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Dental Insurance in Canada

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Dental insurance helps Canadians pay for preventive, basic, and major dental care. With rising dental costs, getting coverage is important for maintaining good oral health. This guide provides an in-depth look at how dental insurance works in Canada, what it covers, and how to choose the right plan.

Overview of Dental Insurance in Canada

Dental insurance refers to private insurance plans that help pay for some of the costs associated with dental care, including routine preventive treatments, basic procedures like fillings, and major work like braces.

These plans help offset expenses for dental services not covered under provincial or territorial government health plans. Some key facts about dental insurance in the Canadian context:

  • Approximately 60% of Canadians have some form of dental coverage through work or private individual plans. (Source)
  • On average, dental insurance covers around 40-60% of costs, with the individual paying the remainder. (Source)
  • Total spending on dental services in Canada was approximately $17 billion in 2018. (Source)

Having dental coverage is important for maintaining oral health. Let’s examine the types of dental insurance available.

Types of Dental Insurance Plans in Canada

Dental insurance for Canadians - types of plans, average costs, covered services, choosing coverage, discounts without insurance.
Types of dental insurance in Canada, monthly premium estimates, covered services, tips for choosing a plan that fits your budget.

There are two primary types of dental insurance plans in Canada: Group Insurance Plans and individual/family plans purchased directly from insurance providers.

Group Insurance Plans

Employers offer these as part of employee benefit packages. The employer contracts with an insurance provider and pays all or a portion of the monthly premiums. Employees are automatically enrolled but can opt out if they wish. Group plans have open enrollment periods, usually once per year.

Some key advantages of group plans include:

  • Automatic enrollment is available for employees, though they can opt-out. Around 86% of full-time employees have group dental benefits.
  • The employer often covers all or a significant portion of monthly premiums.
  • No health questionnaire is required to qualify for coverage.
  • No waiting periods – coverage starts immediately upon enrollment.
  • Pre-tax payroll deductions for premium contributions.

Drawbacks of group dental plans stem primarily from having less flexibility or control compared to individual plans:

  • Limited ability to customize coverage or choose add-ons.
  • Typically restricted provider network.
  • Only open enrollment periods are allowed to make changes.
  • Losing a job means losing insurance coverage.

Group insurance plans offer comprehensive and affordable coverage for many employed Canadians. Most dental insurance purchased in Canada is through employer-sponsored group plans.

Read more: Group Life Insurance in Canada

Individual and Family Dental Insurance Plans

Individuals who are self-employed, unemployed, work part-time, or whose employer doesn’t provide coverage can purchase private dental insurance directly from providers. With individual plans, you deal directly with the insurer and pay the full premiums.

Some features of individual dental insurance plans include:

  • Ability to customize plans – choose from basic, major or orthodontic coverage, annual maximums, deductibles, etc.
  • Underwriting required – you must answer health questions and be approved for coverage.
  • Wait periods of 3-12 months may apply for major work.
  • Access to group rates if part of an association that negotiates deals.
  • Portable plans not tied to a job. You keep coverage when you change employers.
  • Premiums are deductible as medical expenses on income taxes.

What Does Dental Insurance Cover in Canada?

how Canadian dental insurance works
preventive to major services covered, monthly costs, choosing group vs individual plans, tips for saving.

Dental insurance plans cover a portion of costs across three main categories of dental treatments:

Preventive Care

This includes routine oral exams and cleanings, dental x-rays, fluoride treatments, sealants, and other preventive services aimed at maintaining good dental health.

Most dental plans cover 100% of preventive services, and no deductible is required. Many also provide free annual exams and cleanings.

Basic Restorative Care

Restorative care refers to essential dental treatments needed to fix problems and restore function to the teeth and gums. Services include:

  • Fillings for cavities
  • Tooth extractions
  • Root canals
  • Gum disease treatment
  • Denture repairs

Insurance reimburses 50-80% of basic restorative services, up to plan maximums. You pay deductibles and the remaining percentage. (Source)

Major Restorative Care

This category includes complex and expensive treatments like:

  • Crowns and bridges
  • Dental implants
  • Dentures
  • Oral surgery
  • Orthodontics including braces

Reimbursement for significant work is usually lower, around 50% on average. Some procedures may not be covered.

