Dental implants are a popular solution for replacing a missing tooth with an artificial tooth designed to be natural-looking and last many years. But as many Ontarians know, these procedures are not always an option for your budget. If you’re wondering whether insurance usually covers dental implants in Ontario, unfortunately, the answer is a little complicated.
Insurance coverage for dental implants may be available through your workplace benefits or private insurance plan, depending on the specific benefits provided by your plan. While some insurance plans do cover dental implants, the coverage often varies greatly.
Most plans are different, making it difficult to determine whether or not they’ll cover dental implants without speaking to your insurance provider or thoroughly reading your plan. And OHIP—the Ontario Health Insurance Plan—doesn’t usually cover dental implants.
Understanding your insurance plan and exploring all options is the key to getting the most out of your benefits. It can help to speak with your dentist to see what they have to say during your next dental exam.
What Are Dental Implants?
The procedure for getting dental implants is a type of restorative dentistry that involves the surgical insertion of a titanium post into the jawbone. This post mimics the structure of a natural tooth’s root and provides a stable foundation for a replacement tooth or crown.
Once the post has healed, an artificial tooth is installed. Once the process is complete, you’ll have a replacement tooth that can work and look exactly like your natural teeth. Unlike dentures, which are removable, dental implants are permanent. They’re designed to blend in seamlessly with your natural teeth, making them an appealing choice for many people seeking to replace missing teeth.
Are Dental Implants Covered By Insurance in Ontario?
This process can be a little more complicated than most people would like. In Ontario, most residents have access to OHIP—the Ontario Health Insurance Plan. This plan covers a wide range of services ranging from standard doctor appointments to some laboratory testing—but does it cover dental work as well?
Insurance for dental work in Ontario isn’t standardized, and the OHIP plan only covers:
- Certain dental surgeries that must be performed in a hospital
- Limited oral health services for low-income seniors
- Some dental services for children under the Healthy Smiles program
- Emergency dental services in some situations
- Dental procedures for individuals with specific medical conditions
So unless you’re a senior, a child, or considered to be low-income and in need of dental services, OHIP likely won’t cover your dental work. And this remains true for implants, unfortunately.
There is good news for Canadians, however. In 2022, the federal government announced the Canadian Dental Care Plan (CDCP), a plan to provide Canadians with a wider range of dental coverage in the future. Unfortunately, this plan is still being planned, though it does offer some dental services to children as of 2023.
How Insurance for Dental Services Works
So, if the federal or provincial government doesn’t cover dental implants, where do you get coverage? The answer is simple: either through work benefits, a private insurance plan, or both.
Private dental insurance in Canada is often provided through employment benefits packages but can also be purchased individually. These types of insurance policies typically offer coverage for a range of dental services, typically covering:
- Cleanings
- Regular checkups
- Fillings
- Extractions
- Root canals
- Crowns
- Bridges
And fortunately, they often cover dental implants!
However, it’s important to note that coverage will vary from plan to plan. Some may offer partial coverage for dental implants, while others may cover them in full, while others might not cover them at all.
If you have some form of private insurance, it can help to read the fine print or get in touch with your insurance provider to better understand exactly what is and isn’t covered, along with how much. It’s also worth noting that many plans have a waiting period before they cover major procedures such as dental implants, so make sure to check your plan and remember this when planning for any potential dental work.
How to Get Insurance to Cover Dental Work in Ontario
If your insurance plan doesn’t fully cover dental implants, don’t worry. There are a few steps you can take to maximize your coverage.
First, speak with your dentist about your situation. They may be able to suggest alternative procedures that are covered by your insurance or offer a payment plan that makes your dental implants more affordable.
And if your current insurance plan doesn’t cover dental implants, it might be worth shopping around for a new plan that does. There are many insurance providers that offer varying levels of coverage for dental implants.
It can help to speak with your insurance provider. They’ll be able to explain your:
- Policy details
- Deductibles
- Annual maximums
- What procedures are and aren’t covered
This can help you better know how to get your procedure covered.
When Should You Use Benefits for Dental Work?
There’s an important thing to remember when you’re thinking about your insurance benefits: they typically reset at the end of each year and don’t roll over into the next. Most insurance plans operate on a year-to-year basis following the calendar year. This means that any unused benefits won’t carry over, so you’ll lose the coverage.
Near the end of the year, don’t forget to schedule any necessary dental work before your coverage resets so you can maximize the usage of your benefits.
Where to Get Dental Implants
At Shin Dentistry, we pride ourselves on providing quality dental care—and that includes dental implant procedures. Our team of skilled professionals is dedicated to helping you achieve the smile you deserve. If you’re considering dental implants and want to learn more about your options, book an appointment with us today.
