Ministry of Social Development and Poverty Reduction

Decision Information

Decision Content

I APPEAL NUMBER 2018-00336 PART C -DECISION UNDER APPEAL The decision under appeal is the Ministry of Social Development and Poverty Reduction's Reconsideration Decision dated September 5, 2018 which determined that the appellant's request for coverage for 4 root canals was denied, because the amount the ministry is authorized to pay for root canals is less than the dentist's fees for them. Specifically, the dentist's fees were $905, while the ministry rate authorized under the Schedule of Fee Allowances for basic dental services for four or more root canals is $521.77 The Appellant had $503.34 remaining of her coverage for basic dental services, which the ministry could provide towards the payment for the root canals, but that was $401.66 less than the dentist's quotation for the four root canals. As root canals are not classified as emergency dental services, the ministry could only provide $503.34 towards the $905 cost; the ministry is not authorized to provide coverage for fees in excess of those specified in the Schedule of Fee Allowances Dental. EAAT003 (17108/17) 2
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