Does OHIP Cover Dental Services?

Rafi Chowdhury December 14, 2023

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Ontario’s Health Insurance Plan (OHIP) is the provincial health care plan that offers coverage for a wide range of health services to its residents. However, when it comes to dental care, many citizens are left wondering: Does OHIP cover dental services? In this in-depth article, we’ll explore the extent of dental coverage under OHIP and discuss alternative options for dental care insurance in Ontario.

Credit: www.thestar.com

Table of Contents

Understanding OHIP Coverage

First and foremost, it’s important to understand the scope of OHIP. The program primarily focuses on providing medical coverage for services that are deemed medically necessary, such as visits to the doctor, hospital stays, and certain surgeries. Preventative care and elective procedures are generally not covered, including most dental services.

What Dental Services Are Covered By Ohip?

OHIP does cover certain dental surgeries, but these are typically services that must be performed in a hospital. A table of dental services covered by OHIP might include:

Dental Service	Details
Reconstructive Surgery	Following an accident, if dental reconstructive surgery is required, it may be covered under OHIP when performed in a hospital.
Corrective Jaw Surgery	Surgeries to correct severe jaw abnormalities that cause disease or significant dysfunction may be covered.
Removal of Cancerous Growths	OHIP covers the removal of growths or tumors within the oral cavity when performed in a hospital setting.

Non-covered Dental Services

On the other hand, routine dental care such as teeth cleaning, fillings, dentures, and crowns are not covered under OHIP. The following is a list of some common dental services that you would typically need to pay for out-of-pocket if you do not have private insurance:

Cleanings and oral exams
Fillings for cavities
Root canals
Orthodontics (e.g., braces)
Non-surgical periodontal services
Dentures and bridges

Alternatives for Dental Coverage in Ontario

Since most dental services are not covered by OHIP, residents of Ontario should consider their options for dental coverage. Alternatives include:

Private Dental Insurance

Many employers offer group dental insurance plans as part of their employee benefits packages. Additionally, individual dental insurance plans can be purchased from various insurance companies.

Public Programs

Ontario offers some public programs that provide limited dental benefits for specific groups:

Healthy Smiles Ontario: A program for kids 17 and under from low-income households that covers regular dental services.
Ontario Seniors Dental Care Program (OSDCP): Provides free, routine dental services for eligible low-income seniors.

Out-of-pocket Payment

For those without insurance or not qualifying for public programs, dental services may be paid for out-of-pocket. Comparing prices between different dental clinics and seeking out community dental programs that offer discounted services can help manage costs.

Frequently Asked Questions For Does Ohip Cover Dental Care? Unveiling The Truth

What Services Does Ohip Cover?

OHIP, the Ontario Health Insurance Plan, covers many health services, such as doctors’ visits and hospital stays, but does not include dental care for most Ontarians.

Is Emergency Dental Work Covered By Ohip?

No, OHIP typically does not cover emergency dental work. Exceptions exist for specific medical conditions that require hospitalization.

Can Children Access Dental Benefits Under Ohip?

Yes, children 17 and under may be eligible for dental services through the Healthy Smiles Ontario program, which is separate from OHIP.

Are Seniors Eligible For Dental Coverage With Ohip?

Seniors are not covered for dental care through OHIP, but may qualify for assistance under the Ontario Seniors Dental Care Program.

Conclusion

Summing up, OHIP’s dental coverage is limited to specific, more serious procedures that require treatment in a hospital. Those seeking coverage for routine dental care should look into private insurance, explore public programs designed for specific groups, such as children or seniors, or discuss payment plans with their dental care providers. Understanding your options will help ensure you and your family can access the dental care you need.