Federal dental insurance program to be phased in over 2024, benefits to start in May

Dental instruments are shown in Oakville, Ont., Wednesday, April 5, 2023. THE CANADIAN PRESS/Staff

Ottawa -

The new federal dental insurance plan will be phased in gradually over 2024, with the first claims likely to be processed in May, government officials said ahead of a formal announcement scheduled for Monday morning.

Applications are expected to open as early as next week, starting with qualifying seniors over the age of 87, but it will take months before they can start to claim the benefits, the officials said in a briefing provided to The Canadian Press on the condition they not be named.

The insurance plan is a condition of the Liberals' supply-and-confidence deal with the New Democrats to secure the opposition party's support on key votes.

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The deal calls for a plan that would offer dental benefits directly to low- and middle-income Canadians without private insurance.

Eligibility will gradually expand over the course of the year to include all qualifying seniors over the age of 65 by May 2024, then children under the age of 18 and people with disabilities by June.

The first people to enrol in the program are expected to be able to start claiming dental services in May.

The government aims to make the program available to all qualifying Canadians in 2025.

Once the program is fully expanded, it will be available to roughly nine million people, making it the government's largest social program. It is budgeted to cost $13 billion over the first five years.

To qualify, applicants must be Canadian residents with a household income under $90,000 and no private insurance. Those with an annual family income under $70,000 will have no co-pays.

Eligibility for people with disabilities will be based on whether they have an active disability tax credit, at least until the program is expanded to all people who fall under the income threshold.

The Liberal's pact with the New Democrats calls for the program to be launched for seniors, children under the age of 18 and people with disabilities by 2024.

Though enrolment will be phased in over the next year, NDP health critic Don Davies said his party is ecstatic to have a concrete program in motion by the deadline, especially if a gradual approach means a smoother roll-out.

"If you think back to beginning, people thought there were constitutional hurdles, they thought that the speed of it was too ambitious, they didn't think that stakeholders would co-operate," Davies said in an interview Sunday evening.

"Here we are today, poised on the eve of the single biggest expansion of the health-care system in a generation."

The NDP have pledged to monitor the program carefully, and have called for regular reviews to track what is working and what isn't.

The services offered, including preventive teeth cleanings, treatments and removable dentures, will closely reflect the services offered to registered First Nations and Inuit people under the Non-Insured Health Benefits Program.

Dental cosmetic procedures will not be covered.

Davies said the new program is closely modelled on the NIHB, though they have implemented some lessons learned from the federal program for First Nations and Inuit people.

"We have to make sure that the plan is really efficiently administered," Davies said.

"That was something I heard over and over again about current federal plans, is that administrative inefficiencies are a real barrier. And so we want to make sure as we design this from the ground up, that it's efficient, it's fair, and it's comprehensive."

Once the new federal program is up and running, people will be able to bring their benefits card to registered dental-care providers who will submit the claim on their behalf.

The Liberals intend the coverage to mesh with existing federal and provincial dental health benefits, but the government is still in the process of negotiating with individual provinces which program would be the primary payer.

People receiving existing federal dental benefits, including refugees, veterans and First Nations people, will still qualify for the new federal program. So far, there are no plans to amalgamate the programs.

The government signed a $750-million contract with Sun Life Assurance Company of Canada to administer the claims. Procurement Minister Jean-Yves Duclos previously announced a $15-million agreement with the company to lay the groundwork in September.

A copy of that agreement, obtained through access-to-information legislation, shows that work includes preparations for enrolling dental-care providers and setting up a website and call centre to answer questions from oral-health providers and plan members.

The government expects to start mailing out letters to the first cohort of potential applicants next week, and has set up its own call centre to enrol seniors in the program.

In May, the enrolment process is expected to move to an online platform.

Once the government confirms the applicant's eligibility, Sun Life will start the enrolment process.

This report by The Canadian Press was first published Dec. 10, 2023.