When it comes to a lost tooth, there are options available to help: dental implants. These serve as artificial teeth that operate just like your natural teeth. However, there’s a common question associated with having a dental implant installed: Are dental implants covered by insurance in Canada?
There isn’t one simple answer to this question. Whether implants are covered by your insurance is greatly determined by the plan you have and the specific coverage it offers depending on your insurer’s policy. Generally, though, implants—or at least some of their cost—are covered to some extent. It’s important to read through your policy or contact your insurer to clarify your situation and find out whether they’ll cover the cost of an implant.
Due to the factors that are involved when it comes to dental insurance, you should discuss your options with your dentist before making a final decision relating to your oral health.
What Are Dental Implants?
Simply put, dental implants are artificial teeth designed to replace a lost or missing tooth, with several steps involved with the installation process. An artificial tooth root is installed in your jaw just under the gum line to serve as a strong anchor point for a tooth to be placed on top. This artificial root eventually fuses with the bone to act as a base for a crown or bridge later on.
These implants are a long-term solution to a missing tooth that can last for many years if cared for and maintained properly. However, the surgery is a complex procedure that requires you to have healthy gums and bone density before beginning. In some specific situations, a dentist may need to perform other preparatory procedures before the implant is installed so they can ensure that things go smoothly.
Dental implants offer all kinds of benefits, though. They’re strong and long-lasting, and look and feel just like your natural teeth. They can offer improved appearance by replacing a missing or damaged tooth and can help prevent further dental diseases or conditions from developing. This makes them a popular choice for replacing a missing tooth!
Does Insurance Cover Dental Implants?
Unfortunately, there is no one-size-fits-all answer to this question. The extent of your coverage greatly depends on your specific plan or policy and the details included. In general, many plans do cover some or all of the cost of dental implants, but there are often restrictions involved. The Canadian Government typically doesn’t provide dental insurance—instead, it’s often offered by private insurance or through employee benefit packages.
It’s important to look into your policy to determine what’s covered and how much of the cost will be taken care of. Oftentimes, a package will offer coverage for cleanings, X-rays, and fillings, but has certain limitations when it comes to more advanced procedures like implant installation.
There are some factors that are taken into consideration to determine whether or not a policy will cover the implant, like:
The reason for the implant, and whether it’s a cosmetic or medical need
What type of implant will be installed
The patient’s medical history
For example, insurance plans may cover an implant that’s necessary due to injury or disease, but not if it’s simply for cosmetic purposes. They may also take into consideration the location of the dentist’s office and who will be performing the procedure. Due to how many factors are involved with the installation of a dental implant, it can vary whether or not the insurance policy will cover an implant.
This makes it extremely important to discuss your options with your dentist. They can also give you a quote so you have additional information to provide your insurer. By discussing payment information and options with your dentist, you can make an informed decision about the implant.
Are Children Covered by Dental Insurance in Canada?
Typically, children are covered by some form of provincial program that is publicly funded. For example, the Alberta Child Health Benefit provides some free dental services for children aged 17 and younger.
Additionally, children may be covered by their parents’ employee benefits package or through a private insurance plan. It’s important to note, though, that even if a child is covered by their parents’ dental insurance, there may be limitations on what services are covered. We recommend you review the details of your individual plan so you can find out what’s covered.
What Affects Dental Coverage in Canada?
Typically, the most important factor to consider is your specific plan. Some plans offer full coverage, while others only cover cleanings or fillings.
Another factor that comes into play is your specific medical history. Certain medical conditions can make it more likely to develop complications due to the surgery, and this could affect your coverage.
And finally, the cost can vary. Some plans have a limit to their percentage of coverage, where they’ll pay for some or most of the implant’s cost but may require you to foot the bill for the rest. It’s always a good idea to speak with both your dentist and insurance provider so you can prepare for possible out-of-pocket costs.
Alternatives to Dental Implants
When it comes to replacing a missing or damaged tooth, there are alternatives to dental implants. For example, bridges can be installed—these are artificial teeth placed between 2 existing teeth that serve as anchors. These are typically made of porcelain and are often more affordable than implant surgery.
Another option that exists is dentures, which are removable artificial teeth. These can be held in the mouth through a variety of ways and are custom-made for your specific oral needs, and are often the most affordable option for replacing missing or damaged teeth. Both dentures and bridges are excellent ways to replace a tooth, but they often aren’t as long-lasting as dental implants.
Reach Out to Your Trusted Dental Team
When it comes to implant installation and insurance, the most important thing is to be informed before making a decision. You should openly communicate with your dentist and ask questions, and research your specific insurance plan in full. By learning what will be covered and having answers to any questions you may have, you can make the best decision for your oral health.
Schedule an appointment with us here at Symmetry Dental today to speak with an educated and caring professional about your options for dental implants!
