The Trudeau government announced its dental-care plan on Monday, which is a $13-billion insurance program aimed at providing coverage for routine dentist costs starting in 2024. The program is for Canadians struggling with dental expenses, particularly those with low incomes.The government will prioritize coverage for children under 18 and select seniors before gradually expanding the program to include all eligible low- and middle-income Canadians in 2025.The application process is set to start, with seniors aged 87 and older eligible to apply later this month, followed by other age groups in the upcoming year.The government designed a staggered application process to ensure a smooth rollout, anticipating hundreds of thousands of people will benefit from this new program. Coverage will be phased in over time. Some eligible participants can expect to receive benefits as early as May 2024, though costs before the start date will not be covered.This insurance-based program replaces the interim program, which provided direct financial support to families with children under 12 for the past two years. Senior servants responsible for the program said during a background briefing with the media this federal initiative aims to "fill the gaps" in the existing system and not replace provincial and territorial programs that already cover certain oral health services.There is uncertainty about whether provincial and territorial programs will continue to operate once the national program is fully implemented, which could significantly increase the cost of the dental care plan. With those programs still in place, it is expected to cost the federal treasury approximately $4.4 billion annually.To qualify for the program, individuals must have a household income below $90,000 and not have access to an existing private insurance plan. Individuals must have filed a tax return to enable the government to verify their income.The plan offers the most generous benefits to families with a household income below $70,000, covering all costs for covered services such as cleaning, polishing, examinations, X-rays, fillings and root canal treatments. Families with incomes between $70,000 and $79,999 will have a 40% co-pay, while those in the $80,000 to $89,999 income range will have a 60% co-pay, with the federal plan covering the rest of the costs.The program will be administered by Sun Life, with dentists directly submitting claims for reimbursement. In cases where a co-pay is applicable, insured individuals will be responsible for covering that cost out of pocket to the dental service provider.Despite being managed by a third party, the government has assured Canadians they can still seek assistance from Service Canada agents to address eligibility or coverage disputes. A dedicated call centre will be established to handle dental services-related inquiries.The government is optimistic oral health professionals will participate in the program and accept the Canadian dental-care insurance plan as payment. In the coming year, an education campaign will be launched to inform dentists and their representative organizations about enrolling in the program and providing covered care.While a set "fee schedule" for services will be established, the reimbursements provided by Ottawa will vary from province to province. Government officials said the fees paid would be "relatively generous" compared to other public plans across the country, which should incentivize providers to participate and expand access to much-needed dental care for Canadians.
The Trudeau government announced its dental-care plan on Monday, which is a $13-billion insurance program aimed at providing coverage for routine dentist costs starting in 2024. The program is for Canadians struggling with dental expenses, particularly those with low incomes.The government will prioritize coverage for children under 18 and select seniors before gradually expanding the program to include all eligible low- and middle-income Canadians in 2025.The application process is set to start, with seniors aged 87 and older eligible to apply later this month, followed by other age groups in the upcoming year.The government designed a staggered application process to ensure a smooth rollout, anticipating hundreds of thousands of people will benefit from this new program. Coverage will be phased in over time. Some eligible participants can expect to receive benefits as early as May 2024, though costs before the start date will not be covered.This insurance-based program replaces the interim program, which provided direct financial support to families with children under 12 for the past two years. Senior servants responsible for the program said during a background briefing with the media this federal initiative aims to "fill the gaps" in the existing system and not replace provincial and territorial programs that already cover certain oral health services.There is uncertainty about whether provincial and territorial programs will continue to operate once the national program is fully implemented, which could significantly increase the cost of the dental care plan. With those programs still in place, it is expected to cost the federal treasury approximately $4.4 billion annually.To qualify for the program, individuals must have a household income below $90,000 and not have access to an existing private insurance plan. Individuals must have filed a tax return to enable the government to verify their income.The plan offers the most generous benefits to families with a household income below $70,000, covering all costs for covered services such as cleaning, polishing, examinations, X-rays, fillings and root canal treatments. Families with incomes between $70,000 and $79,999 will have a 40% co-pay, while those in the $80,000 to $89,999 income range will have a 60% co-pay, with the federal plan covering the rest of the costs.The program will be administered by Sun Life, with dentists directly submitting claims for reimbursement. In cases where a co-pay is applicable, insured individuals will be responsible for covering that cost out of pocket to the dental service provider.Despite being managed by a third party, the government has assured Canadians they can still seek assistance from Service Canada agents to address eligibility or coverage disputes. A dedicated call centre will be established to handle dental services-related inquiries.The government is optimistic oral health professionals will participate in the program and accept the Canadian dental-care insurance plan as payment. In the coming year, an education campaign will be launched to inform dentists and their representative organizations about enrolling in the program and providing covered care.While a set "fee schedule" for services will be established, the reimbursements provided by Ottawa will vary from province to province. Government officials said the fees paid would be "relatively generous" compared to other public plans across the country, which should incentivize providers to participate and expand access to much-needed dental care for Canadians.
