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HIP Dental Benefits

Benefits are payable in accordance with the Bermuda Dental Fee Schedule.

Your HIP Dental Plan is designed to cover basic dental procedures. Your HIP dental benefits cover the following:

Basic Dental Services

% of Fee Schedule

Policy Year

Lifetime

Preventative and Diagnostic

75%

Unlimited

Unlimited

Exams, Consultations, Polishing, Scaling or Root Planing, Fluroide

75%

$1,200

Unlimited

Surgical and Minor Restorative

75%

Unlimited

Unlimited

The following services are not covered:

  • Endodontics - Root Canal Services
  • Periodontic - Treatment of Gum Disease
  • Major Restorative - Crowns, Inlays, Onlays
  • Dentures or Bridgework
  • Braces
  • Dental Implants and Related Procedures

Schedule of Benefits for HIP Dental Coverage

Preventive and Diagnostic Dentistry

A.  Diagnostic Services:

(a)    Complete oral examinations,

(b)    Recall examinations, 

(c)    Emergency examinations,

(d)    Specific examinations,

(e)    One complete series or one panoramic radiograph in any 36 months,

(f)    Eight bitewing radiographs during any plan year,

(g)    Problem specific periapical or occlusal radiographs,

(h)    Consultations.

B.  Diagnostic Procedures:

(a) Soft and hard tissue biopsies,

(b) Cytological testing.

C.  Preventive Services:

(a)    Polishing, 

(b)    Scaling or root planing,

(c)    Topical application of fluoride.

Surgical & Minor Restorative Dentistry

A.  Surgical services performed in a dentist's office or hospital:

The fee for the following surgical procedures includes anaesthesia other than general anaesthesia, appropriate radiographs, surgery, control of haemorrhage, sutures and routine post-surgical care.  No additional benefit is payable for these services. 

(a)    Extractions of erupted teeth,

(b)    Extractions of impacted teeth, 

(c)    Removal of root, bone or foreign body,

(d)    Excision of torus, tumours, or cyst,

(e)    Surgical incision and drainage,

(f)    Surgical exposure without orthodontic attachment,

(g)    Alveoloplasty, if performed without a surgical extraction,

(h)    Frenectomy,

(i)    Haemorrhage control. 

B.     Minor Restorative Services:

The fee for the following restorative procedures includes local anaesthesia, removal of decay, pulp protection, placement of a base and occlusal adjustment. No additional benefit is payable for these services.

Multiple restorations on a common surface placed on the same date will be considered a single restoration.

The maximum benefit payable will not exceed the fee for a five surface restoration regarding the same tooth during one sitting.

(a)    Amalgam restorations, limited to the cost of non-bonded amalgam restorations,

(b)    Acid-etch and non acid-etch tooth coloured restorations,

(c)    Retentive pins for restorations,

(d)    Prefabricated metal and plastic crowns, limited to primary teeth, 

(e)    Relining and rebasing of existing dentures, provided at least six months have elapsed since denture   insertion, and limited to once in any three year period,

(f)    Caries, trauma and pain control, when provided on a separate date from the final restoration. 

Contact Information 

If you have any questions regarding your dental coverage under the HIP Dental Plan or on any submitted or rejected claims, please contact Argus Customer Service Centre at: (441) 298-0888.

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