Canada's dental care plan begins today. Here's what you need to know - Action News
Home WebMail Thursday, November 21, 2024, 09:41 PM | Calgary | -10.9°C | Regions Advertise Login | Our platform is in maintenance mode. Some URLs may not be available. |
Politics

Canada's dental care plan begins today. Here's what you need to know

Canadas national dental care plan begins covering 1.9 million seniors today the first phase of a massive public oral health-care insurance program that eventually will cover one quarter of Canadians. But many patients may still be kept waiting to get their dental visits covered.

Seniors 70 and older can be covered starting May 1, but some could be stuck waiting for care

First phase of Canada's national dental care plan begins

5 months ago
Duration 2:02
The first phase of the Canadian Dental Care Plan began on May 1, providing coverage to nearly two million seniors aged 70 and older.

The Canadian Dental Care Plan (CDCP) begins covering 1.9million seniors today but many patients may have to wait a while to get theirdentalvisits covered.

Beginning May 1, coveragebeganfor seniors 70 years and older. Thoseaged 65 to 69 can also now applyfor the program online.

The massive public oral health-care insurance programwill eventually cover one quarter of Canadian residentswho don't haveprivate dental plans, at a cost of $13 billionover the next five years. Ottawa is rolling out eligibility gradually, starting with seniors.

"They are very excited to have their teeth cleaned because it has been many years," said Shannon Maitland, an independent dental hygienist who runs a mobile clinic out of Carleton Place, just outside of Ottawa.

Maitland is one of the now 6,500 oral health-care providers who have signed up so far for the CDCP. But she won't start seeing patients under the program for several weeks becauseshe's decided to wait and see how the initial rollout goes.

Dentists, denturists and hygienists have generally supported a national, publicly funded dental insurance program, arguing it will fill thegap of ninemillion low- and middle-incomeCanadians who have to pay for oral health care out ofpocket.

But some patients are finding out their dentist isn't participating. Changes Ottawa made that will allow dentists to still process claims without registering don't come into effect until July. On top of that, it will also be another six months until certain dental services thatrequire pre-approval are covered, like crowns and partial dentures.

Since the plan was announced in December, there has also been confusion over who qualifies, how the plan affects other insurance programsand whether enough dentists will sign up to meet demand.

Here areanswers to some common questions about the plan.

How can I find a professional offering the CDCP?

The federal government contracted insurance provider Sun Life to administer the program. The company recently launched asearchable database of available CDCP providers.

According to their associations, there are about 30,500 oral health-care professionals who could sign up to offer the program, including roughly 26,500 dentists, 1,700 independent hygienists and 2,400 denturists.

That means only about one in fiveoral health-care providers have signed upso far.

Why won't my dentist sign up?

Some dentists have been reluctant to register for the program because Ottawa wants them to signcontracts to provide care and they think the program willrequire an unreasonableamount of paperwork.

"The vast majority of dentists are still waiting for more information before they agree to participate," said Dr. Joel Antel, a Winnipeg dentist and the newly elected president of the Canadian Dental Association.

Dr. Joel Antel stands in his Winnipeg dental office.
Dr. Joel Antel, president of the Canadian Dental Association, says many dentists remain reluctant to sign up for the national program. (Trevor Brine/CBC)

He said he hasn't signed up to provide the CDCPin his own clinic.

"I have to admit to a certain amount of disappointment, because I was involved in this process very early on and it looked really promising," he said.

"Then at some point, it just took a turn and became complicated and onerous and unnecessarily so."

Will I have to switch dentists?

Dentists have the right to choose if they will accept patients through the CDCP, as they can with existingpublic programs.

"If the dentist isn't participating they can't go to those dentists," Dr. Antel said. "So they may have to change dentists where they've had a long-term relationship built up."

Can I access CDCP at a dentist that hasn't registered?

Two weeks ago,Health Minister Mark Holland attempted to addressconcernswhen he announced that oral health-care providers could bill the program directly without formally signing up.

That option won't be available until July. That means if your dentist isn't a registered provider, but will still accept you under the CDCP, you won't be able to see them until the summer.

On Tuesday, Holland pushed back against the dental associations' continued criticism of the program, saying Ottawa listened to their concerns andsimplifiedthe CDCP.

WATCH: Health minister pushes back against dental associations' claims:

Health minister calls dental associations claims about national program 'nuts'

5 months ago
Duration 1:33
Federal Minister of Health Mark Holland says the federal government has worked to adjust the insurance claim process so its as simple and as basic as anything else out there. Some dental associations have raised concerns about the administrative burden of the national dental care program, which is set to begin Wednesday.

