Provinces are reviewing their own dental care programs as Ottawa announces federal plan
Ottawa wants premiers to maintain other publicly funded programs — but will they?
When he announced the federal government's $13-billion dental care insurance plan, Health Minister Mark Holland said the new program is meant to "fill the gaps" — not to replace existing provincial programs.
He said the premiers shouldn't "shove" dental costs onto Ottawa's lap now that the federal government has a program to help the estimated nine million Canadians who don't have dental insurance.
But some provinces tell CBC News they are reviewing their own dental plans now that another level of government is willing to pick up the tab for eligible low- and middle-income Canadians.
A move to wind down provincial programs could push up the price tag of the federal program substantially. Ottawa's dental program is expected to cost the treasury about $4.4 billion a year after the initial $13 billion tranche is spent.
There are still many details to sort out before the program's launch — including how many oral health professionals will accept the federal insurance plan (Holland has said he's optimistic) and how the tangle of dental plans will apply (if it all) when a patient's bill comes due.
A spokesperson for Mark McLane, P.E.I.'s health minister, said there will be a change to how dental bills are covered in that province once Ottawa's program is up and running.
"The federal Canadian Dental Care Plan will be the payor of first resort, while the provincial plan will be the payor of last resort," said Samantha Hughes.
That means the federal plan will pick up the costs for eligible patients who go to a dentist, hygienist or denturist, while the P.E.I. program could be invoked to cover some other costs.
It's not clear that P.E.I. will have to pay much. The province's program is not nearly as generous as the one Ottawa is set to roll out next year.
To qualify for the new federal dental plan, applicants must have an annual adjusted family net income under $90,000 and no access to private insurance.
For families with household incomes under $70,000, there's no co-payment — Ottawa pays for the covered services in full.
There's a 40 per cent co-pay for people with household incomes between $70,000 and $79,999. The co-pay jumps to 60 per cent for families with incomes between $80,000 and $89,999.
P.E.I.'s program has different income cutoffs based on family size. The highest net income that would still allow Islanders to qualify for dental coverage is $68,914 for a family of five or more. And that only allows the family to claim 20 per cent of their dental-related costs.
"The intention is to ensure the federal and provincial plans are coordinated, so that there is a seamless provision of benefits to clients, and so that clients who are currently eligible for benefits under the provincial plan will not see a decline in the benefits they receive. That work is ongoing," Hughes said.
Alberta has its own dental program to help some kids and seniors get the oral care they need.
But that coverage is not as comprehensive as Ottawa's planned program.
A single senior in Alberta is eligible for some level of coverage if their income is under $31,675. A senior couple must have an income below $63,350.
The Alberta Child Health Benefit provides benefits to kids who need dental care, prescription drugs or eyeglasses. It pays for basic and preventative dental services like fillings, x-rays, examinations and teeth cleaning for low-income residents.
The Alberta program's maximum income guidelines vary by income and family size.
The highest possible income to qualify for dental coverage is $46,932 for a couple with four children.
A spokesperson for Alberta's Health Minister Adriana LaGrange said the province provides "the most extensive dental coverage in Canada."
Alberta wanted cash, not a new program
The province would have preferred to see Ottawa inject cash into those programs rather than roll out an entirely new insurance-based plan, said spokesperson Charlotte Taillon.
"Low-income Albertans currently receive publicly funded dental care through a variety of low-income health benefit programs," she said.
"Alberta urged the federal government to work with the provinces and territories to improve this existing dental coverage for low-income individuals rather than introduce a new program. We are currently reviewing the federal announcement."
A spokesperson for Ontario's Health Minister Sylvia Jones said there won't be any immediate changes to the provincial seniors dental care program — a relatively new initiative that was launched in 2019 — or a similar plan for kids in low-income households.
"While we await details on the federal program, we will continue to offer the Healthy Smiles program for low-income children under 17 years of age, providing dental care to nearly half a million children and youth in Ontario," Hannah Jensen said.
The Nova Scotia Department of Health and Wellness said through a spokesperson that the province is "currently reviewing the federal dental program details to better understand the impacts it will have on dental programs" in that province.
The federal government says it hopes those provincial programs will remain intact after the provinces have done their reviews.
A spokesperson for Holland said the provinces and territories will be "engaged on the implementation of the (federal) program" and Health Canada is helping to "identify the process for the coordination of coverage" between Ottawa's plan and other publicly funded programs.
The federal government also doesn't want private employer-sponsored plans or out-of-pocket plans to vanish now that there's a robust program slated for a mid-2024 rollout.
"The [Canadian Dental Care Plan] is not intended to be a replacement for existing dental benefits offered through employer/pension or private sponsored plans. However, it is intended for the CDCP to fill existing gaps in coverage and complement existing provincial and territorial dental programs," the federal spokesperson said.
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