Dentists are notoriously expensive. Many people put off going to the dentist as long as possible, but it can become painful to ignore serious dental issues. If you don’t have dental insurance, dental procedures could cost you thousands.
With the cost of living rising across the country, it is a good idea to compare your dental insurance options and see if dental insurance is right for you. There are many options for dental insurance, including group plans through your employer, individual plans, and government-subsidized dental coverage.
- Group dental insurance
- Individual private dental insurance
- Provincial dental insurance plans
- Dental Insurance FAQ
Group dental insurance
Group insurance policies are most likely the best option for your dental insurance needs. These policies are cheaper than individual plans because they are bought in bulk and often partially paid for by your employer. Insurance rates are discounted when many plans are bundled together, which is known as group buying.
You could qualify for insurance through certain membership groups. For example, universities typically have insurance options for students and sometimes even alumni. Groups like labour unions or community associations may also have group insurance plans.
The upside of a group plan
Group plans typically don’t require you to submit medical evidence or history before being approved for coverage. Not needing to submit your health history can be a big help if you have known dental issues, like a missing tooth, the replacement of which individual insurance won’t usually cover. Being automatically eligible for insurance through an employer can take much of the stress of insurance shopping off your hands.
Typically, you just need to work a certain number of hours or have a waiting period before benefits start kicking in. Check with your employer to learn more about your dental insurance options.
Individual private dental insurance
If you don’t have insurance through your employer or another group, individual private insurance might be an option for you. The downside is that since you are only purchasing one plan individually, you will not qualify for the preferred rate most organizations receive for buying group insurance.
Since you are also not receiving a subsidy on insurance from an employer, your coverage options may be more limited. Someone paying $60 a month for a work-subsidized insurance plan will likely have higher maximum compensation rates or more extensive coverage than someone paying $60 a month for an individual plan. Unfortunately, getting a dental insurance plan with great coverage will cost you.
The upside of a private plan
Although many group insurance plans bundle dental care with other health areas, buying individual insurance gives you more flexibility. You can choose to only get dental insurance if that is what you need most, and you can pick a plan with premiums and maximum coverage limitations that meet your needs. It is crucial to weigh the pros and cons of insurance before buying an individual plan.
Which one is better?
There is no one correct way to shop for private health insurance. Choosing an insurance plan is personal, and the coverage you need depends on your situation. It could be worth paying for a more extensive dental insurance plan if you have significant health issues.
If you have never had a cavity, paying for dental care out-of-pocket or getting a more affordable plan with minimal coverage may be cheaper in the long run. The important thing is to compare dental insurance companies to make sure you are getting the plan you need at the best price possible.
Provincial dental insurance plans
Many provinces offer dental insurance plans for people who meet specific eligibility requirements. These programs typically focus on seniors, low-income earners, people with disabilities, or children. Below, we have outlined the dental insurance coverage offered in each province and territory.
British Columbia offers dental insurance coverage for adults who receive income or disability assistance and children under 19 in a family receiving assistance.
Adults receiving income or disability assistance can receive up to $1,000 over two years for basic dental care, denture care, and certain crown and bridge repairs.
Children whose family receives income or disability assistance are eligible for up to $2,000 of dental care over two years and $1,000 per year for dental care that requires general anesthesia.
Alberta has a designated dental insurance stream for seniors with moderate to low incomes. To apply for the senior’s program, you must be at least 65 years old, have a single income of less than $31,675, or a combined income of less than $63,350, and have lived in Alberta for at least three months.
The insurance policy lasts five years before automatic renewal, and coverage is up to $5,000, depending on your income bracket. Basic dental procedures include exams, fillings, extractions, root canals, and dentures.
Saskatchewan has broad supplementary health benefits for government wards, inmates of provincial correctional institutions, residents of special care facilities who are eligible for senior assistance, and citizens enrolled in disability or income support programs.
Within the general health benefits program, you may qualify for emergency benefits for services related to relieving pain and infections, or full benefits for essential dental services.
Children eligible for the program automatically receive full benefits. Dentures are partially covered under this program as well.
Manitoba announced in April 2021 that it would be unrolling a dental care assistance program for those on employment and income assistance (EIA). To qualify, you must have received EIA for three months, or six months if you are an adult in the general assistance category.
Still, you can sometimes skip the waiting period if you need emergency dental care. Primary services like exams, cleanings, and extractions are covered under this program.
Ontario has four separate government dental insurance programs. There are different streams for seniors, children, adults receiving disability support, and individuals living on a low income. Services covered by the programs are basic, such as exams, fillings, etc. But emergency dental care may also be covered depending on the situation.
Quebec provides those who receive “last-resort financial assistance” with dental insurance coverage. The longer you receive government financial assistance, the more extensive your coverage.
For example, if you have received support for fewer than 12 consecutive months, you will only have dental coverage for emergency dental events. After 12 months, you can access free annual dental exams, x-rays, scaling, fillings and more. Your coverage extends even further after 24 consecutive months, with dentures becoming accessible through government coverage.