Most plans have an annual maximum amount they will pay per person, typically $1,000 to $2,500. You can purchase riders to increase maximums.

How Much Does Dental Insurance Cost in Canada?

The cost of dental insurance in Canada depends on several key factors:

Individual vs. Group Plan: Individual plans are more expensive, given they don’t split premiums with employers. Group plan rates are, on average, 30-40% lower.

Coverage Type: Comprehensive plans with higher reimbursement rates and maximums cost more than basic coverage.

Deductible Amount: Lower deductibles lead to higher monthly premiums. $50 is common.

Family Size: Costs rise as you add dependents. Couples pay less than families.

Age: Premiums vary by age group, with middle-aged adults paying the most.

Province: Rates differ by province depending on dentist fees, taxes, and regulatory environment.

Here are some examples of average monthly Canadian dental insurance premiums:

Plan TypeIndividualFamily of 4
Basic Group$40-$60$110-$170
Comprehensive Individual$75-$125$220-$400

Dental Insurance for Self-Employed Canadians

Here are some tips for the over 2.9 million self-employed Canadians seeking dental insurance:

  • Look into associations or groups like chambers of commerce that may offer group plans with lower rates.
  • Consider a spousal plan if your partner has coverage via their work. Dependent premiums are usually very low.
  • Individual plans offer flexibility but require paying total premiums yourself.
  • Discount dental plans provide savings on procedures when paying cash.
  • Make sure to get routine preventative care to avoid costly problems down the road.
  • Set aside a dental fund through automatic savings for future expenses.
  • Take advantage of tax deductions. Dental plan premiums qualify as medical expenses.

While often pricier, individual plans allow customization and coverage control as a self-employed Canadian.

Alternatives for Uninsured Dental Care

For those without traditional dental insurance, here are some options to obtain discounted dental services:

Discount Dental Plans

These plans provide access to a network of dentists offering set procedure fees, usually 20-60% below regular rates. Annual costs range from $150-$500. There are significant savings, but no reimbursements.

Dental Schools

Dental hygiene schools and universities with dental programs offer reduced-rate cleanings, x-rays, fillings and other basic procedures supervised students perform. Care is high quality, and costs are 30-70% below private practice prices.

Public Health Dentistry

Provincial and municipal public health departments offer limited free or low-cost dental services based on financial or health circumstances. Care is often focused on children, seniors and those with disabilities or low incomes.

Pro Bono Dental Clinics

Volunteer dentists staff free or low-cost dental clinics across Canada for uninsured individuals and families who can’t afford dental care. Treatments address pain, infections and other immediate issues.

Negotiate Discounts for Cash Payments

Many dentists may provide a 10-40% discount when you pay cash for treatment instead of billing insurance. Always ask if they offer a cash price.

Choosing the Right Dental Insurance Plan

Here are key factors to consider when choosing dental insurance in Canada:

Coverage Needs

Do you want just basic and preventative care or more comprehensive significant services? Consider your dental health status and typical expenses.

Plan Type

Are you eligible for an employer group plan, or do you need an individual plan? Group plans often cost less but provide less customization.

Annual Maximums

How much does the plan payout per person in a year? The average is $1,000-$2,500. Choose based on your expected dental costs.

Deductibles

You pay less in premiums but more out of pocket at the dentist with higher deductibles like $100 per person.

Reimbursement Percentages

Plans that pay 80% versus 50% on basic and major services reduce your costs but have pricier premiums.

Orthodontic Coverage

Verify whether orthodontics, like braces, are covered, which is especially important if you have children.

Network Access

Do you want to choose any dentist or save more by picking one in-network? Look for broad provider networks.

Insurer Reputation

Research dental insurance provider ratings and reviews regarding ease of claims, customer service and payments.

