Taking care of your oral health is an essential part of taking care of your overall well-being. However, dental services aren't always cheap, which can create a significant barrier for many Canadians.
While the recently introduced Canadian Dental Care Plan (CDCP) provides coverage for some individuals, many people do not qualify and must seek alternative options. This is where dental insurance comes in.
To help you understand how dental insurance works, who needs it, and how much it costs, we'll cover everything you need to know about dental insurance in Canada. If you'd like to start keeping your teeth and gums healthy without financial stress, you're in the right place!
Why Dental Insurance is Important
Dental insurance helps cover the costs of routine check-ups, preventive care, and more complex dental procedures. Without coverage, even the cost of basic services like cleanings and fillings can add up quickly. More extensive procedures, meanwhile, can often cost thousands of dollars or more if you have to pay completely out of pocket.
Beyond cost savings, dental insurance also encourages regular visits to the dentist, which can help prevent minor issues from becoming major problems. Poor oral health has been linked to conditions such as heart disease, diabetes, and respiratory infections, making it even more critical to stay on top of dental care. "How often should I go to the dentist?" is a question that many Canadians ask, and the generally recommended schedule is once every six months. With dental insurance, you can stick to this schedule without it being a financial strain.
How Does Dental Insurance Work in Canada?
Dental insurance in Canada generally works by covering a portion of dental expenses, though there are many cases where a dental insurance plan will cover your entire bill (or at least the large majority of it). The coverage that is provided will differ from one plan to another, which makes it important to carefully research the plans you are considering before you commit to one.
Common procedures covered by dental insurance include things like:
- Preventive Care: For example, routine check-ups, cleanings, and X-rays.
- Basic Procedures: For example, fillings, extractions, and periodontal treatments.
- Major Procedures: For example, crowns, bridges, dentures, and root canals.
- Orthodontics (in some plans): Some plans include coverage for braces or aligners, particularly for children.
Most insurance plans work on a cost-sharing model, where the insurer covers a percentage of the total bill, and the patient pays the rest. Some plans also have deductibles (which are a minimum amount that you will have to pay out-of-pocket before the policy takes effect) and annual maximums that limit coverage. Once again, it's always important to research details such as these when choosing a plan.
Who Needs Dental Insurance?
Not every Canadian needs to purchase a private dental insurance policy. If you already have dental insurance through your employer or are covered by the Canadian Dental Care Plan (CDCP), there's probably no point in paying extra for a private policy. For many Canadians, however, purchasing private dental insurance will be necessary. Here are a few examples of cases where a private policy is a good option to consider:
1. Individuals Without Coverage Under the Canadian Dental Care Plan
The CDCP aims to provide coverage to eligible low-income Canadians, but not everyone qualifies. To qualify for coverage under the Canadian Dental Care Plan, your adjusted family net income needs to be less than $90,000 per year, and you must not have access to dental insurance through your employer or a family member's employment benefits. For anyone who doesn't meet these qualifications, a private dental insurance policy will be necessary.
2. Self-Employed Individuals and Gig Workers
Unlike employees who may receive dental benefits through their workplace, self-employed individuals and gig workers must secure their own coverage. Those who don't qualify for coverage under the CDCP will have to purchase a private policy.
3. Retirees and Seniors
Many employer-sponsored benefits, including dental coverage, end upon retirement. When you combine this with the fact that retirees often face increased dental care needs due to aging-related issues such as gum disease and tooth decay, it becomes especially important for anyone who is retired or over the age of 65 to secure dental insurance.
4. Families with Young Children
There are a couple of reasons why it's a particularly good idea to purchase a dental insurance policy if you have young children. For one, it means more mouths to care for, which multiply the cost of your dental expenses. Young children also often require more frequent dental treatments as well as costly orthodontic treatments such as braces. Speaking of orthodontic treatments, keep in mind that not every dental insurance policy covers these, so be sure to look into this if you have children who may need braces or aligners in the future.
5. Individuals with a History of Dental Issues
Dental insurance is even more essential if you have a history of dental issues. Not only will it save you a lot of money since frequent visits to the dentist can add up, but it will also help encourage regular check-ups and preventative treatments to prevent further complications.
What to Consider When Choosing a Dental Insurance Policy
There are a few important factors to consider when choosing a dental insurance plan, including:
- Coverage Levels: Be sure to determine whether the plan covers preventive care, basic procedures, major treatments, or orthodontics.
- Network of Dentists: Some plans may require you to visit specific dentists or clinics, while others offer more flexibility.
- Waiting Periods: Some insurance plans have waiting periods for major procedures, so it's important to check when coverage begins.
- Annual Maximums: Many plans have a yearly limit on the amount they will pay for dental treatments.
- Cost: The plan's monthly premium is one obvious cost to think about but be sure to also check to see the percentage you are required to pay out-of-pocket and if the plan has any deductibles.
Take your time when choosing a policy and be sure to read the fine print. That way, you can be sure to choose a dental insurance plan that meets your needs and budget while avoiding any unwanted surprises.
How Often Should I Go to the Dentist?
If you're trying to decide whether a dental insurance policy is worth the cost, how often you plan on going to the dentist is a key factor to consider. Most dental professionals recommend coming in at least twice a year for a check-up and cleaning. However, some people may require more frequent visits, especially if they have conditions like gum disease, a history of cavities, or ongoing orthodontic treatment. Keep in mind that regular visits to the dentist will help detect potential issues early, preventing costly and invasive procedures down the road.
How Much is Dental Insurance?
How much a dental insurance policy costs in Canada can depend on a variety of factors. Things like your age, your location, your level of coverage, and whether the plan is individual or family-based can all have an impact on the premium that you pay. On average, though, Canadians can expect to pay anywhere from $30 to $80 per month for basic to comprehensive plans.
Purchasing Dental Insurance as a Health Insurance Add-On
One popular option for Canadians looking to save a little money while still getting comprehensive dental coverage is to purchase dental insurance as an add-on to your health insurance policy. If you already pay for private health insurance, purchasing a policy that includes dental insurance is often more affordable than purchasing a separate dental policy.
At GMS, we offer several comprehensive health insurance policies for Canadians, and dental care coverage is an optional add-on in our BasicPlan, ExtendaPlan, and OmniPlan. If you are looking for an affordable health insurance policy that includes dental insurance bundled in, these policies with the dental care add-on are excellent options to consider!
Final Thoughts
Dental care can be costly. However, the consequences of not visiting the dentist on a regular basis can be costly as well. Thankfully, dental insurance solves both of these problems, allowing you to visit the dentist routinely without high out-of-pocket costs.
The same principle applies to health insurance, too, and purchasing a health insurance policy that includes coverage for dental care is a great way to save on both. At GMS, we proudly offer several health insurance plans that include comprehensive dental coverage as an optional add-on. Feel free to contact us to learn more about these plans and to get a custom quote!