Clients of the Office of Social Development in New Brunswick can receive up to $1,000 of coverage annually for exams, dentures, and certain fillings through the Health Services Dental Program. There is also a dental insurance program for children called “Healthy Smiles, Clear Vision.”
Children qualify for this basic dental coverage if their family’s income meets specific requirements. For both the general and children’s dental insurance programs, you must have no other private or government dental insurance.
The Children’s Oral Health Program in Nova Scotia is its only government-funded dental insurance option. This program provides children 14 and younger who have a valid MSI number with annual exams, x-rays, cleanings, fillings and necessary extractions. The program is available to all children regardless of their family’s income and can be used in conjunction with private dental insurance plans.
Prince Edward Island (PEI)
Last January, PEI began offering the Provincial Dental Care Program for families with low income. You can apply if you receive social assistance or assured income from the Department of Social Development and Housing, or if you meet the income threshold specified by the government.
The program is open to all PEI citizens and their dependents. PEI’s program is especially inclusive because even if you earn too much to receive full dental coverage, you can still receive between 20% and 80% coverage, depending on your income. Dentures and mouth plates are both covered once every ten years, along with basic dental services like cleanings and one filling per tooth per year.
Newfoundland and Labrador
In Newfoundland and Labrador, there are three separate government-funded dental care streams. The Children’s Dental Health Program covers basic dental services for all children 12 years of age and under. Family income does not play a role in eligibility. There is a separate program for youth aged 13 to 17 based on family income levels.
The Adult Dental Program is also based on income and is available to Newfoundlanders and Labradorians enrolled in the Foundation Plan prescription drug assistance program. Under the adult stream, dentures are covered every eight years, and x-rays and fillings are covered under a three-year cycle. Cleanings and fluoride are not covered.
Seniors in the Yukon can apply for extended health care benefits, including dental care. The specifics of the program are unclear, but there have been talks in recent years of extending dental coverage to more residents. The Yukon government also provides a children’s dental care program in schools.
The Northwest Territories does not have government-subsidized dental insurance. However, the government has school-based and early-childhood oral health programs providing some free dental services to children in addition to a prenatal oral health program for expectant mothers.
Nunavut does not provide dental care coverage for residents. As mentioned below, many Inuit residents may already qualify for dental coverage under a federal government program.
Canada offers three different dental services programs. Each of these programs, except the Veterans Affairs program, falls under a greater health insurance package, including vision care and prescription drug coverage.
The Interim Federal Health Program provides extensive services to resettled refugees with no dental insurance coverage. The Non-Insured Health Benefits program is designated for eligible First Nations and Inuit who do not already have dental coverage from their province or territory, private insurance, or social programs. This program covers many dental services, including braces. The Veteran’s Affairs office also provides dental services to eligible veterans who do not have pre-existing provincial or territorial or private dental insurance.
In collaboration with the Liberals, the federal NDP Party has introduced a plan to provide free dental care to low- and middle-income families across the country. The coverage should start rolling out by the end of this year for children 12 and under before coming into full effect for other age groups by 2025.
Dental Insurance FAQ
Seniors living on a low income in Ontario are eligible for the Ontario Seniors Dental Care Program (OSDCP). OSDCP is a government-provided service that offers free routine dental services. To qualify, you must be 65 or older, and your income must be less than $22,000 per year, or $37,100 combined. You can apply for this program online or by picking up a physical application at your local public health office. Some of the services covered by OSDCP include cleaning, repairing broken teeth or cavities, oral surgery, root canals, and treating gum conditions and diseases. Dentures and other prosthodontic services are also eligible for partial coverage.
British Columbia does not have the same designated dental care coverage for seniors that other provinces offer. That being said, the BC government provides dental coverage for adults who receive income or disability assistance. This dental coverage program has no age requirements, so seniors are welcome to apply.
You will have to do some math to determine if dental insurance is worth it. Some people don’t require substantial dental work other than cleanings and the odd filling. However as you get older, more dental problems are likely to arise, so getting dental coverage as a senior could really pay off.
The median dental cleaning cost in Canada is about $80 to $175. That means you will pay about $160 to $350 a year in dental costs if you go for a cleaning twice per year as recommended. If your dental care plan is $600 per year, and you typically only pay a maximum of $350 per year for basic cleanings, dental insurance may not be worth it. But, if you find out you need a root canal, which could cost about $1,000, having dental insurance could come in handy.
You also have to factor in how much your insurance company is willing to pay for your overall dental costs. Some policies cap the amount of money you can claim. A plan with the ability to claim up to $10,000 should give you a decent amount of coverage. Plans with a $500 maximum in dental care costs might give you trouble if you have a dental emergency. Some policies will also only cover specific percentages of your care, like 80% per visit, which means you need to pay out-of-pocket for the remainder of the bill.
Dental insurance, like almost all insurance, is a personal choice. Each side has pros and cons depending on your situation. If you are younger, you may be able to get by without dental coverage, but it could come in handy for seniors as oral health declines. It is important to compare all your insurance options to find the plan that best suits your needs.