Dental Plans for Seniors: Affordable Dental Care

by | Apr 7, 2015 | Dental Health, Health

Good oral health is a must for maintaining overall health, and it holds true for people of all ages, especially those among us who are seniors. Due to age-related health troubles, seniors are even more in need of proper dental care to avoid serious complications. Unfortunately, many seniors avoid visiting dentists for regular health checkups, and at times even keep delaying necessary dental treatment, due to financial constraints and lack of dental insurance. Though around 62% of Canadians have private dental insurance, the percentage of seniors that have it is a mere 53%.

The Canada Health Act (CHA) does not include general oral healthcare, and citizens either pay for themselves to receive oral health care through private clinics, or pay through dental insurance. However, Toronto Public Health provides free dental care to seniors (ages 65 and above) living in Toronto. The assessment for eligibility is done at the dental health clinic by their staff. Apart from this, Toronto Public Health also provides services like dental screening, workshops for seniors on dental health related issues, professional cleaning and identification of dentures, demonstrations on brushing techniques, etc. They can provide this for seniors facilities like retirement homes, nursing homes, long-term care facilities and collective living centers.

Ontario Health Insurance Plan (OHIP)

The Ontario Health Insurance Plan (OHIP) provides some dental benefits like coverage for services that can only be performed in a hospital by a dental surgeon. However, there is no coverage for major routine services like cleaning, fillings, endodontics, extractions, periodontics, crowns and bridges, dentures, etc. Treatment for accidental injury to teeth is also not covered under OHIP ( Though prescription drugs are not covered by OHIP, seniors with a valid Ontario Health Card can take advantage of some assistance under the Ontario Drug Benefit (ODB) program.

Private Dental Insurance Plans for Seniors

Seniors can purchase supplementary health insurance plans from private insurance companies. Dental insurance is usually included in general health insurance plans. These companies charge a premium, and as required, reimburse the cost of treatments covered under the plan, as well as treatments not covered under the Provincial Health Plan. This includes, for example, prescription drugs, vision and dental care, registered therapists and specialists, etc. Premiums are based on the kind of plan you opt for.

Many companies offer plans that take into account the special needs of seniors. However, it may or may not have special benefits for dental treatment. These plans do not usually require a medical questionnaire to be answered, and can cover fillings, cleanings and scaling, oral examinations, polishing, and certain extractions. Depending on the plan, it may cover recall visits every 6 months or every nine months. Expensive treatments like oral surgery, endodontics (RCT), orthodontics, periodontics, crowns, bridges and dentures are usually not covered in the first year. In the second year, around 60% is covered by the insurer, while the third year onward, 80% is covered by the insurer. They usually also have a combined maximum coverage per three year period. Additionally, these plans may also come with certain core benefits like visits to registered therapists, vision care, home care and nursing, accidental dental care, and much more.

Of course, premium rates and plan benefits vary with insurance providers, and you must carefully compare plans offered by different insurers before making your selection. There are many online portals, today, that help you compare the plans so that you can make an informed decision.

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