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6/8/2023

National Dental, much to do about nothing

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What do I need to know about the national dental program?
The federal budget highlighted the national dental care program again, providing slightly more details on the future of the plan. Let’s break it down.
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Currently the national dental care program offers coverage for dental for:
  • Kits under 12 years old
  • Who live in families with an income of $90,000 or less
  • Does not currently have insurance

The family income is measured by the income of the total family, not each individual. In Canada the median family income is $90,390. Median is different from average. Median is the middle – it means that half of Canadian families make more than $90,390 and half make less. Using the median income in Canada to qualify for the plan, means half of Canadas will not be allowed to use the national dental care plan. Of the half that are able to use the plan, many will still have to pay to use the coverage. Only those with a family income of less than $70,000 will not have to pay anything for the plan. 
 
What’s being covered? (Effective Dec 1 2022)
$650 per child with income under 70,000
$390 per child with income bt 70,001 and 79,999
$260 per child income 80,000-89,999

What’s next?

Creating a structured list of included and excluded dental services. Right now, it’s a free for all, manual reimbursement.

Health Canada is administering the plan, but a Tender for 3rd party payor is in the market, a corporation will be chosen to facilitate the claim reimbursement to the dental office at time of claim.
Plans to introduce legislation that will compel employers to report existing dental coverage offered to employees through T4/T4A reporting. That seems like it’s going to be a colossal challenge and probably a mess.

Expand the program to people under the age of 18, then seniors and people with a disability, eventually all Canadians.

Should employers make changes to their dental program or remove their dental program?
This is an individual choice, however, this writer does not recommend dropping dental in favour of this plan. Between the extremely low coverage amounts and large number of uncovered Canadians, there is little incentive to drive coverage away from employer paid dental plans and into the government plan.
This plan is designed for low-income families who have no access to care. It’s not designed to replace employer paid dental plans.

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