, and minor treatments) is limited to a maximum of $600 per person (insured person, spouse, or dependent child aged under 21 years) per insurance period for all plans offering this coverage (basic, supplementary, or retirees’ plan). To find out the refundable amount for different treatments, especially if their cost is over $500, it is recommended that you submit a treatment plan (cost estimate) to MÉDIC Construction. The amounts are limited according to the rates set in the Guide des tarifs et nomenclature des actes buccodentaires published by the Association des chirurgiens dentistes du Québec (ACDQ) or in the Guide des tarifs et nomenclature des actes buccodentaires published by the Association des denturologistes du Québec (ADQ) and those set by the Guide des services professionnels des hygiénistes dentaires au Québec, when applicable.

Coverage for dental care includes the following:

• Complete oral examination (once every 36 months*)
• Recall oral exam, including x-ray and cleaning performed during the examination (maximum once every 9 months*)
• Certain special examinations (maximum once every 12 months*)
• Emergency examination with specific diagnosis
• Interproximal x-rays (maximum once every 12 months*)
• Panoramic x-rays (maximum once every 60 months*)
• Fluoride application (patient aged under 16 years; maximum once every 9 months*) **
• Installation of space maintainers following premature loss of primary teeth (baby teeth) and installation of apparatuses to correct harmful habits
• Polishing of the tooth crown (prophylaxis) (maximum once every 9 months*) **
• Consultations required by the attending dental surgeon
• Certain examinations, lab tests, and x-rays for diagnostic purposes (except during complete or recall oral exams)
• Bacteriological test (maximum once every 12 months*)
• Diagnostic waxing (except for cosmetic purposes)
• Application of sealing material to pits and fissures on permanent teeth (patient aged under 16 years; maximum once per tooth) **

* Example of calculation of treatment frequency:

• If the treatment frequency is 9 months, the person must not have received the same treatment over the 9 preceding months to have the right to a reimbursement. For example, to obtain a reimbursement for a dental exam received on February 15, 2023 the person must not have had such an exam since May 15, 2022.

** These treatments may be provided by a dental hygienist in independent practice. The fees payable are limited to those set in their guide in force for the current year.

The Bulletin MÉDIC Construction for each plan gives the reimbursable amounts.

Specific conditions, limitations, and exclusions other than those mentioned above may apply to the reimbursement of certain types of coverage; only the Règlement sur les régimes complémentaires d'avantages sociaux dans l'industrie de la construction has legal value.

The reimbursement for basic dental care (diagnosis, prevention, and minor treatments) for all insureds with this coverage is limited to a maximum of 600 $ per person (insured person, spouse, and dependent child aged under 21 years) per insurance period for all plans (basic, supplementary, and retirees insurance plan). To find out the refundable amount for different treatments, especially if their cost is over $500, it is recommended that you submit a treatment plan (cost estimate) to MÉDIC Construction. The amounts are limited according to the rates set in the “Guide des tarifs et nomenclature des actes buccodentaires” published by the Association des chirurgiens dentistes du Québec and in the Guide des tarifs courants of the Association des denturologistes du Québec.

Coverage for dental care includes the following minor treatments:

• Amalgam or composite fillings and retentive pins. The eligible expenses are limited to the usual and customary cost for this kind of dental care. Exception: for a child under 10 years of age, MÉDIC Construction does not reimburse amalgam fillings (grey fillings), because they are reimbursable by the RAMQ
• Simple or complex extraction of teeth and roots
• Surgical treatments such as alveolectomy, alveoloplasty, osteoplasty, tuberplasty, ablation of hyperplasic tissue, and frenectomy
• Surgical ablations of tumours, cysts, and neoplasms, including incision and drainage of abscesses
• General anaesthesia for dental surgery (maximum $300 per session)

Specific conditions, limitations, and exclusions other than those mentioned above may apply to the reimbursement of certain types of coverage; only the Règlement sur les régimes complémentaires d'avantages sociaux dans l'industrie de la construction has legal value.

The reimbursement for all periodontics and endodontics is limited to a maximum that varies according to the insurance plan. To find out the refundable amount for different treatments, especially if their cost is over $500, it is recommended that you submit a treatment plan (cost estimate) to MÉDIC Construction. The amounts are limited according to the rates set in the Guide des tarifs et nomenclature des actes buccodentaires published by the Association des chirurgiens dentistes du Québec (ACDQ) or in the Guide des tarifs et nomenclature des actes buccodentaires published by the Association des denturologistes du Québec (ADQ) and those set by the Guide des services professionnels des hygiénistes dentaires au Québec, when applicable.

Coverage for dental care includes the following:

• Root canal treatments
• Endodontic surgery
• Scaling of teeth (maximum 4 time units per 4 months*) **
• Periodontal irrigation (maximum once every six months)**
• Application of a desensitizing agent (maximum once every six months)**
• Treatment for gum disease (maximum 1 treatment per tooth every 60 months*)
• Occlusal adjustment (maximum once a year* for minor treatments and once every 5 years* for major treatments)
• Gingival curettage and surfacing (maximum 1 treatment per tooth per 60 months*)

*For an example showing how the frequency of reimbursement is calculated, see the Diagnosis and Prevention section.

** These treatments may be provided by a dental hygienist in independent practice. The fees payable are limited to those set in their guide in force for the current year

Specific conditions, limitations, and exclusions other than those mentioned above may apply to the reimbursement of certain types of coverage; only the Règlement sur les régimes complémentaires d'avantages sociaux dans l'industrie de la construction has legal value.

