The guide below will give you all the relevant information to know about dental health insurance in Quebec and will allow you to understand and find the best dental insurance in just a few minutes!
Dental insurance in detail
What is the definition of dental insurance?
Dental insurance is a form of private dental insurance that is used to cover a good portion of dental costs for you or your family.
It covers problems related to teeth and gums, as well as preventive care such as annual cleanings.
However, family dental insurance can be more advantageous than individual dental insurance. By grouping all the members of the family on a single plan, the price per person is considerably reduced.
How does dental insurance work?
Dental insurance coverages help many people cost-effectively budget the cost of maintaining a beautiful smile.
Here is how dental insurance works.
- First, you select a dental plan based on your needs. The chosen plan can be individual or family.
- Then you pay for your insurance policy with a monthly premium and you receive coverage for some of your medical expenses.
- Monthly premiums will depend on the insurance company, your location, and the plan you choose.
- Dental policies are contracts between you and an insurance company.
- Most policies are simple and specific regarding the procedures covered and the exact amount you must pay out of pocket.
Dental insurance is available as part of medical insurance plans, but rarely as a standalone policy.
How much does dental insurance cost?
The price of dental insurance varies according to the treatments covered, the maximum amount reimbursed, the type of coverage, the age of the insured, and the current offer of insurers.
The average cost of dental care can vary greatly from city to city. For example, cleaning can cost $75 in Shawinigan compared to nearly $190 in Montreal.
You agree to pay an annual or monthly fee called a dental insurance premium, and the company agrees to pay the benefits that are insured under the policy.
For many people, the monthly premium for men starts from $47.26 per month. While for women, the monthly price starts from $57.61 per month.
Most policies do not cover all medical costs, and sometimes we have to pay the annual deductible. You may have to pay part of the medical costs for yourself and your dependents.
What types of dental insurance plans are available?
There are many types of dental insurance plans, but they all share a common goal: to help you pay for the cost of dental care.
Some plans are designed for people who don’t have dental insurance, while others are for people who already have coverage.
The dental insurance plans are:
- Individual dental insurance plans
- Group dental insurance plans
- Government dental insurance plans (RAMQ)
Individual dental insurance plans are designed for people who do not have dental insurance through their employer or who are self-employed. These plans typically offer a variety of dental coverage options, including preventative care, major dental procedures, and orthodontics.
Group dental insurance plans are offered by employers to their employees.
The RAMQ administers the public drug insurance plan, but insurance covering drugs is also offered by private plans.
On the other hand, if you would simply like to have dental insurance protection, basic dental insurance coverage would be offered to you.
You may need dental insurance if you:
- are not eligible for benefits offered through your employer.
- are self-employed.
- retire.
- lose your protection.
What is the waiting period for dental insurance?
Most dental insurance policies have waiting periods ranging from two to four weeks before standard work can be performed.
Depending on the insurance company, the waiting period for dental insurance or for major care can start from the second year.
These periods are set by insurers to ensure they benefit from a new account and to discourage people from applying for a new policy to cover impending proceedings.
Why is dental care important?
Oral health and regular visits to the dentist are integral to overall good health. These visits help keep your teeth healthy, which affects your overall health.
The Canadian Dental Association recommends a visit every six months. Many Quebecers do not respect this recommendation and they do not have coverage for dental care.
Oral problems such as cavities or gingivitis can be very bothersome. They can also get worse and lead to repeated infections, hence the importance of having your teeth checked by a dentist.
At every stage of your life, the health of your mouth is important. Removing plaque and tartar, detecting problems early, and paying particular attention to your oral health are other important reasons for these visits. Children and adults should visit the dentist regularly in order to get the proper care.
Basic services covered include the following:
- Visits to the doctor;
- Hospital visits and stays;
- Travel for health care for residents of Quebec
In general, the RAMQ card does not cover the following:
- Prescription drugs prescribed in a non-hospital setting, including antibiotics, pain relievers, and certain drugs to treat cancer;
- Special non-emergency medical services, including those of a chiropractor or massage therapist;
- Single and double bed hospital rooms;
- Certain medical examinations, tests, and vaccinations;
- Dental care.
