Canada Dental Care Plan and Benefit Insurance Program: Read Why Our Office Is NOT Signed Up!

The most up to date information on Canada’s Dental Benefits Program can be found on the Canadian government website.   The BC Dental Association also has a dedicated web-page with information. A recent news article highlights many of the issues that concerns dental care providers such as myself.

In the current proposal our office is not ready to commit to providing coverage care for those under the plan. The government has put up barriers that we feel is unjust for patients in the right to choose what offices they can go to. Until these barriers are removed, we feel it is best to hold off on accepting the plan in its current form at our office. Patients are more than welcome to visit our clinic, but know that we cannot file the claim on their behalf and would have to pay for costs upfront out of their own pocket.

As dental providers, we only know as much as the public does and direct any inquiries to the government website. A lot of people assume the government will be a full coverage plan, but in reality it is not as comprehensive as the public is expecting. The government has said that it will likely be similar to the NHIB dental plan that already exists.

The National Dental Plan is very limited and falls short of the recommended fee guide and basic treatments we feel are important for the public’s oral health. The plan itself does NOT cover all the procedures and only SUBSIDIZES the costs of some procedures, resulting in patients being out of the pocket to pay the difference in what the plan does not cover. Moreover the plan does NOT allow for offices to direct bill to the patient and get the dental plan to reimburse the patient directly (we see it as another barrier for patients to choose their preferred provider). As dental offices we have no control over what is covered and not covered, and ultimately it should be up to the patient to understand what the coverage will entail. The government does NOT ALLOW dentists to treat the plan like any other insurance plan, and puts a large administrative burden on our clinics. The Canadian Government has not been forthright with the public on the out of pocket costs, claiming that everything would be covered: this is false. Moreover the government wants dentists to commit to a one sided contract that can be changed any time and the details of that contract/obligations are not even complete or made public at this time!

Our office would happily participate if the following barriers were removed:
Right to bill patients directly, as this is who we have a relationship with(not the insurance company)
Removal of Contract requirement or implied agreeing to their unique terms, where patient confidentiality concerns and administrative burdens are imposed on dentists. No other insurance plan has these kind of stipulations!
The Dental Plan is treated like any other dental plan, where the relationship is solely between the patient and the Government/Sunlife.

As dentists we are care providers and not dental plan administrators. We prefer to keep doing what we do best, and that is providing dental care.