Federal dental insurance plan to be phased in in 2024, with benefits starting in May

Ottawa –

The new federal dental insurance program will be phased in in 2024, with the first claims likely to be processed in May, government officials said ahead of the official announcement Monday morning.

Officials said in a briefing provided to The Canadian Press that applications are expected to open as early as next week, starting with eligible seniors aged 87 and older, but it will be several months before they start receiving benefits. Not to be named.

The insurance plan is a condition of the Liberals’ supply and confidence deal with the NDP to secure support for the opposition party on key votes.

The agreement calls for the creation of a program to provide dental benefits directly to low- and moderate-income Canadians without private insurance.

Eligibility will be gradually expanded over the year to include all eligible seniors over 65 by May 2024, then children under 18 and people with disabilities by June.

The first people in the program are expected to begin applying for dental services in May.

The government’s goal is to make the program available to all eligible Canadians by 2025.

Once the program is fully expanded, it will cover approximately 9 million people, making it the government’s largest social program. The budgeted cost for the first five years is $13 billion.

To be eligible, applicants must be Canadian residents with a household income of less than $90,000 and without private insurance. Those whose annual household income is less than $70,000 will have no deductible.

Eligibility for people with disabilities will depend on whether they have a valid disability tax credit, at least until the program is expanded to all people below the income threshold.

The Liberals’ deal with the NDP calls for launching the program by 2024 for seniors, children under 18 and people with disabilities.

Although registration will be phased in over the next year, NDP health critic Don Davis said his party is excited to launch a concrete plan before the deadline, especially if a gradual approach means a smoother rollout.

“If you think back to the beginning, people thought there were constitutional barriers, they thought the pace of it was too ambitious, they didn’t think the stakeholders would cooperate,” Davis said in an interview Sunday night.

“Today, we are on the eve of the largest expansion of the health care system in a generation.”

The NDP pledged to carefully monitor the plan and called for regular reviews to track what is working and what isn’t.

Services provided, including preventive dental cleanings, treatments and removable dentures, will closely mirror those provided to registered First Nations and Inuit people under the Uninsured Health Benefits Plan.

Cosmetic dental procedures are not covered.

Davis said the new program is very similar to the NIHB, but they also draw some lessons from federal programs for First Nations and Inuit people.

“We have to make sure that this plan is actually implemented effectively,” Davis said.

“What I hear over and over again about current federal programs is that administrative inefficiencies are a real impediment. So we want to make sure that when we design it from the ground up, it’s efficient, equitable and comprehensive.”

Once the new federal program is up and running, people will be able to hand their benefit cards to registered dental care providers who will submit claims on their behalf.

The Liberals want the coverage to be consistent with existing federal and provincial dental health benefits, but the government is still negotiating with the provinces over which program will be the primary payer.

People receiving existing federal dental benefits, including refugees, veterans and First Nations, will still be eligible for the new federal program. So far, there are no plans to merge the plans.

The government signed a $750 million contract with Sun Life Insurance Company of Canada to manage claims. Procurement Minister Jean-Yves Duclos previously announced a $15 million deal with the company, laying the groundwork for work in September.

A copy of the agreement obtained through Access to Information Legislation shows work includes preparing to recruit dental care providers and establishing a website and call center to answer questions from oral health providers and plan members.

The government expects to start mailing letters to the first potential applicants next week and has set up its own call center to recruit seniors to the program.

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

Once the government confirms the applicant’s eligibility, Sun Life Financial will begin the registration process.

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

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