The Children’s Oral Health Program covers basic dental care for children in Nova Scotia aged 14 and younger who have a valid Medical Service Insurance (MSI) health card number.
Fillings, necessary extractions and nutritional counselling are covered by the Nova Scotia Children's Oral Health Program with no frequency limits. It also covers the following services once per year for each participant:
- 1 routine dental exam
- 2 routine X-rays
- 1 additional preventive service (i.e., brushing and flossing instruction)
- 1 fluoride treatment*
- Scaling (one unit for children 10 and younger; two units for children 11 to 14)
*Additional fluoride treatments are sometimes covered if they are determined to be necessary by the dental care provider.
Families must first use their private insurance for dental services before the program will provide coverage.
The patient’s MSI health card must be presented to the dental care provider before covered dental services can be administered. The dental care provider will bill MSI directly for covered services and receive payment based on the regulated fee.
Dentists who have opted out of the program must provide patients’ parents or guardians with all information necessary to complete and submit the claim form.
When registering for an MSI health card in Nova Scotia for the first time, families must contact the MSI Registration and Inquiry Department to start the application process. Each application is evaluated individually, and documentation proving citizenship or immigration status is necessary. After processing and approval of the application, a health card will be issued.
Key Nova Scotia Children's Oral Health Program Details
Services must be provided by a licensed dentist in order to be covered under the Children's Oral Health Program. Treatments completed by registered dental hygienists can not be billed under the program (unless performed under the direct supervision of a dentist).
Children can only receive dental care under the Children's Oral Health Program while in Nova Scotia. Any services performed outside of Nova Scotia must be covered by the individual or alternate insurance policies.
Before beginning treatment for an insured service, the dentist must ensure that the patient is entitled to receive the service. The patient must possess a valid Nova Scotia Medical Services Insurance (MSI) Health Card. If alternate identification is accepted by the dentist, and the claim cannot be processed due to identification errors, it will be the dentist's responsibility to locate the patient, parent, or guardian to obtain the correct information.
FAQs
Is pre-authorization required for any dental services under the program?
Eligibility is determined by the dental care provider according to the coverage guidelines. Pre-authorization is not required. If a dentist is unsure about the patient’s eligibility, they can choose to submit an electronic predetermination form through the Canadian Dental Association to acquire this information.
References
- Nova Scotia, Children’s Oral Health Program
- Nova Scotia, Dental Programs
- Dental Facts, Nova Scotia Children’s Oral Health Program
- Nova Scotia, MSI Health Cards
- Nova Scotia, MSI Brochure
- Nova Scotia Dental Association, Children’s Oral Health
- Nova Scotia, Dentist’s Guide
*The content provided in this article, including text, graphics, and referenced material, is intended for informational purposes only and is not a substitute for professional dental advice, diagnosis, or treatment. Always consult with your dentist or another qualified oral health professional for questions regarding your dental condition. Never disregard professional dental advice or delay seeking it based on information from this article. If you believe you have a dental emergency, contact your dentist, or seek immediate assistance from an oral healthcare professional.
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