14Monetary limit on dental benefits (Act s. 62(2)(c))

14 Monetary limit on dental benefits (Act s. 62(2)(c)) (1) The total of dental benefit payable in respect of dental services provided to an eligible dental patient must not exceed the specified monetary limit for the relevant 2 year period. (2) In this rule: specified monetary limit is the cap. (3) An eligible dental patient shall be subject to a cap as listed in Schedule 3. (4) The cap is the maximum amount of dental benefits paid for services listed in the Dental Benefits Schedule provided to the eligible dental patient within a relevant 2 year period referred to in column 1 of Schedule 3. (5) In this rule: relevant 2 year period, for an eligible dental patient, has the meaning given by subrules (6), (7), (8) and (9). (6) If: (a) an eligible dental patient received a dental service on or after 1 January 2014; and (b) the dental service is the first dental service that the eligible dental patient has received on or after 1 January 2014; the calendar year in which the eligible dental patient received that first dental service and the following calendar year is a relevant 2 year period for the eligible dental patient. (7) Once the limit set by the cap for a relevant 2 year period has been reached the eligible dental patient will not receive any more benefits in that relevant 2 year period. (8) Once a relevant 2 year period has ended, the first time thereafter that a dental service listed in the Dental Benefits Schedule is rendered to an eligible dental patient it will trigger the commencement of a subsequent relevant 2 year period. (9) If there is no cap listed in Schedule 3 for the relevant 2 year period in which a service is provided, the cap for the most recent 2 year period listed in that Schedule shall apply. Example 1 A person who first receives a dental service on 25 January 2014 will be eligible for not more than $1,000 in dental benefits for all dental services provided to the person in 2014 and 2015. A further relevant 2 year period commences for that person in the calendar year when the person first receives a dental service on or after 1 January 2016.