Dental

The Health Benefits Program is available to First Nations people with Indian status who live in BC. The Health Benefits Program is also available to infants (up to 24 months) if at least one parent is eligible for the program. For full eligibility information visit the webpage here.​

Your plan covers certain dental items and services under the following categories:

• Orthodontic services (coverage has age restrictions and medical criteria)
• Periodontal services (e.g., cleanings, scaling or root planing)
• Root canals and related services
• Crowns, inlays, onlays, veneers
• Exams and X-Rays
• Fillings
• Bridges
• Dentures
• Preventive services
• Dental surgery

You can find detailed information about your dental benefits through your PBC Member Profile, which you can access online or through the PBC app.

You can find detailed information about your dental benefits through your PBC Member Profile, which you can access online or through the PBC app.

When you make an appointment, the best way to access your coverage and avoid out-of-pocket costs is to discuss your treatment plan and billing details with your provider.

• Ask your dental provider if they are registered with PBC. Providers who are registered can bill directly. If you see a provider who is not registered with PBC you will need to pay out of pocket and request reimbursement.
• Make sure any prior approval requests for items or services have been approved. Some items and services require prior approval, which your provider can request directly from PBC.
• Check if your dental provider requires payment up front. Some providers ask their clients to pay for items and services before undergoing treatment.
• Talk to your provider about which items and services are fully covered by your plan. Some providers charge more than the dental benefit maximums. Make sure you are aware of all charges before undergoing treatment.

Check your benefits online

• Login or Create an Account
• Download the PBC App
• PBC Website

Some items and services are considered Exclusions. Exclusions cannot be covered as an exception and cannot be appealed. Dental benefit Exclusions include, but are not limited to:

• cosmetic treatments
• implants
• ridge augmentation

When a coverage request for a dental item or service has been denied, you have the right to appeal the decision. Items and services that are Exclusions cannot be appealed. See the Appeals page for more information about the appeals process.​

If you have any questions about your dental plan, how to access coverage, or why a claim was denied, call Health Benefits at 1-855-550-5454.​​