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7B.3. Dentures

 

Ontario Works Effective Date: July 1, 2009
Topic: Benefits/Discretionary Benefits Replaces: November 1, 2004
Subject: Dentures Policy No. H.7B.3.

 

POLICY  

Authority OW Act: Sec. 8 and 74(4) & OW Directives: Dir. 7.2 

Cost of dentures and partial denture is paid in accordance with the Annual Denturist Association of Sudbury Social Service Fee Guide (see Appendix A). Participants contribute 20% of the cost of dentures, partials or repairs. 

All second requests will be reviewed by the Supervisor and approved under exceptional circumstances only.
 

PROCEDURE

  1. Participant requests prior approval from the Case Manager through the submission of one estimate for cost of dentures. 
  1. Authorization form completed by Case Manager allowing 80% of the cost up to a maximum in accordance with the fee schedule distributed annually by the Denturist Association of Sudbury Social Service Fee Guide. 
  1. Notation to be made in the Social Assistance Computer System –Benefits. 
  1. The Case Manager must complete the Discretionary Benefits form and copy this information into the Social Assistance Computer System notes.
  1. The Case Manager will forward the completed request for approval.
  2. Once approved the request will be forwarded to the Integrated Program Assistant in Espanola. The Supervisor will put a note in the Social Assistance Computer System that the item was approved.

The Integrated Program Assistant will:

  1. Assign a P.O. number on the form and then mail it to the client.
  2. Keeps a copy of the P.O. in a pending file.
  1. When the original P.O. is returned from the supplier with an invoice attached, The Integrated Program Assistant will: 
  1. Match up the copy in the pending file, ensuring the client has not exceeded the maximum approved.
  2. Request the payment via the payment tab in the Social Assistance Computer System. The payment will be requested in the Vendor’s name. Enter a notation in the Social Assistance Computer System that the cheque was issued to_______ and for_______ in the amount of ________.
  1. The Supervisor will release the cheque via daily pay list reviews.  
     

Cross Reference: Section 7B.2 - Emergency Dental Coverage for Adults

The Denturist Association of Sudbury

1612 Lasalle Blvd., Sudbury ON P3A 1Z7

Tel: (705)566-8721  Fax: (705)566-8947

2022 Ontario Works Fee Guide

  • As per policy, participant pays 20% deposit
  • No charge for estimates
Procedure Code              Service                           D.A.O      Ontario Works Pays 
       
  Exam (New Patient)    
10010 Maxillary & Mandibular $137.00 $97.00
10030 Recall-Patient Exam $66.00 $47.00
       
  Dentures    
31310 Complete maxillary $1,181.00 $827.00
31320 Complete mandibular $1,404.00 $983.00
31311 Immediate maxillary $1,236.00 $866.00
31321 Immediate mandibular $1,516.00 $1,062.00
37110 Tissue Conditioner (For Immediate) $69.00 $50.00
       
  Partials (Acrylic)    
41612 Partial max. (without clasps) $879.00 $616.00
41622 Partial mand. (without clasps) $925.00 $648.00
41611 Immed partial max (w/o clasps) $1,101.00 $771.00
41621 Immed partial mand (w/o clasps) $1,161.00 $813.00
71010 Clasps-wrought/each $51.00 $36.00
       
  Relines    
37120 Temporary tissue conditioning (upper or lower) $90.00 $63.00
32110 Reline maxillary $324.00 $227.00
32120 Reline mandibular $351.00 $246.00
42116 Reline partial max. $351.00 $246.00
42126 Reline parital mand. $375.00 $263.00
  Repairs    
36110 Repair-no impression $111.00 $78.00
36210 Repair with impression $167.00 $117.00
71310 Repair model $25.00 $18.00
71313 Additional tooth/each $25.00 $18.00
71314 Multiple fracture/each $43.00 $31.00