Everything we know (so far) about the Canadian Dental Care Plan

Posted on January 14, 2024 in Health Delivery System

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TVO.org – Affordability
Dec 18, 2023.   Written by Kat Eschner

Who’s eligible? How does it work? How do I apply? TVO Today has answers

The long-awaited Canadian Dental Care Plan is accepting its first wave of applications this month. By the end of 2025, as many as 9 million previously-uninsured Canadians will be eligible to access insurance coverage for between 40 and 100 per cent of their dental costs. About 3.5 million Ontarians will be eligible for the plan, according to Health Canada numbers shared with TVO Today.

“This was a way to ensure that oral health care was available to all Canadians,” says Minister of Health Mark Holland.

The first stage of applications will target seniors over 87 who don’t have private insurance and reported an adjusted net household income of less than $90,000 per year in 2022 — in other words, most seniors over the age of 87. Qualifying seniors should receive letters in the mail this December with instructions on how to apply.

“We …ask people not to proactively do anything,” Holland says. “They’re going to receive a letter, and it’s going to give them a unique code.” The first phase of applications will take place over the phone, according to Health Canada, but the application process will move online in the new year.

The program will roll out over two years. By May 2024, everyone over the age of 65 who meets eligibility requirements will be able to apply and everyone enrolled will have access to services. By the end of the year, qualifying disabled people and those under 18 should be enrolled. After that, enrollment will open to all other eligible Canadians who meet the income threshold (less than $90,000 in household take-home pay) and don’t have access to private insurance through their employer.

That number will be subject to a few adjustments for a minority of recipients, including those who still receive lump-sum payments from the now-defunct Universal Childcare Benefit or who receive income from a registered disability savings plan.

But for “most people, it will be their net income, plus the one of their spouse or common-law partner,” says Marika Nadeau from Health Canada’s oral health branch. Program eligibility will depend on the income reported on your previous-year tax return.

Nadeau hopes that Canadians will register when and if they become eligible to apply for coverage — and that they’ll use the insurance to see a dentist regularly. “Hopefully they will not just become eligible but actually go to their oral health provider on a regular basis,” she says.

Holland says the ministry is still talking to stakeholders, including provincial and territorial dental associations and program details are still being ironed out. Traditionally, medical care is the purview of provinces, but the federal dental benefits are directly administered by Health Canada.

“We still have some work to do,” he says. “There’s the work that we’re doing with providers to finish the last technical aspects, but those meetings are going exceptionally well.”

Brock Nicolucci, president of the Ontario Dentist’s Association, says right now there aren’t enough publicly available details about the plan to make a comprehensive statement: “Really, we won’t find out until we have future meetings and more details are released.”

Nicolucci operates a dental practice in London. He says that most Canadians who have private insurance are happy with their current arrangement. Both the Canadian Dental Association as well as the Ontario Dental Association have lobbied the federal governmentto protect third-party insurance.

Dental care has never been part of Canada’s publicly-funded medical system, and public spending on dental has dropped over the years. Today, the dental system is almost entirely privatized.

According to Statistics Canada, 35 per cent of Canadians didn’t have dental insurance in 2022. In some groups — including seniors — more than half didn’t have insurance, which means they would have to pay out of pocket for dental expenses. People without insurance are nearly three times as likely to avoid seeing a dentist because of concerns about the cost, the statistical agency found.

The new plan, which is not fully public and will be administered by Sun Life, is a game-changer for the long-neglected public dental file, experts say — and goes a long way towards democratizing access to a basic medical need many Canadians have long been denied.

“Oral health is a big part of your overall health. And for far too long, it’s been neglected and kind of treated as something different than what it is, which is essential health care,” says Hasan Sheikh, an emergency and addictions doctor with the University Health Network.

Sheikh is one of a number of Canadian emergency physicians pushing for the introduction of universal dental care and is a board member of Canadian Doctors for Medicare. He says many patients enter emergency rooms with dental conditions, like abscesses, that should be treated earlier and better in a dentist’s chair.

The CDCP is “a big step in the right direction,” he says, but he and his colleagues want to see dental care that looks like primary medical care. “I’m worried that in a multi-payer system like this [dentists] could just increase their fees,” Sheikh says. “For all the same reasons that single-payer system makes the most sense for health care, it makes sense for dental care as well.”

Holland cites timeliness and cost-effectiveness as two primary reasons behind his government’s approach. “This is going to allow us at a much-reduced cost to be able to get everybody covered and, and to do it at speed,” he says.

The dental insurance programis part of the Liberal government’s supply-and-confidence agreement with the New Democratic Party. “We know that this is going to help out a lot of people,” NDP leader Jagmeet Singh said in a December 11 press conference.

Holland is hopeful that the CDCP will come to be seen as a “lighthouse” for preventive care in general: “When we take strong action in the realm of prevention, we can make such a big change in reducing future costs, reducing future illness, and improving productivity.”

If you have questions about the program, Nadeau says canada.ca/dental will have answers. Information will be expanding in the coming months, she says, as the program is rolled out.

https://www.tvo.org/article/everything-we-know-so-far-about-the-canadian-dental-care-plan

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