Dental insurance coverage in Canada is a complex landscape with various factors influencing what is covered, the extent of coverage, and who is eligible for it. One specific area of interest for many individuals is the coverage for dental implants. Dental implants are a popular and effective solution for replacing missing teeth, but their cost can be a concern for many patients. Understanding how dental insurance works in Canada, what factors affect coverage, and whether children are covered is crucial for making informed decisions about dental care. Dental Insurance in Canada: Unlike some countries where dental insurance is part of a comprehensive healthcare plan, in Canada, dental insurance is typically offered separately. The Canadian government does not provide universal dental insurance. Instead, individuals can obtain dental insurance through private insurance providers or as part of their employee benefit packages. These insurance plans can vary significantly in terms of coverage, cost, and the specific dental services they cover. Coverage for Dental Implants: Dental insurance plans in Canada often cover some or all of the costs associated with dental implants, but there are typically restrictions and limitations. Basic dental services such as regular check-ups, cleanings, X-rays, and simple fillings are commonly included in insurance plans. However, more advanced procedures like dental implant installation may be subject to different terms and conditions. The extent of coverage can depend on various factors. Factors Affecting Dental Implant Coverage: Purpose of the Implant: One of the most significant factors that can influence whether a dental implant is covered by insurance is the reason for the implant. Insurance plans are more likely to cover implants that are deemed medically necessary due to an injury, congenital defect, or certain health conditions. In such cases, the implant is considered a vital component of the patient’s overall health and well-being. Type of Implant: The specific type of dental implant may also influence coverage. Some insurance plans may have preferences for certain implant types, and coverage might be more extensive for commonly used implant systems. Patient’s Medical History: Insurance providers often consider the patient’s medical history. Certain medical conditions or pre-existing oral health issues can make it more likely that complications may arise during the surgery. In such cases, insurance plans may adjust their coverage terms accordingly. Dentist’s Location and Qualifications: The location of the dentist’s office and the qualifications of the dental professional performing the procedure can also impact coverage. Some insurance plans may have preferred networks of dentists or specific geographic coverage areas. If your chosen dentist is out of network, it might affect coverage. Cosmetic vs. Medical Need: Insurance plans typically distinguish between cosmetic and medically necessary procedures. While implants needed to restore normal oral function or address health issues are more likely to be covered, purely cosmetic procedures may not be eligible for coverage. Discussing Coverage with Your Dentist: To navigate the complexities of dental insurance and the coverage for dental implants, it is crucial to have open and honest discussions with your dentist. Your dentist can evaluate your specific needs, explain the reasons for the implant, and provide you with a cost estimate for the procedure. Having this information can help you make an informed decision about how to proceed and what to discuss with your insurance provider. Out-of-Pocket Costs: Even if your dental insurance covers a portion of the dental implant procedure, there may still be out-of-pocket costs for you to consider. Many insurance plans have limits on the percentage of coverage they provide, meaning they will pay for a certain percentage of the implant cost while you are responsible for the rest. Understanding the potential out-of-pocket expenses is crucial for financial planning. Children’s Dental Coverage in Canada: Dental coverage for children in Canada can vary depending on several factors. Typically, children are covered by provincial programs that are publicly funded. These programs offer some free dental services for children up to a certain age. For example, the Alberta Child Health Benefit extends coverage to children aged 17 and younger. However, even with provincial coverage, there may be limitations on the services provided. Parental Coverage: Children may also be covered by their parents’ dental insurance plans, either through employer-sponsored benefit packages or private insurance. However, the extent of coverage can vary, and parents should thoroughly review the details of their individual plans to understand what dental services are covered for their children.
Factors Affecting Dental Coverage in Canada: Several factors can affect dental coverage in Canada: Type of Insurance Plan: The primary factor is the type of insurance plan you have. Some plans offer comprehensive coverage, while others may be more limited, primarily covering basic dental services such as cleanings and fillings. The more extensive the coverage, the more likely it is to include advanced procedures like dental implants. Medical History: The patient’s medical history plays a significant role. Certain health conditions, such as diabetes or heart disease, may increase the risks associated with dental surgery, which can affect insurance coverage. Insurance Provider Policies: Different insurance providers may have varying policies and preferences when it comes to dental implant coverage. It’s important to understand your provider’s specific terms and conditions. Cost of Procedures: The cost of dental implant procedures can vary based on factors such as the type of implant, the complexity of the case, and the geographic location of the dental practice. Insurance plans may have different limits and thresholds for covering these costs. Coverage Limits: Many dental insurance plans have coverage limits, meaning they will pay for a certain percentage of the cost, up to a specified maximum amount. Beyond this limit, the patient is responsible for the remaining costs. Dentist’s Network: Some insurance plans have preferred networks of dentists or dental specialists. If your chosen dentist is within the network, you may receive more extensive coverage. Going out of network may affect coverage terms. Emergency vs. Preventative Care: Dental insurance often emphasizes preventative care, such as regular check-ups and cleanings, as these measures can help avoid more extensive and expensive treatments. Emergency procedures, like dental implants due to injury or disease, may be more likely to receive coverage. In conclusion, dental insurance coverage for dental implants in Canada is a multi-faceted subject that depends on the type of insurance plan, the specific circumstances of the patient, and the purpose of the implant. Understanding the coverage terms, discussing your situation with your dentist, and being aware of potential out-of-pocket costs are essential for making informed decisions about your oral health. Additionally, children’s dental coverage in Canada is available through provincial programs and parental insurance plans, but the extent of coverage can vary. To ensure that you and your family have adequate dental coverage, it’s crucial to review the details of your insurance plan and communicate effectively with your healthcare providers. Dental care is a vital aspect of overall health, and being well-informed about your insurance options is the first step in maintaining good oral health and a confident smile.
Dr. Saleema Adatia earned her Doctorate of Dental Medicine (DMD) from Tufts University in 2006. Since then, she’s been committed to serving her patients’ needs with the utmost passion. Dr. Adatia has owned and operated Symmetry Dental since 2013 and has integrated high-quality services with friendly care into the philosophy of the practice.
With a goal of providing the best patient care possible, Dr. Adatia ensures that her practice stays up to date with the latest dental technologies and techniques. Her personal passion for dentistry stems from a desire to create a positive impact on each patient’s quality of life. Whether that means treating people’s pain or restoring function and beauty to their smiles, the goal is always the same: to help make patient’s lives just a little bit better by working together in harmony.