Dental Basics
Basics of Dental Care in Canada
Dental care in Canada is primarily managed outside the public healthcare system, meaning most services are not covered by provincial or territorial health plans (GHIP).
Canadians usually pay out-of-pocket or use private dental insurance to cover the costs of routine dental care, which includes regular check-ups, cleanings, and treatments.
Understanding the types of dental services and how they are categorized can help you better navigate your dental care options.
Dental Basics
Basic Preventative Care
Major Restorative Care
Orthodontics
Estimate coverage for cleanings, fillings, and major work
The Importance of Dental Insurance
Without dental insurance, the costs of these services can add up quickly. A good dental insurance plan helps offset these costs and ensures you and your family maintain good oral health without significant financial strain.
Dental Basics
What is Covered by Provincial Health Insurance Plans (GHIP)?
Provincial and territorial health insurance plans, often referred to as Government Health Insurance Plans (GHIP), generally do not cover routine dental care such as cleanings, fillings, or orthodontics. However, there are some exceptions:
Emergency Dental Services
Certain provinces provide coverage for emergency dental services when they are deemed medically necessary. This typically includes procedures performed in a hospital setting, such as surgeries to treat severe infections, trauma, or fractures of the jaw.
Specific Populations
Some provinces offer limited dental coverage for specific groups, such as:
- Children: Coverage may include basic dental care for children from low-income families.
- Seniors: Some provinces provide basic dental coverage for seniors, particularly those receiving social assistance.
- Low-Income Individuals: Provincial programs may offer limited dental services for individuals and families with low income.
Dental Basics
The Canadian Dental Care Plan (CDCP)
The Canadian Dental Care Plan (CDCP) is a federal initiative designed to improve access to dental care for Canadians without private dental insurance. This program aims to provide coverage for essential dental services to eligible individuals and families.
Eligibility Criteria for the CDCP:
Canadian Residents: Must be a resident of Canada.
Income Threshold: Annual family income below $90,000, with full benefits provided to those with incomes under $70,000.
Targeted Groups: Initially prioritizes children under 18, seniors, and individuals with disabilities who do not have access to private dental insurance.
Geographical Considerations: Eligibility and coverage details may vary depending on the province or territory, reflecting regional healthcare structures and existing programs.
Get expert guidance on CDCP eligibility + private coverage
Dental Basics
Private Dental Insurance
Since public coverage for dental care is limited, many Canadians opt for private dental insurance. These plans can be obtained through various channels:
Employer-Sponsored Plans
Many employers offer dental insurance as part of their employee benefits package. These plans often cover a portion of dental costs, ranging from preventive to major restorative care.
Individual or Family Plans
If your employer does not provide dental coverage, you can purchase a private plan. These plans are customizable to fit different needs and budgets. Aeva is designed to help you find a plan that is an appropriate fit.
Student Plans
Colleges and universities often offer dental insurance plans to students at a reduced rate.
Dental Basics
Key Components of a Private Dental Insurance Plan
Basic terminology you should know.
Premiums
The cost you pay for insurance coverage, usually charged on a monthly or annual basis.
Deductibles
The amount you must pay out-of-pocket before your insurance starts to cover a portion of the costs.
Co-payments (Co-pays)
A fixed amount you pay for specific services at the time of your appointment.
Annual Maximums
The maximum amount an insurance plan will pay for your dental care in a given year.
Dental Basics
Tips for Choosing the Right Plan
Understanding these factors will help you choose a plan that fits your dental care needs and budget.
When selecting a dental insurance plan, consider the following:
Coverage Options
Make sure the plan covers the types of services you need, such as basic preventive care, major restorative procedures, or orthodontics.
Cost Considerations
Evaluate premiums, deductibles, co-pays, and any annual maximums to understand your out-of-pocket costs.
Specific Needs
If you anticipate needing orthodontic treatment or other specialized care, ensure your plan covers these services.
Use Aeva
Aeva is designed to help making finding the plan best suited to you as easy as possible.