What is the best dental insurance in Quebec?
In order to choose the best private dental insurance, it is important for the subscriber to assess his real needs in this area.
Most insurances offer at least basic dental coverage. Some plans only pay for preventive care, while others have more extensive coverage.
In some dental insurances cleanings, X-rays, crowns, dental extractions, dental prostheses, gum treatments, etc. are included.
However, cosmetic procedures, such as tooth whitening or cosmetic orthodontics, are not.
You will be able to determine which private dental insurance best meets your oral health needs by consulting your dental treatment plan submitted by your dentist and the estimated cost of your dental expenses.
Are all dental treatments reimbursed?
Reimbursement depends on the insurance company and coverage chosen. In most cases, a good part of the dental care is reimbursed and it must appear on the list of acts and services reimbursable by the Health Insurance.
For example, voice services supported by insurers :
- Reimbursement of expenses not covered by the RAMQ card, such as those relating to dental care, medication and professional fees, and vision care.
- Automatic routing of certain dental claims.
- Possibility of paying for your coverage by pre-authorized debit.
Types of dental insurance coverage
Choose between four types of protection:
- Individual
- Couple
- family
- single parent
How to get a free dentist?
To be eligible for free dental care, you must have been a recipient of the Social Assistance Program or the Social Solidarity Program for at least 12 months, without any interruption.
The Temporary Reimbursement Program for certain dental services, Canada Dental Benefits, Project Mouth B Dental Insurance, dental clinics in faculties of dentistry is other solutions for having a free dentist.
How does the RAMQ work?
The RAMQ administers the health insurance plan. Those who are eligible and enrolled in the plan can benefit from various covered health services.
You could be eligible for health insurance if you settle, live or stay in Québec. In addition, you must respect the rules of presence in Quebec to remain eligible.
The services covered by the health insurance plan are paid for by the RAMQ when they are rendered to the insured persons. No fees may be charged for these services by health professionals participating in the plan.
What is free dental care with the RAMQ?
Dental care for oral surgery in a hospital setting is free for all beneficiaries of the RAMQ plan who present a valid health insurance card. This also includes related examinations, local or general anesthesia, and x-rays.
- bone graft,
- drainage of an abscess,
- removal of a cyst or tumor,
- reduction of a fracture,
- laceration repair,
- jaw repositioning,
- treatment of inflammation of a bone,
- jaw joint treatment,
- salivary gland treatment.
However, tooth and root extraction services are not covered.
Who benefits from free dental care with the RAMQ?
Dental care is covered by the RAMQ (Régie de l’assurance maladie du Québec) for:
- children aged 9 or under, with a sun card allowing them to benefit from health insurance
- children and adolescents aged 10 to 17 attached to their parents benefiting from a social benefit
- social assistance recipients with a valid dental record.
First Nations and Inuit people are eligible for the Uninsured Health Benefits (NIHB) program provided they meet certain criteria. Only certain dentists, however, accept reimbursements made by the NIHB program.
Who does not benefit from dental care reimbursed by the RAMQ?
Persons residing in Quebec who are not eligible for the RAMQ plan are:
- people who already have private health insurance covering dental care, through their employment, that of their spouse, or by voluntary subscription to dental insurance
- Quebec residents who are not covered by RAMQ or private insurance.
How do I know if a drug is covered by RAMQ?
The public prescription drug insurance plan covers more than 8,000 drugs. The medications and the conditions of coverage are presented in the List of medications
There are certain conditions for the drug to be covered:
- You must have purchased the drug in Quebec
- The medication must be on the list of covered medications
- The drug must have been prescribed by a doctor or health care professional
- Medicines sold at the lowest price (ex: coverage of the cheaper generic copy instead of the brand name medicine)
