Unlike health care, dental care isn’t covered by Canada’s public health system. This leaves many Canadians navigating the landscape of private dental insurance. Let’s unpack the coverage, costs, and key considerations of dental insurance:

What’s Covered in Private Dental Insurance?

  • Preventive care: Most plans cover routine checkups, cleanings, X-rays, and fluoride treatments.
  • Basic restorative care: Fillings, crowns, and bridges often have some level of coverage, though percentages vary.
  • Major restorative care:
    • Implants: The coverage for implants under your insurance largely depends on the specifics of your plan and the extent of coverage provided by your insurer’s policy. In general, implants, or at least a portion of their cost, are typically covered to some degree.
    • Root canals: As it is considered a medical necessity, it is expected that the majority of dental insurance plans will naturally provide coverage for it.
    • Dentures: The coverage of dentures under private dental insurance varies depending on the specific insurance plan. Many private dental insurance policies provide coverage for dentures, especially if they are deemed medically necessary.
  • Orthodontics: Braces and other orthodontic treatments may be partially covered for children, often with annual or lifetime maximums.

How Much Dental Coverage Do You Need?

The amount of coverage you need depends on a few factors.

  • Prioritize preventive care: Choose a plan that covers regular check-ups and cleanings.
  • Assess your oral health needs: Existing issues may require a more comprehensive plan.
    Consider family and orthodontic needs: Ensure the plan covers your family and any potential orthodontic treatments.

Cost of Private Dental Insurance

Dental insurance is usually purchased in combination with a health insurance plan. With Ontario Blue Cross, for example, dental benefits are an add-on and you can choose different levels of coverage. The premiums can vary widely depending on your age, location, the level of coverage, and the deductible. And be mindful of waiting periods. A 6-month waiting period is common for basic exams and cleanings, before coverage kicks in.

Alternatives to Private Dental Insurance

There are 2 alternatives to a private dental plan.

  1. Government programs: The new Canadian Dental Care Plan and the Canada Dental Benefit offer coverage for low-income families and children under 12.
  2. Health spending accounts: Some employers offer these accounts which allow you to set aside tax-free dollars for health care, including dental expenses.

What’s in the New Canada Dental Benefit?

Recently, the government introduced the Canadian Dental Care Plan (CDCP), a $13-billion effort to help uninsured families earning less than $90,000 a year with basic dental costs. It includes important dental services like:

  • Preventative: Cleanings, polishing, sealants, and fluoride treatments
  • Diagnostic: Exams and X-rays
  • Restorative: Fillings to repair damaged teeth
  • Oral Surgery: Extractions of teeth
  • Endodontic: Root canal treatments for infected teeth (available starting fall 2024)
  • Periodontal: Deep scaling for gum disease (available starting fall 2024)
  • Prosthodontic: Complete and partial removable dentures (available starting fall 2024)

How much help you get depends on your income. Families making less than $70,000 won’t pay for covered services, and the government covers the fees for participating dentists. But for those families earning $70,000 to $89,999, the government will pay some of the costs.

To join, your yearly family income must be under $90,000, and you shouldn’t have other dental insurance. You have to file taxes every year, and they’ll check each year to make sure you still qualify. As well, people with dental insurance from work or a private plan can’t join. Dentists can sign up to be part of the program and get paid directly for services.

Registration will start in 2024, beginning with seniors and moving to younger ones slowly. They’re doing it in stages to make it easier for people to apply.

Before You Purchase Dental Insurance

  • Compare dental benefit plans from different providers to find the best fit for your needs and budget.
  • Ask about exclusions and limitations before signing up.
  • Regularly review your coverage and adjust as your needs change.

With careful planning and consideration, finding the right dental insurance in Canada can help you maintain optimal oral health without breaking the bank

Talk To Us Today

Here’s why you should talk to a health and dental insurance agent today:

  • Get peace of mind, knowing you’re covered for dental emergencies, like that surprise root canal!
  • Enjoy the freedom to choose your dentist. Smile, it’s your choice! Don’t get stuck in a limited network.
  • Protect your wallet from painful out-of-pocket expenses. Insurance absorbs the shock, so your bank account doesn’t have to.
  • Invest in your future smile. Regular checkups and preventive care, often covered by private plans, keep your teeth happy and healthy for life.

Learn more about dental plan options from Ontario Blue Cross. Then talk to an agent now and discover a plan that fits your budget and your smile. Remember, a little prevention is worth a lot of pearly whites down the road.

Dental Insurance in Ontario: Navigating Coverage and Considerations