Dental Basics
Dental Fee Guides in Canada
Understanding the cost of dental care can be challenging, as prices for services can vary significantly between dentists and regions. To help standardize pricing and provide transparency, each province and territory in Canada has its own Dental Fee Guide.
Dental Basics
What is a Dental Fee Guide?
A Dental Fee Guide is a document published annually by the dental association of each province or territory. It provides recommended fees for various dental treatments and services. These guides are intended to serve as a reference point for dentists when setting their prices and for insurance companies when determining reimbursement amounts.
Understanding the Dental Fee Guide for your province or territory can help you make more informed decisions about your dental care and manage your expenses more effectively.
Insurance Reimbursements
Insurance companies often refer to the local Dental Fee Guide when deciding how much they will reimburse for a particular dental procedure. If your dentist charges more than the fee guide's suggested price, you may need to pay the difference out of pocket.
Variations in Pricing
While some dentists adhere closely to the Dental Fee Guide, others may charge higher fees based on their expertise, location, or additional costs associated with running their practice. It's important to discuss pricing with your dentist before undergoing any procedures to understand what your financial responsibility will be.
Shopping Around
Knowing the Dental Fee Guide rates can help you shop around for a dentist that offers competitive pricing. Some dentists might be more flexible with their fees, especially if they know patients are comparing prices.
Regional Differences
Since each province and territory publishes its own Dental Fee Guide, there may be regional differences in the suggested fees for the same procedures. If you are moving to a different province or territory or considering dental treatment while traveling, it's a good idea to review the local Dental Fee Guide to understand potential costs.
Dental Basics
Tips for Managing Dental Costs
While dental insurance can help reduce the cost of care, there are additional strategies to manage dental expenses effectively:
Shop Around for Dentists
Dental prices can vary widely, so compare local dentists' services, pricing, and reviews to find quality care at a good price, potentially saving you money.
Prioritize Preventative Care
Regular check-ups and cleanings can prevent more severe and costly dental problems down the line.
Maximize Available Benefits
Make full use of any private health insurance, or government benefits you qualify for to reduce out-of-pocket costs.
Explore Payment Plans
Some dental offices offer payment plans for more expensive treatments, allowing you to spread out the cost over time.
Dental Basics
What insurance do you need and when?
Personal Health Insurance is the foundation of any sound financial plan and should be maintained throughout life - both in your working and retirement years.
Dental coverage may be built-in to Personal Health Insurance plans, and can be a helpful coverage to ensure optimal ongoing oral health.
Use Aeva.ca to find a Health Care plan that includes dental coverage.
Plan Types
Types of health insurance in Canada
There are three different types of health care plans.
Which one is right for you and your family depends on your unique personal circumstances.
Medically Underwritten Plans
Best for those with minimal health history.
- Apply anytime
- Medical questionnaire required
- Most benefits & features
- Coverage effective 1st of next month subject to qualifying medically
- Best value profile
Guaranteed Issue Plans
Best for those losing their employee benefits.
- Apply within 60-90 days of employee benefits termination
- No medical questionnaire
- Moderate benefits & features
- Coverage effective 1st of next month
- Moderate value profile
Guaranteed Acceptance Plans
Best for those previously declined.
- Apply anytime
- No medical questionnaire
- Fewest benefits & features
- Coverage effective 1st of next month
- Lowest value profile
What's covered by my provincial government health insurance plan (GHIP)?
Each Canadian province or territory offers its own health plan for residents. All plans provide access to publicly funded medical insurance and emergency care, but plans may vary in what they cover and costs. What is covered under your provincial or territorial plan?
Click on your province or territory below to learn more:
Cost
How much does dental insurance cost?
There are a number of factors that can affect pricing for dental plans, including:
Age
Generally, insurance cost less for younger age groups, and more for older age groups.
Single, couple or family
Plan cost will vary depending on the number of people covered.
Province of residence
Plan cost can vary from one province/territory to the next.
Plan selection
Plans that include more benefits and higher coverage amounts come at a higher cost.
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