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    Patient Education

    How much does a Dental checkup cost in Toronto? Is it covered by insurance? Is it covered by OHIP?

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    By Mandeep Singh

    If you’re wondering about the cost of a dental checkup in Toronto, you’re not alone. Many people have questions about the cost of dental care and whether or not it is covered by insurance or OHIP. In this blog post, we’ll explore these questions in more detail and provide some information about understanding your insurance coverage.

    The Cost of a Dental Checkup in Toronto

    According to the Canadian Dental Association (CDA), the cost of a dental checkup in Toronto can vary depending on a number of factors. These include the type of dental practice you visit, the services you need, and your location.

    Generally speaking, a routine dental checkup in Toronto for an Adult can cost anywhere from $250 to $350. This includes a visual exam of your teeth, gums, and mouth, as well as a cleaning to remove plaque and tartar build-up. Depending on your needs, your dentist may also recommend additional services such as additional units of scaling, X-rays, fillings, or extractions, which can increase the overall cost of your visit.

    Is Dental Care Covered by Insurance?

    Many dental insurance plans cover at least a portion of the cost of a routine dental checkup. However, the amount of coverage you receive will depend on your specific plan and the services you need.

    According to the Ontario Dental Association (ODA), most dental insurance plans have annual maximums that limit the amount of coverage you can receive each year. For example, your plan may have a maximum benefit of $1,000 per year, which means that you will only receive coverage up to that amount.

    In addition to annual maximums, most dental insurance plans also have deductibles that you must pay before your coverage kicks in. For example, you may have a deductible of $50 per year, which means that you will need to pay for the first $50 of dental services yourself before your insurance begins to cover the cost.

    It’s important to note that dental insurance plans may also have exclusions or limitations on certain types of services. For example, some plans may not cover cosmetic procedures such as teeth whitening or veneers.

    Is Dental Care Covered by OHIP?

    Unlike many other countries, Canada does not have a universal dental insurance plan. As a result, most dental care is not covered by OHIP (the Ontario Health Insurance Plan).

    However, there are a few exceptions to this rule. Ontario does cover some dental services for children and adolescents. At this time of writing this post, this service is covered under the Healthy Smiles program.

    For children and adolescents, Healthy Smiles program covers a range of preventative and basic dental services, including:

    • Regular checkups and cleanings
    • X-rays
    • Fillings
    • Extractions

    It’s important to note that OHIP coverage for dental services is limited and may not cover all of the services you need. For example, OHIP does not cover cosmetic procedures such as teeth whitening or veneers.

    Understanding Your Insurance Coverage

    If you have dental insurance, it’s important to understand your coverage and what is included in your plan. This can help you make informed decisions about your dental care and ensure that you get the services you need.

    To understand your coverage, you should:

    • Review your policy documents: Your dental insurance plan will have a set of policy documents that outline the terms of your coverage. These documents should include information about your annual maximums, deductibles, exclusions, and any other limitations on your coverage. Make sure to read these documents carefully and ask your insurance provider or dental office if you have any questions.
    • Know your plan’s network: Many dental insurance plans have a network of participating providers, which means that you will receive the most coverage if you visit a dentist who is in-network. If you visit an out-of-network provider, you may have to pay more out-of-pocket. Be sure to check your plan’s network before scheduling an appointment.
    • Understand your copays and coinsurance: Many dental insurance plans have copays, which are fixed fees that you pay for each dental service. For example, you may have a $20 copay for a routine checkup. Coinsurance is a percentage of the cost of a service that you are responsible for paying. For example, if you have a 50% coinsurance plan, you will pay 50% of the cost of a service, while your insurance covers the other 50%.
    • Know what services are covered: As mentioned earlier, not all dental services are covered by insurance. Make sure to understand what services your plan covers and what you will need to pay for out-of-pocket.

    Contact Dr. Abinaash Kaur at The Village Dentist for More Information

    If you have questions about dental insurance or would like more information about understanding your coverage, we recommend contacting Dr. Abinaash Kaur at the Village Dentist in Toronto. Dr. Kaur and her team are experienced in working with insurance companies and can help you navigate the complex world of dental insurance.

    To contact the Village Dentist, you can visit our office at 750 Annette Street in Toronto, give us a call at (416)-760-0404, or send us an email at [email protected]. We look forward to helping you get the dental care you need.

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