The Importance of Discussing Your Dental Insurance Plan With Your Broker or Financial Advisor

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While the Canadian government provides basic health insurance coverage to all of its residents, that coverage does not include dental care for most individuals.  As a result, many people choose to purchase an individual dental insurance plan to get the coverage they need for themselves and their families.

While dental insurance will help protect you from unexpected out-of-pocket costs, it’s not enough to just purchase a policy. It’s important that you familiarize yourself with your policy and what it offers. Once you have a good understanding of your particular plan, be sure to discuss it with your dentist, so you can be fully educated about the coverage your Canada dental insurance plan provides.

Frequency of Visits

Regular visits to the dentist are critical to maintaining good oral and overall health. Most dental insurance plans cover routine, preventative care visits that include a dental exam, cleaning and X-Rays.  But how often visits are covered vary from plan to plan.  For example, some policies  cover a visit every nine months, while others may cover one visit every six months.

It is important to discuss with your dentist how frequently you should have regular exams to maintain good oral health based on your individual needs. Your dentist’s recommendations may be different than the number of visits covered by your dental insurance plan. In addition, your dentist will be able to work with you to develop a plan that will help you keep your teeth healthy between visits.

Treatment Options

Different insurance plans offer different levels of coverage for routine and emergency dental care.  Some plans cover certain treatments; partially cover others; and exclude some altogether. When your dentist recommends a particular treatment, it is important to find out whether or not it is covered under your insurance plan.  If it is not covered, let your dentist know. He/she may be able to recommend another, equally effective treatment that is covered under your dental insurance plan.  Obtaining treatment covered by your policy will help you reduce your out-of-pocket costs and minimize the impact to your bottom line.

Pre-Determination:  Is it Required?

Most Canada dental insurance plans require dentists to complete a pre-determination or a pre-treatment plan form for treatment in excess of a certain dollar amount. If your plan includes this requirement, it is important that you let your dentist know, so they can complete the necessary paperwork before you receive your treatment. If your insurance company requires pre-determination but your dentist does not complete it, your Canada dental insurance plan may not cover the cost of your treatment, leaving you to pay the bill on your own.


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