What to Know About Dental Insurance in Canada

Dental Insurance in Canada

Did you know that one in five Canadians avoid seeing a dentist because they can’t afford the cost of doing so? After all, the publicly funded Canadian Medicare doesn’t cover general oral healthcare services.

As a result, Canadians have to pay out of their pockets if they don’t have private dental insurance. But unfortunately, one in three of them doesn’t.

The good news is that dental insurance plans in the Great White North don’t have to cost an arm and a leg. We’ll give you the lowdown on the most vital facts you need to know about them below, so read on.

Canadian Medicare and Dental Coverage

Canadian Medicare refers to Canada’s publicly funded health care system. It encompasses 13 medical care and health insurance plans. That’s one for each province and territory.

Under Medicare, the country’s residents have reasonable access to medically necessary services. That includes hospitalizations, doctor visits, and emergency care. So long as covered, patients don’t have to pay out-of-pocket.

Unfortunately, Medicare excludes general oral healthcare coverage. However, there are government dental programs that cover some oral healthcare services. Still, they’re not comprehensive like private insurance and often have strict requirements.

An example is British Columbia, offering adults up to $1,000 in dental coverage over two years. To qualify, you must be a recipient of disability or income assistance. Either that or you qualify as someone with persistent multiple barriers.

Other provinces and territories have similar programs and requirements, so check yours. But if you don’t qualify, your best option is to purchase private dental insurance.

The Benefits of Private Dental Insurance

Insurance companies cover about 60% of all private dental care costs in Canada. Patients then shell out the rest (40%) from their pockets.

So if not for private dental insurance, folks in the Great White North would pay 100% of their oral care costs. Thus, one of the chief benefits of dental health insurance is that it helps cut the costs of dental services.

As a result, covered Canadians find oral healthcare services more affordable. That makes them more likely to visit a dentist for preventive and restorative care.

Remember: Oral health is crucial to overall health, as the mouth is home to over 700 bacterial species. While most are benign (not harmful) and some even helpful, others can cause disease.

Even worse, some oral pathogens don’t just stay in the mouth; they can spread to the rest of the body. So it’s no wonder scientists link oral microbes to heart, lung, gut, and kidney diseases. They even found an association between oral health and diabetes mellitus.

All that highlights how vital it is to maintain optimal oral health. And with the help of a dental insurance plan, you may find that goal easier (and less costly) to achieve.

Coverage Provided by Private Dental Insurance

How much a dental plan covers depends, but most cover up to 80% of standard oral healthcare services. These often include dental cleanings, x-rays, fillings, and root canals. So if you need a covered procedure that costs $100, and your insurer pays up to $80, then you only pay $20.

Many dental plans in Canada also cover up to 50% of more complex procedures, such as crowns and bridges. That can be a lot of help, as dental crowns in the Great White North can cost anywhere from $900 to $1,500 per tooth. So having private insurance that covers 50% of that cost is like getting a 50% discount.

Orthodontic treatments are also often part of more comprehensive dental insurance plans. These include braces and retainers aimed to correct tooth and jaw misalignment. Most private insurance policies cover a portion of the total cost of such procedures.

Where Can You Get Dental Insurance?

If you’re an employee, check your benefits package before buying private dental insurance. Many employers include basic dental coverage in their employee benefit plans. So you may already be getting some coverage which you may then opt to increase.

If you’re self-employed, you can purchase a dental plan from one of the 100+ health insurers in Canada. Most of them allow online applications, enabling you to buy a policy from the comfort of your home (or office).

Tips for Buying Canadian Dental Insurance

A crucial factor to consider before buying dental insurance is your dentist preference. Most dentists in Canada accept insurance, but some insurance companies have approved dentists. In other words, they restrict who you can see if you need dental treatment.

So if you already have a preferred dentist, ask them about their insurance network. Then, ensure your employer-provided plan covers the services you get from your dentist. Otherwise, you have to pay out-of-pocket if your dentist isn’t insurer-approved.

What if your dentist isn’t in the insurer’s network, but you don’t want to see another dental care provider? In that case, your other option is to buy a separate plan. Just be sure your preferred dentist is an approved provider of the insurer you choose.

Alternatively, you can buy a combined plan if you want a new policy from a different provider. These programs provide both medical and dental coverage and may cost less together. You can then get an instant health insurance quote to determine how much these plans cost.

Lastly, don’t forget to factor in your current and future oral healthcare needs.

For example, a plan with significant prosthesis coverage may be best if you’ve lost one or more teeth. That way, if you decide to get a tooth replacement, your insurer will cover a more sizeable portion of its cost. You, in turn, will have lower out-of-pocket costs.

Invest in Dental Insurance Today

Remember: Untreated dental diseases like tooth decay can lead to pain and a lower quality of life. That’s why you should never underestimate the health of your mouth. Nor should you let the cost of dental care get in the way.

Instead, consider buying dental insurance now. The sooner you do, the sooner you can see a dentist and get the help you need to keep your oral health in top condition.

Are you looking for other informative insurance-related guides like this? Then please feel free to browse our latest posts!