‘Absolutely huge’ need for dental coverage as new federal program rolls out in Hamilton
From who’s covered to how to register, here’s what you need to know
Years of plaque buildup. Cavities. Broken teeth. Bone loss. “Teeth that are so decayed that you just can’t keep them anymore,” says Hannah Balkhi.
“We had one poor patient that we saw, I think last week, and pretty much every tooth in his mouth was just broken,” adds the office manager at Barton Dental. “There’s no saving those at this point.”
It’s been about two weeks since coverage under the federal government’s Canadian Dental Care Plan began, and already her Barton Street East clinic has seen several patients, including a couple who booked weeks in advance to get an appointment on May 1, when the initial stage of the program was rolled out to seniors.
Other local clinics have also had patients come in with similar, significant issues.
The plan, which offers dental benefits to uninsured Canadians with an annual household income under $90,000, covers services from cleaning to surgery for an estimated nine million people countrywide.
As of Thursday, more than two million seniors had enrolled in the program and more than 50,000 had received dental care in the first two weeks, Christopher Aoun, press secretary to Health Minister Mark Holland, said in an email.
Local data wasn’t available as of May 16.
“We’re thrilled with the number of claims already filed and processed,” Aoun wrote. “We are looking forward to even more oral health professionals signing up.”
It’s a “phenomenal milestone” in oral health, said Ontario Dental Association president Brock Nicolucci, but the program has also been met with hesitation by some in the dental community, who feel the development of the program has been rushed.
Patient privacy, the government’s ability to make changes to the program and fear of red tape are among the concerns causing some dentists to hold off on signing up.
“They’re worried about locking themselves into something that could potentially lead to more problems down the road,” Nicolucci said.
Meanwhile, several local clinics say they signed up immediately and their doors are “wide open” to anyone, including those receiving government assistance.
“The need for this program is absolutely huge,” said Zanina Cavoto, regional manager for any time Dental Group, which operates five clinics in Hamilton and Burlington. “There’s a lot people that have not had the ability to have their dental concerns taken care of.”
Since May 1, about 150 seniors have had appointments at any time Dental’s Ontario clinics, including between 20 and 30 at Hamilton Dental, its Dundurn Street South location.
And clinics say they only expect demand to rise as more people become eligible.
“I think we’re going to see a huge surge in people applying,” Cavoto said.
What clinics are participating?
It’s up to clinics whether they want to participate in the program, so patients may need to find a new dentist if theirs hasn’t opted in.
Scores of local clinics are taking part, with a quick online search of family dentists returning more than 250 results within a 10-kilometre radius of downtown Hamilton. Patients can find dental care providers offering services covered by CDCP through Sun Life, the insurance company administering the program. Search here: sunlife.ca/sl/cdcp/en/member/provider-search/.
Who is eligible?
The plan offers benefits directly to Canadian residents with an annual household income under $90,000 who don’t have access to private insurance. To qualify, you and your spouse or common-law partner must have filed taxes the previous year.
Coverage will ultimately be available to Canadians of all ages, but currently only seniors aged 65 and up can apply. Adults with a valid Disability Tax Credit certificate and kids under 18 can apply starting in June, and all other residents become eligible in 2025.
How do you sign up?
Residents can apply online at https://www.canada.ca/en/services/benefits/dental/dental-careplan/apply.html or call 1-833-5374342.
To apply, residents will need to provide their social insurance number, date of birth, full name, address and any existing dental coverage through government social programs.
Balkhi, who helped her parents apply, said the process took just several minutes online.
What does it cover?
Coverage includes a “wide range” of oral care services, including preventive, diagnostic, restorative and surgical, according to the government. Cleanings, examinations and X-rays, fillings, root canals, dentures and extractions are among the services included in the program.
Similar to private insurance, the CDCP will reimburse a percentage of the cost, determined in part based on household income. Those with a net income of $70,000 and up are required to pay out of pocket 40 to 60 per cent of costs, and may be required to pay additional fees when the cost of a service is more than the established program fees.
Can it be used with other programs?
Patients already receiving coverage through provincial social assistance programs like ODSP, Ontario Works, Healthy Smiles Ontario (HSO) or Ontario Seniors Dental Care Program (OSDCP) can enrol in the CDCP. In some cases, patients may be required to choose which coverage they want to use for a service.
“Clients enrolled in the OSDCP will have the ability to choose either OSDCP or CDCP coverage at the point of service, as benefits cannot be co-ordinated between the two programs,” reads an April 19 document shared with The Spectator by Hamilton Public Health Services.