Dental insurance
Dental insurance is an policy that provides coverage for eligible dental expenses. General oral health care is typically not covered under publicly funded health care.[1] However the federal government is introducing a "Canada Dental Benefit", intially for children under 12 years old[2] but with the intention of expanding the program.
The current article reflects the situation before the "Canada Dental Benefit" introduction, which is that about 65% of Canadians have dental insurance.[1], while the uninsured pay out of pocket. Dental insurance is typically part of a company benefit plan, but private dental insurance is also available. There is evidence that Canadians who benefit from dental coverage go to the dentist more often and have better oral health, on average.[3]
Group plans
Many group plans offer a tiered model: basic coverage, major restorative services and orthodontic coverage.[4] Basic services normally include "dental examinations, x-rays, cleanings, topical application of fluoride, oral hygiene, fillings, scaling of teeth, tooth extractions, periodontic services to treat the bone and gum around the tooth and endodontic services including root canal therapy".[4], although check your specific plan for details. Major services include "dentures, crowns, inlays, onlays and bridgework".[4]
There may also be a choice between coverage for the individual or for a family. Dental plans come in all shapes and sizes. An informed consumer will spend time reviewing the policy documents to understand the details of the plan, in particular the coverages and the limitations. You shouldn't just accept the default option, it might not be the most suitable for you.
When reviewing your policy there are a few key items that you should make sure you understand. What is covered each year? Is there a deductible? Does the plan have a total dollar limit? How does the plan co-ordinate with any other plan(s) that you may have?
Other considerations are the rules for making changes to the coverage, for example based on life events (marriage or birth of children), what happens in the case of loss of employment (can coverage be continued and for how long). Company plans typically have an annual enrollment period that locks in coverage for one or two years and they often restrict changes between coverages, for example it may only be possible to move one level per enrollment.
Individual plans
Statistics Canada writes that[5]:
- Dental plan coverage is not actually a form of insurance, but an economic benefit that prepays some or all of an individual's dental care costs.
True insurance is typically purchased to protect against high-cost (or even catastrophic), low-probability events, like dying young (with dependents) or your house burning. Dental care, in contrast, often consists largely of predictable, relatively low cost, relatively frequent checkups and cleanings. Saving up for it is therefore a reasonable alternative to private dental insurance.[6][7] There are rarer unpredictable higher cost procedures like crowns and bridges, but "basic policies won’t cover any of those costs".[6]
See also
References
- ^ a b Statistics Canada, Health Fact Sheets - Dental Care, 2018, viewed April 11, 2020.
- ^ Government of Canada, Canada Dental Benefit, modified December 5, 2022, viewed January 6, 2023.
- ^ Zivkovic N, Aldossri M, Gomaa N, et al. (2020) Providing dental insurance can positively impact oral health outcomes in Ontario, BMC Health Services Research, volume 20, article 124, viewed October 24, 2022
- ^ a b c GroupBenefits.ca (a division of Park & Associates Insurance Agency Inc.), Dental care, viewed April 11, 2020
- ^ Wayne J. Millar and David Locker, Dental insurance and use of dental services, Statistics Canada, Health Reports, Summer 1999, Vol. 11, No. 1
- ^ a b Adam Mayers, In retirement, is dental insurance worth the bite?, Toronto Star, October 27, 2014, viewed April 11, 2020.
- ^ Boomer & Echo, Health And Dental Insurance – Not Really Insurance, February 1, 2012, viewed April 11, 2020.
