On Monday, the federal government revealed its groundbreaking dental care plan, a $13-billion insurance initiative set to commence coverage for routine dentistry costs in the coming year, specifically targeting individuals meeting a predetermined income threshold.
The comprehensive plan will initially prioritize coverage for children under 18 and certain seniors, gradually expanding to encompass all eligible low- and middle-income Canadians by 2025. Seniors aged 87 and above can apply later this month, while other age groups will be eligible to apply in the upcoming year.
The phased application process aims to facilitate a seamless rollout, with the government anticipating a significant number of participants benefiting from this addition to the country’s social safety net. While coverage will be introduced gradually, some eligible individuals may begin receiving benefits as early as May 2024. It’s crucial to note that costs incurred before the designated start date will not be covered.
This insurance-based program replaces the interim initiative that had been providing direct cheques to families with children under 12 for the past two years. In a briefing with reporters, program administrators emphasized that the federal initiative aims to “fill the gaps” in the existing system rather than replacing provincial and territorial programs covering certain oral health services.
However, the federal government has not secured assurances from provincial premiers regarding the continued operation of their programs once the national plan is implemented.
The decision to dismantle provincial plans could elevate the cost of the dental care plan, projected to be around $4.4 billion annually in its current form.
Eligibility for the program
Eligibility for the program hinges on a household income below $90,000, the absence of access to an existing private insurance plan, and the filing of a tax return for income verification. The plan is most favorable for households with an income below $70,000, where no co-pays are required for covered services like cleaning, examinations, and fillings.
Families with incomes between $70,000 and $79,999 will face a 40% co-pay, while those in the $80,000 to $89,999 bracket will have a 60% co-pay, with the federal plan covering the remainder of the costs incurred.