A-29, r. 5 - Regulation respecting the application of the Health Insurance Act

Full text
36.1. For the purposes of sections 35 and 36, an insured person referred to in these sections is entitled to only one examination per 12-month period, except in case of an emergency or where the person is followed for oncological purposes by a dentist practicing in an institution which operates a hospital centre listed in Schedule E, and this is a second examination.
O.C. 1893-84, s. 1; O.C. 922-89, s. 134; O.C. 1287-96, s. 5; O.C. 446-2020, s. 3.
36.1. Notwithstanding section 36, the dental services listed therein are considered insured services only for an insured person 10 years of age or over who has held, for at least 12 consecutive months, a valid claim booklet issued in accordance with section 71.1 of the Act; notwithstanding the foregoing, for the acrylic prosthesis services contemplated in paragraph H of section 36, the period shall be 24 consecutive months.
The period of 12 consecutive months provided for in the first paragraph does not apply where the following services, including the preliminary examination, have been rendered as emergencies:
— extraction of a tooth or root;
— opening of the pulp cavity;
— incision or drainage of an abscess;
— alveolitis;
— hemorrhage control;
— repair of laceration of soft tissue;
— reduction of an alveolar fracture;
— immobilization of a tooth loosened by traumatism;
— re-implantation of an entirely exfoliated tooth.
O.C. 1893-84, s. 1; O.C. 922-89, s. 134; O.C. 1287-96, s. 5.