Understanding Your Dental Insurance Plan and the Types of Services Available

Understanding Your Canada Dental Insurance Plan and the Types of Services Available
You know how important regular trips to the dentist are for maintaining your oral and overall health. But most provincial insurance plans do not provide dental coverage. One way to get the protection you need is to purchase an individual policy that helps cover your out-of-pocket expenses.

When you are shopping for a Canada dental insurance plan, there are many options to choose from, with varying levels of coverage. Some plans cover certain services, partially include others, and exclude some altogether. In addition, many dental insurance plans have waiting periods before you can begin receiving benefits for some or all of the services they cover. It’s important to take the time to review all your options to ensure the plan you choose provides the coverage you need.

In general, four types of services can be covered by a dental insurance plan: basic, comprehensive basic, major and orthodontic.

Basic Services

Most plans provide basic services that are available right away or after a short waiting period. These services consist of routine maintenance treatments, like preventative cleaning and polishing, dental exams and x-rays, and fillings and extractions for patients of all ages. For children, coverage for basic services also usually includes preventative measures such as fluoride treatments and pit and fissure sealants.

The frequency with which an insurer will pay for these treatments varies from plan to plan. For example, some plans may cover a routine exam and cleaning every six months, while other plans may cover them every nine months. It’s important to remember that to monitor your oral health, your dentist may recommend more frequent examinations than are covered by your insurance plan. Be sure to discuss their recommendations before making a final decision on your insurance coverage.

Comprehensive Basic Services

Dental insurance plans that pay for comprehensive basic services cover treatment that goes beyond the scope of routine therapies covered under a basic services plan, but are necessary to keep your smile happy and healthy. Examples of comprehensive basic services include periodontal treatment, endodontics and root canals, denture cleaning and repairs, and more.

Like all dental insurance coverage, the best sources of information for what services you may require are your personal history, your family history, and your dentist’s recommendations. Be sure to discuss your current and likely future needs with your dentist before making a final choice on a plan.

Major Services

Major services include the most extensive treatment available for helping you maintain good oral health, including crowns, bridges and possibly more. There will usually be a waiting period under any dental insurance plan; meaning these services will not be covered until you have been a policyholder for up to three years.

Your dentist can review your personal and family history to help you get a sense of what dental treatments the future may hold. If it is likely that you will need major dental services to replace missing or damaged teeth or crowns, be sure to check with your insurer to find out if and when you are eligible to receive these services under your policy.

Orthodontic Services

Orthodontic services include treatments that are used to straighten a person’s teeth and/or correct their bite. This type of therapy is most commonly used for children and teenagers but can be necessary at any age. Orthodontic treatment usually includes braces or some other type of aligner that is used to straighten a person’s teeth or change the shape of their bite.

Understanding Your Canada Dental Insurance Plan and the Types of Services Available

If you are the parent of a young child, orthodontic work may be something you need to consider sooner rather than later. An estimated 300,000 Canadian children are currently in the care of an orthodontist, and many of the conditions that lead to a need for braces are hereditary. That means if you or someone in your family needed braces, the odds your child will also need them are much higher. While your individual dental insurance plan may offer some coverage for braces, like most coverage for major dental services, there is usually a waiting period of up to three years for orthodontic treatments.

How to Choose the Right Plan

Choosing the right dental insurance plan for you and your family may not be as easy as it seems at first glance. It’s important to select a plan that will meet your needs now as well as in the future as your needs change or your family grows. Working with an insurance broker is the best way to ensure your current and future dental insurance needs are covered.

One of our helpful customer service representatives can review the insurance options with you, answer your questions, and help you find the plan that is right for you. Contact us today.


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