Understanding the Cost of Dental Insurance in Canada

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In virtually every purchase we make, we wonder if we’re getting the best value for our money. Health and dental insurance policies are no exceptions; it can be hard to understand exactly how an insurance company determines the monthly or annual premium amount. To help you gain a better understanding of what drives the cost of dental insurance, we’ve prepared the following guide. Read on to learn more about the factors that affect dental premiums and what you can do to help lower your insurance costs.

Factors that Affect Dental Insurance Premiums

There are a number of factors that affect dental insurance premiums. They include demographic factors like age, marital status, and the number of dependents in your family. There are insurance packages available for individuals, couples or families.

Geographic factors like the city and province you live in will also affect your dental insurance premiums. Each province releases a dental fee guide annually which determines the suggested price of services. However, the provider can charge more than the fee guide. Your insurance provider will generally only cover the “usual and customary” fees charged by the dentist. If the dentist’s fees are higher, you will be responsible for the difference.

Finally, the coverage level you select for the dental care needs of you or your family will have an impact on the cost of dental insurance. This decision will be largely based on the state of your family’s dental health and your budget, but there varying degrees of coverage that will suit your family.

Ways to Mitigate the High Cost of Dental Insurance

Regular trips to the dentist are an important part of maintaining your oral health, which affects your overall health. Because dental care falls outside of provincial health care packages in Canada for the most part, carrying health and dental insurance is a wise decision for everyone.

However, the reality is that dental insurance is not inexpensive. To balance dental care needs and household finances, it’s a good idea to investigate ways to mitigate the high cost of dental insurance, including:

  • Increased co-payments/coinsurance: Most people understand the principles of deductibles when it comes to auto insurance. Co-payments and coinsurance also require you to pay for a portion of the cost for each visit to the dentist, up to an annual limit. If you have a higher  co-payment, you will generally have a lower monthly or annual premium.
  • Evaluate coverage levels: It can be a financially sound decision to purchase a lower level of coverage, like a plan that offers only basic services. Please consider reviewing your plan and your dental history with your dentist before choosing a policy. If it is likely that you or a member of your family will require major services (orthodontia, cap, crown or bridge, etc.), most insurers have an eligibility waiting period. This means your policy will not cover these services until your third year on the plan.

If you are having trouble determining the appropriate level of coverage for your family at a rate you can afford, an insurance broker can help.

Discuss Your Policy with Your Dentist

The Ontario Dental Association has laid out guidelines explaining patient/dentist responsibilities with respect to dental insurance coverage. In short, it is your duty to know the ins and outs of your dental insurance plan. If a course of treatment requires documentation, like a pre-treatment form, your claim may be denied if you fail to provide one, even if the service is one that is generally covered by your plan.

Your dentist is required to provide the best treatment options for your oral health care needs, whether or not those treatments are covered by your dental insurance plan. However, your dentist can help by providing the documentation you need, like pre-treatment forms and claim forms, to help you get the most out of your dental insurance benefits.

It’s important to remember that dental insurance is intended to help you pay for dental care, but it doesn’t extend to all dental treatments. The best way to make sure you don’t encounter unexpected costs at the dental office is to discuss your dental plan with your insurance broker.

Choose to Work with an Insurance Broker

When you work with an insurance broker, you have the benefit of an experienced professional on your side. An insurance broker can help you better understand the dental insurance options available to you, and what will work best for your family within your household budget.

Contact us today to start working on insurance solutions that will benefit you and your family for many years to come.


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