Health Insurance With Dental Coverage in Canada: What You Need to Know

Posted on December 26, 2018

It's a well-documented fact that dental care is an important component of overall health, but millions of Canadians still go without it due to costs. A dental health survey revealed that a lack of dental insurance is a leading reason they are not accessing this form of health care. So you need to know if your plan covers it, and how to access affordable dental insurance if it doesn't. Discover everything you need to know to make sure your health insurance dental coverage is meeting every need in your family.

Health Insurance Dental Coverage Plans Explained

Before you can make any plans to go to the dentist, you first need to see if you are covered for it financially. That is the case whether you are digging out of pocket for those expenses, or using your existing health insurance for dental coverage.

Before you make an appointment, it's important to review your existing health insurance policy. This could be a work policy or a policy of your own.

If you have a work policy, checking with your human resources or benefits manager is the first place to go for this. But if you have your own, you may need to do some digging.

It can help to call the dentist first and ask them to help you out with this.

Dentists in Canada are well versed in the insurance game and have contacts with every major insurance company in the nation.

Other things you need to know before you make that appointment is how much will you be out of pocket for your visit? There are very few plans in Canada that cover 100 percent of the costs for dental care.

This is something that your human resources or benefits manager can help with, and something your dentist can help you out with as well. It's an important step to take because the last thing you want is to leave the dental chair and find out you owe the dentist more money than you were expecting.

If you don't have dental coverage, that doesn't mean you need to throw in the towel on your existing health insurance. There are many ways to supplement your insurance through various health insurance plans.

But you'll need to understand how health insurance dental coverage works first.

Levels of Dental Insurance

In every dental plan in Canada, there are levels of coverage. These are usually tiered, and then there are levels even within the levels of coverage.

This is to ensure that every insurance company has something to offer everybody in Canada. The levels within the top 5 Canadian dental insurance providers are tiered for costs so that there are affordable options for everybody.

So when you go to an insurance company for quotes, you will see that there are usually about three tiers to start out with. This will be basic coverage, a basic plus type of coverage, and then something that may be called an elite plan.

The basic coverage will usually include all of your basic dental care needs that you need to stay healthy. This includes fillings, cleanings, and sometimes some extractions if necessary.

If you feel you may need more coverage for things like root canals or crowns in the future, this type of plan will not cover it.

You may see those things covered in the next type of plan, however. That is sometimes called a "Basic Plus" type of benefit program, but every insurance company calls it something different.

The last tier may actually cover all of the same things a Basic Plus type of plan does, but it may cover more financially.

So for example, in the first tier, you may see only a percentage of the costs covered, say, 50%. That means you will have to pay for half of your appointment.

The next tier may cover a little more, for example, 75 percent. And the final tier will cover, even more, sometimes 85 percent or more.

Your insurance premium will go up according to the tier that you choose.

Add-Ons in Dental Insurance

In addition to the basic tiers of dental coverage, you want to know if you will be covered for more than the existing coverage. In the world of dentistry, these are for procedures such as major surgeries, orthodontics, crowns, or any of the higher-end dental procedures you may need down the road.

Rarely will you find those in the opening tiers of dental insurance. So the insurance company will call these "Add-Ons", which means you add on additional riders to your dental coverage, and pay a nominal fee every month for those add-ons.

Every insurance company knows you aren't going to be getting crowns or orthodontics every month. You are only going to need that once in a while.
But these procedures could cost you thousands down the road. So putting a little upfront every month for down the road could help you in the long run.

Add-On to Your Existing Coverage

No matter where you go to access dental insurance, you will find that plans in Canada are all very similar. This is true with any work plan that you may be working with or any supplemental plan that you may access for dental insurance.

But you may find when you begin exploring this that your existing coverage isn't enough. You are permitted to have more than one health insurance plan in Canada.

You are not permitted to use more than one insurance benefit for one practitioner. So for example, while you may be able to use more than one credit card to pay for a dental visit, you can't use more than one insurance plan to do so.

So Canadian insurance companies do offer multiple avenues to help you ensure you have everything you need insurance wise. You can purchase dental insurance alone to supplement an existing health insurance plan.

Ensure You Are Insured

In Canada, it is estimated that approximately 2.2 million days of school or work are missed a year due to dental problems. This is true even if you have existing health coverage.

Many Canadians avoid going to the dentist simply because they feel they can't afford it. But insurance companies today don't want that to be the case, and dentists don't either.

You can supplement your existing health insurance dental coverage in affordable ways that will meet the entire needs of you and your family. Explore the essential guide to Ontario dental insurance options today, and buy your self peace of mind today.

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