Reimbursement for major restorations is limited to a maximum that varies depending on the insurance plan. The amounts are limited according to the rates set in the “Guide des tarifs et nomenclature des actes buccodentaires” published by the Association des chirurgiens dentistes du Québec and in the Guide des tarifs courants of the Association des denturologistes du Québec. Major restorations are not reimbursed by all plans. To find out the refundable amount for different treatments, especially if their cost is over $500, it is recommended that you submit a treatment plan (cost estimate) to MÉDIC Construction. The employee then receives a letter from MÉDIC Construction containing information on the amount that may be reimbursed. Under certain conditions, the MEDIC Construction card can be use to pay the major restoration expenses.

Coverage for dental care includes the following:

• Veneers and inlays or onlays in porcelain, resin, ceramic or, if such restoration cannot be done with other substances, gold; the replacement of these elements only if they have been in place at least 5 years
• Initial installation of a complete or partial removable prosthesis (denture) provided that it is permanent, and of a transitional or immediate denture following an extraction
• Initial installation of a fixed prosthesis supported by natural teeth (bridge, crown, cast element) provided the prosthesis is permanent and the installation is part of an extraction and replacement process within one year following the extraction. If the placement is done after this time period, the maximum reimbursement is the cost of a standard removable prosthesis per maxilla
• Replacement of a permanent prosthesis identical to the one currently in the mouth, if this prosthesis has been in place for at least 5 years
• Rebasing or repair of a permanent prosthesis as well as the addition of teeth or of a structure to a prosthesis
• Initial installation, following congenital absence of a tooth, of a fixed permanent prosthesis
• Laboratory fees up to 50% of eligible costs
• Pipefitter's insurance plans (AT, BT, RT1, RT2) and millwright`s insurance plans (AM, BM, RM1, RM2) cover reimbursement of certain treatments related to dental implants. Consult the Bulletin MÉDIC Construction for more information

Specific conditions, limitations, and exclusions other than those mentionned above may apply to the reimbursement of certain types of coverage; only the Règlement sur les régimes complémentaires d'avantages sociaux dans l'industrie de la construction has legal value.

These treatments involve the use of apparatuses to correct an abnormal position of the teeth and jaws in order to prevent an anomaly or to prevent the appearance or deterioration of a malformation. Only dependent children under 21 years of age are covered.

The MÉDIC Construction card cannot be used for reimbursement of orthodontics costs. A treatment plan giving the date that treatment begins, its duration, and its cost must first be authorized by the Commission de la construction du Québec (CCQ).

Orthodontics treatments are reimbursable in a single payment following the payment at the time aparatus is installed. Certain conditions apply:

• You must send to MÉDIC Construction the original receipt for payment that you made to the orthodontist.
• The insurance plan that you have at the time the appartus is installed must include reimbursement for orthodontic care.
• The maximum reimbursable annuity per child under your insurance plan must not have been reached.

If the treatment plan is interrupted, you must notify the CCQ and reimburse all overpayments.

The Bulletin MÉDIC Construction for each plan indicates the amounts that may be reimbursed.

Specific conditions, limitations, or exclusions may apply to reimbursement of certain coverage. Only the Règlement sur les régimes complémentaires d'avantages sociaux dans l'industrie de la construction has legal value.

Costs incurred for the following treatments are not covered by MÉDIC Construction:

• Dental care for children 21 years or over even if they are full-time student;
• Replacement of a lost or stolen prosthesis duplication of a prosthesis or any other dental apparatus;
• Nutritional counselling and recommendations, instructions for oral hygiene or plaque control;
• Fees charged by a dentist for a missed appointment or to fill out a form;
• Treatments reimbursed under the Act Respecting Occupational Health and Safety or any other provincial, federal, or foreign law to the same effect;
• Fees in excess of those charged for the replacement of a prosthesis equivalent to the one the person already had;
• All treatments regarding the vertical dimension of the temporo-mandibular articulation;
• Cosmetic treatment or subsequent related treatment, including fixed prostheses (facing, crowns, inlays, etc.);
• Dental implants (except for insurance plans AM, AT, BM BT, RM1, RT1, RM2 and RT2);
• Application of cavity-fighting substances;
• Caries susceptibility test;
• Polishing of fillings and grinding of teeth.

Specific conditions, limitations, and exclusions other than those mentionned above may apply to the reimbursement of certain types of coverage; only Règlement sur les régimes complémentaires d'avantages sociaux dans l'industrie de la construction has legal value.

The reimbursement of your dental expenses is based on the rates of the Québec dental surgeons and denturologists, or if applicable, on those of the Guide des services professionnels des hygienists dentaires au Québec. MÉDIC Construction uses the current year’s rates. These rates apply even if:

• The treatments are performed by a specialist whose rate is higher
• The dental care is received outside of Québec at a higher rate

Most dental care may be paid for by using the MÉDIC Construction card. If it is not the case, the insured may submit a claim with the MÉDIC Construction application, by using MÉDIC online at sel.ccq.org or by sending the form Claim for dental expenses by mail. A claim form approved by the Association des chirurgiens dentistes du Québec (ACDQ) may also be used. In this case, the insured (employee or retiree) must write their client number on the form. 

Specific conditions, limitations, or exclusions other than those described above may apply to reimbursement of some coverage. Only the Règlement sur les régimes complémentaires d'avantages sociaux dans l'industrie de la construction has legal force. 

The Bulletin MÉDIC Construction for each plan indicates the reimbursable amounts.