Simple Guide to Government Dental Care Coverage in Canada

For Canadians, universal health care is one of our most beneficial government programs, even if there are some limitations to the services that are covered. However, recent developments in health care funding in Canada have resulted in an increase in funding for dental health care, and the introduction of a new Canadian Dental Care Plan that will help cover the cost of basic dental care. Find out more about how this program will work, and what Canadians will need to know.

It’s no secret that dental care is absolutely essential as a part of our overall health and well-being. Nevertheless, in many cases the responsibility for paying for dental care services has historically been placed on individual Canadians. For some families, the majority of their dental costs can be managed through dental care coverage commonly included in corporate benefits programs offered to employees. Other Canadians who do not have dental benefits provided by their employer may purchase a dental insurance policy for individuals or for a family. However, for low-income families, these may not be options available to them. This is why the introduction of a government-funded dental health care plan is such an important step forward for Canada.

Here, we’re going to look at the new Canadian Dental Care Plan, along with several other government-funded dental care programs that you may not currently be aware of. If you’ve been holding back on getting essential dental care services due to costs, this information could hold the answers you’ve been looking for. Let’s begin by exploring the details of the new federal dental care plan that was introduced and signed into law in 2022.

Canadian Dental Care Plan

While the full Canadian Dental Care Plan is still in the early stages of introduction, the Canadian Dental Benefit has been introduced as an immediate measure to provide low-income families (under $90,000 annual family income) in Canada with $260 – $650 of coverage per child under 12 (as of Dec 1, 2022), per year, depending on adjusted net annual income. This benefit is retroactive to cover dental expenses back to Oct 1, 2022 and is only available for two reporting periods. Period 1 covers dental care performed between Oct 1, 2022 and Jun 30, 2023. Period 2 covers dental care performed between Jul 1, 2023 and Jun 30, 2024.

The current schedule for implementing the ongoing Canadian Dental Care Plan starts with children who are under 12. The next phase will extend coverage to Canadians under 18, seniors, and those persons with disabilities sometime in 2023. The final stage will broaden the accessibility to all Canadians with household incomes under $90k annually, and is currently set to roll out by 2025.

Eligibility for the Canadian Dental Care Plan is mainly determined by household income. Families with income levels under $70k per year will receive full coverage of costs for essential dental health services. Families with income levels between $70k and $90k per year will receive partial coverage for essential dental health services. However, any person who currently has existing dental coverage through private insurance or an employer-provided benefits program would not qualify for the Canadian Dental Care Plan.

Other Federal Dental Health Care Programs

Above and beyond the new Canadian Dental Care Plan, there are also several other programs available that include partial dental coverage for certain individuals.

Interim Federal Health Program – For refugees to Canada, an emergency dental benefit program is available to provide partial temporary coverage and treat dental health conditions such as infections, severe pain, or hemorrhages resulting from oral trauma.

Non-Insured Health Benefits Program – First Nations and Inuit can take advantage of a range of government-funded dental health care services under this program. Eligible recipients can obtain services such as x-rays, fillings, cleanings, fluoride, crowns, root canals, and treatments for gum disease and periodontitis.

Provincial Dental Care Programs

Federal dental care benefits are not the only source of dental coverage for those people living in Ontario. There are also provincial programs that are available to Ontario residents who match certain criteria. To begin with, it’s important to know what types of services are covered under the Ontario Health Insurance Plan (OHIP).

Limitations on OHIP Coverage for Dental Care – OHIP covers a wide range of health services, but is quite limited when it comes to dental coverage. In most cases, OHIP will only cover emergency dental work performed in a hospital, as well as certain types of dental surgeries that require extensive reconstruction. Some examples of procedures that may be performed in a hospital include the removal of tumors, repair of facial or oral fractures, and emergency tooth extractions.

Ontario Seniors Dental Care Program – Low-income seniors can obtain a variety of routine dental care services under the Ontario Seniors Dental Care Program. Services are able to be accessed at the local level through community health centers that are participating in the program, as well as public health units and Aboriginal health service centers.

Ontario Works Program – People who are in financial need can utilize the services provided by the Ontario Works program to obtain assistance with employment, as well as with a variety of health care services. For adults under the Ontario Works program, dental coverage is determined at the individual level, so they would need to contact the program directly to obtain specifics on what could be covered.

Ontario Disability Support Program – Ontario residents living with a disability and their spouse may be eligible for dental coverage under the Ontario Disability Support Program. This coverage is limited to basic dental care treatments like checkups and cleanings, but can be expanded to include other services if the patient is in need of prescription medications that may have adverse effects on their oral health.

Healthy Smiles Ontario – Under the Ontario Works program and the Ontario Disability Support Program, children under 17 are automatically eligible and enrolled in Healthy Smiles Ontario. This program includes regular checkups, cleanings, x-rays, fillings, scaling, and extractions through a licensed dental care provider. Emergency dental care for pain or toothaches is also included under the Healthy Smiles Ontario program for children.

Easy Financing Options for Dental Health Care Costs

While these dental programs can certainly make it easier to obtain basic dental care services, sometimes they just don’t go far enough to provide coverage on all the services that a patient may want. For example, common dental services such as tooth whitening, orthodontics, dental implants, or dentures may still need to be paid for by the patient. Some of these procedures, particularly orthodontics and reconstructive dental work using dental implants or All-on-4 mouth restoration, can be more costly than expected.

In cases like these, there are other options available that can help patients manage costs and make it easier to get the dental treatments they need. Here at Georgian Dental, we help patients with fast and easy in-house financing plans that work for them. If you’ve been wanting to get your smile in style with a restorative or cosmetic dental procedure, but are apprehensive about the costs, affordable financing plans can help get you where you want to be.

Learn More About Dental Benefit Coverage & Flexible Financing Plans Today

There’s never been a better time to get your smile looking great, and we here at Georgian Dental are eager to help you obtain all the important dental care treatments that you need. We’ll gladly walk through all your available options in a no-stress, no-obligation consultation. You should have all the information before you make a decision, and that includes knowing each and every one of your choices when it comes to managing the costs of your dental care. If there’s a program you are eligible for, we’ll help you find out all the details.