"That's nuts. Just to be fair ...at some point let's call a spade a spade here. Are you crazy?" he said outside a cabinet meeting in the House of Commons.

Holland said the federal government madethe system easier to use while still keeping the necessary checks in place to guard against abuse, such as allowing Ottawa to audit claims.

"We created a normal claim process that exists in every other insurance claim process everywhere, and they wanted us to simplify it. We did," Holland said.

"We've got it down now to a process that's as simple and as basic as anything else out there, if not simpler."

How does the CDCP compare to other provincial plans?

If you have access to dental care through an existing public program, you can still qualify for the CDCP. That could be a provincial program offered through social assistance, disability, or national programs like the Non-Insured Health Benefits program for First Nations and Inuit.

Dr. Brandon Doucet, a Nova Scotia dentist who has advocated for anational public dental insurance plan, saidhe understands many dentists'reluctance and a lot of it has to do with their experiences trying to provide the public programsin place right now.

"The existing public dental programs are very, very meagre and a lot of dentists are frustrated because the fees those programs pay out are often under half of what private plans pay," Doucet said.

By comparison, theCDCPcovers more servicesand at a better rate than existing public plans, Doucet said. In Nova Scotia where he practises, Ottawa pays around89 per cent of what the feeguide suggests. Those fee guides are put out by provincialdental association, which dentists reference when they bill private insurance companies for their service.

Doucet says he thinksmore dentists will sign up once the program gets underwaywhen they realize they may lose money by not accepting CDCP patients.

"Many dentists just do not and have never wanted public dental care, similar to physicians' opposition to universal health care in the 1960s," he said.

Doucet said Canada's public spending on dental care is about sixper cent of the total spent on all oral care services substantially less than the10 per cent public share in the U.S., and the 57 per cent in Germany. The national program will bring that number closer to about 25 per cent.

Will I get free dental care?

As Doucet mentioned, the federal government has created its own fee grid of what it will pay oral health-care providers for each procedure, which isa slightly lower rate than the guides put out by provincial associationsdentists.

But this is not"free" dental care.

WATCH | Minister'confident' more providers will sign on to national dental program:

Minister Holland 'confident' more providers will sign on to national dental program despite some concerns

5 months ago
Duration 9:59
Health Minister Mark Holland tells Power & Politics that conversations with dental associations have gone smoothly and Ottawa has 'answered all of their questions' about the Canadian Dental Care Program.

Like private plans, the CDCP only covers a certain amount of the cost of services, meaning a dental care provider can still charge their patient the difference. Patients whose income (or combined family income) is under $90,000 should qualify but the coverage is only partial if you make between $70,000 and $90,000. More details can be found here.

What's covered?

Most routine dental care will be covered under the CDCP, including cleanings, X-rays, fillings, root canalsand dentures.

Some of the more complex dental services such as partial dentures and crowns will require federal pre-authorization of payment. Pre-authorized services won't be covered until November 2024.

"There are some things that certainly we were hoping to get all launched at the same time," said Jaro Wojcicki, a denturist inPenetanguishene, Ont., and president of the Denturist Association of Canada.

"The government did say it's been difficult to manage having everything launch May 1. So they made some exceptions andsome decisions ultimately onsplitting up some of the procedures."

Oral health-care providers will need to educate their patients to co-ordinate the treatment over this period, he said.

You can learn more about what's covered and when on thegovernment's website here.

When will I be eligible?

The federal government is expanding eligibility forthe CDCP gradually. As of May 1, Canadian residents 70and older can get their oral health-care services covered by the program, and seniors aged65 to 69 can now sign up online.

In June, people with disabilities and children under 18 will be included. (That's also when an interim dental benefitthat has been covering kids under the age of 12 since December 2022 will be replaced by the CDCP.)

The program will be available to all eligible Canadian residents starting in 2025,according to the federal government.

To qualify, a patient can't have access to any existing private dental insurance,regardless of how comprehensive your existing private coverage is. Ottawa has clarifiedthat if you went out and purchased private insurance on your own, you will qualify for the CDCP once that plan is no longer in effect.

The government passed legislation last summer that requires employers to declare to the Canada Revenue Agency if they offer workers a private dental plan. This will enable Ottawa to audit claims through the CDCP.


Do you have questions about howCanada's new dental care plan may affect you? Send an email to ask@cbc.ca.