Waiting Periods

Individual plans may impose 3-12 month waiting periods before covering major services upon enrollment.

Taking the time to evaluate both group and individual plan options will ensure you select the right dental insurance plan for your specific needs and budget.

Leading Providers of Dental Insurance in Canada

Below are some of the top dental insurance providers in Canada to consider:

Sun Life

Offering both group and individual plans. My Sun Life mobile app provides straightforward claims and ID cards.

Manulife

Extensive nationwide provider network and competitive rates. Vitality program rewards healthy choices with premium savings.

Great West Life

Leading group insurer with student and retiree individual plans. Gives access to Modo car share program.

Green Shield Canada

Non-profit insurer with “Green” innovative benefits and administration. Strong coverage for orthodontics.

Canada Life

Both group and individual dental plans are available, including basic and major coverage.

RBC Insurance

Solid nationwide provider network. Discounts and savings are available through the Avion Rewards program.

Blue Cross

Focuses on individual markets with affordable premiums and no deductibles. Part of the Manitoba Blue Cross network.

Desjardins

Quebec-based cooperative insurer with discounted group and individual dental plan options.

When reviewing options, check plan details like fees, coverage, waiting periods, frequencies, deductibles and maximum benefits. Consider enhanced benefits like scaling reimbursement and composite (white) fillings.

Read more:

Conclusion

There is a wide range of options for obtaining dental insurance and coverage in Canada. Employer-sponsored group plans offer comprehensive benefits at lower costs for many working Canadians. Individual plans allow greater customization but come at higher premium prices.

For those without traditional insurance, discount dental plans, public health options, and cash discounts provide some cost relief for procedures. Understanding your specific needs and comparing plan details allows you to select the right dental insurance for your oral health and budget needs.

What is Dental Insurance in Canada?

Dental insurance in Canada refers to private dental plans that help pay for services not covered under provincial/territorial health plans like cleanings, fillings, and braces. Approximately 60% of Canadians have dental insurance through work or individual plans.

How Does Dental Insurance Work in Canada?

There are group plans offered through employers and individual plans purchased directly from insurance providers. You pay premiums each month and the plan covers a portion, usually 50-80%, of your dental bills up to an annual maximum amount.

What Does Dental Insurance Cover in Canada?

Most dental plans cover preventive services like exams and cleanings at 100%, basic procedures like fillings at 80%, and major work like crowns and braces at 50%. Orthodontics is also included on some plans. Cosmetic dentistry is generally excluded.

How Much Does Dental Insurance Cost in Canada?

Premiums range from $40-$60 per month for group plan individuals and $110-$170 for families. Individual plans are more expensive at $75-$125 monthly for an individual or $220-$400 for families.

Does Canadian Dental Insurance Cover Implants and Braces?

Dental implants and orthodontics like braces are classified as major services and partially covered, typically around 50% of the cost. Lifetime orthodontic maximums range from $2,000 to $5,000.

How Can Seniors Get Dental Insurance in Canada?

Seniors can look into individual plans, spousal plans, discount dental plans or public options like provincial programs and dental schools to get coverage. Many lack adequate affordable dental care.

Are There Dental Insurance Options for Unemployed Canadians?

Unemployed individuals can purchase cheaper individual dental plans, explore provincial programs based on income, or use dental savings plans and clinics for discounted care.

What Provinces Have the Best Public Dental Coverage in Canada?

Provinces like Ontario, Quebec, Manitoba and Nova Scotia offer free basic dental services to low-income children and seniors. However, public dental coverage remains limited across Canada.

What are the Top Dental Insurance Providers in Canada?

Leading national providers include Sun Life, Manulife, Canada Life, Green Shield, Blue Cross, Desjardins, RBC and Great West Life. Compare plan details like networks, premiums, and coverage.

How Do I Choose Dental Insurance in Canada?

Look at your dental needs, budget, whether you need orthodontic coverage, deductible and reimbursement rates. Also consider insurer reputation. Individual or group plan access depends on your employment status.

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