How Does Dental Coverage Works for Canadians

Learn How does Dental Coverage Works for Canadian Residents 

It’s no secret that your dental hygiene has an impact on your overall wellbeing. Health Canada states poor oral hygiene can cause health problems such as cardiovascular diseases and diabetes. Hence, visiting your dentist twice a year will contribute to optimum oral health. But not many can afford it. In Canada, some provincial insurance plans offer dental coverage for low-income individuals and/or children. Not everyone has access to this coverage. In addition, the coverage differs from one province to another, leaving many Canadians without dental protection. In this article, we will cover the benefits of dental coverage for Canadians and why you should obtain dental insurance. Here’s how dental coverage work for Canadians.

Benefits of Dental Coverage for Canadians

Getting dental insurance has various benefits. Primarily, it gives you access to dental care that provincial health insurance plans do not cover. You can seek basic dental services such as routine cleanings, fillings, and x-rays or comprehensive treatments from dentures to bridges, crowns, and orthodontics. Dental insurance comes in handy especially in times of an emergency. Furthermore, patients with dental insurance can seek treatments with a peace of mind as it minimizes dental expenses.

How Does Dental Coverage Work?

The Canada Health Act (CHA) has no provisions for oral health care. Therefore, there are only two ways to obtain dental insurance- either through your employer or buying your own dental insurance. Most dental insurance has a system of 80-20 or 50-50 where Canadians pay 20% for the basic services and 50% for major treatments. Hence, it is important to research what is covered in your insurance plan.

Furthermore, there are other alternatives. Few Canadians are eligible for state-funded dental treatment. Additionally, odontology schools often conduct procedures at much cheaper rates.

1. Fee for Service

Fee for service is the most common type of dental coverage Canadians gets under their employer. Thi type of plan comes in handy since most employees wouldn’t know when they will have a dental emergency. Hence, the plan activates only when the employee schedules an appointment, receives the treatment, and is ready to pay.

Your payment process through this type of coverage is easy. The patient informs the dental office which insurance company is covering the services. The dental office will then inform you how much your company covers and you are responsible for paying the balance. It is usually only a nominal fee. In addition, patients can also set up payment schedules.

2. Direct Pay

Those who are not keen to buy a dental cover, they can pay for dental services if required. This process is known as direct payments. Direct payers agree to pay a fixed amount per service. Direct payers spend maximum on dental health care, on a per-visit basis.

Without knowing about dental insurance, you may either be overcharged for dental services or not getting dental care at all. Understanding how dental coverage benefits you in the long run. Most Canadians like a direct pay dental arrangement.

The Payment Process

Canada also has specific laws involving dentistry. The person performing the procedure cannot waive the co-payment. It’s actually a federal crime, a kind of insurance fraud. If found guilty of this crime, your dentist is subject to large fines or loss of their license to practice.

For preventing legal issues, a claim form is signed for the services the dentist provided and the total cost of the treatment. The insurer keeps this form. The form states that the patient agrees to pay for their balance of the insurance. Once the charges are verified, the insurer must also pay their part.

Importance of Dental Insurance

Dental Insurance is important as it affects your overall health. It also gives you the peace of mind to get treatments quickly and hassle-free when you have a dental emergency. It reduces the risk of you ignoring your dental health concerns and facing the dreadful consequence-overpaying! Most Canadian health insurance plans provide dental coverage as an option.