Eligible seniors are now receiving letters inviting them to join Canada’s $13 billion national dental plan, but there’s a catch.
Those who currently have private dental insurance are not eligible for the national plan.
And according to a government website To explain the plan, anyone who opts out of “available benefits” is “still considered to have access to dental insurance.”
This appears to mean that switching from a private to a public plan is not permitted. But the office of the Federal Minister of Health has not yet clarified the rule.
The uncertainty has older people with minimal private dental cover, or those who have signed up for a scheme themselves, wondering if they are being left behind.
“There are double standards,” said Richard McDonald-Donaldson, 71, who pays $180 a month for a private insurance plan he purchased.
Starting in May, Canadian residents aged 65 and older in households earning less than $90,000 per year will be able to have part or all of their routine dental care paid for through the Canadian Dental Care Plan . Work as scaling, fillings, root canals and dentures Will be covered.
But you cannot qualify for the new national scheme if you already have private dental insurance through your employer, pension or other body, or through a scheme you have taken out yourself.
“I thought, well, maybe I’ll give up my dental plan. It’s costing me a fortune. And then I’ll qualify,” McDonald-Donaldson said. “But apparently that’s not the case.”
McDonald-Donaldson said it didn’t seem fair that seniors like him were forced to continue paying for private insurance.
“The rules seem to be detrimental to someone who has made the effort to try to get their own insurance to avoid some problems later with their teeth,” he said.
“There is something wrong with this system.”
CBC News has heard from many seniors wondering what would happen if they ditched their existing dental plan and sought to join the public plan.
CBC News asked Health Canada and Health Minister Mark Holland’s office to explain how dropping an existing private insurance plan would affect a person’s eligibility for the national dental plan, but did not receive a response.
“The Canadian Dental Care Plan aims to help nearly nine million Canadians who do not have access to dental insurance,” said a statement from Holland’s office.
St. Thomas, Ontario. retiree Doug Carter has little dental coverage through his former employer, a plan he says only reimburses him for basic dental care at the rate the procedures cost in 1988. He said he needs of a replaced tooth, but his insurance would not cover it. .
“It really makes me think, what am I going to do? Four thousand dollars is a lot to pay,” Carter said.
“I don’t think it’s fair because, if you have almost nothing in the media coverage, it’s just taking a whole section of people and saying, ‘Who cares.'”
Seniors should have the option to ditch their private insurance plan for the national plan, Carter said, “if the plan they have is bad enough…In this case, this one is.”
Ottawa must explain the rules, says expert
An expert on dental care programs says Ottawa needs to provide answers.
“The policy approach may not completely cover all the situations at play here,” said Dr. Carlos Quiñonez, chair of dentistry at Western University in London, Ont.
“Could it be that I can opt out of my plan, and then there is a waiting period that I would have to follow before I can then receive coverage through the federal plan?
“These are important questions that need to be clarified.”
Quiñonez said if the intention is to reduce financial barriers to dental care, Ottawa should address the problem of “underinsurance” – people on minimal private dental plans who cannot afford to pay. necessary work that their plans do not cover.
Still, any government plan will need to set limits and rules in order to operate within allocated funds, which will inevitably leave some people behind, Quiñonez said.
“There will always be winners and losers. I know it doesn’t sound nice, but it’s reality,” he said.
For now, Quiñonez said he advises seniors to keep their current private dental insurance plans until the federal government provides more clarity.
Do you have questions about how Canada’s new dental plan might affect you? Email Ask@cbc.ca.