The Tooth Corner Dental Offices in Ontario Canada
888-929-2987

DENTAL INSURANCE SPECIFICS

DENTAL INSURANCE SPECIFICS

Does The Tooth Corner bill the insurance companies directly?

Yes, we accept insurance payments directly from the insurance companies. Most insurance companies in Canada allow for this with a few exceptions. The advantage of this is that it allows you to keep your money in your pocket and lets us worry about collecting payment and we’re more than happy to do so. However, you will have to pay your deductible which varies from one insurance policy to another. Call us with the name of your insurance provider for more information.

What’s Non-Assignment?

Only two of our offices are Non-Assignment (The Tooth Corner in Owen Sound and The Tooth Corner on Edward St. in downtown Toronto), and the rest are Assignment offices. Non-Assignment is where you pay us first and then we submit your claim to your insurance company. We do this electronically and on the spot so you don’t have to worry about it. The insurance company then reimburses you for the portion they cover as part of your insurance policy within a few business days. You can receive the money as quick as 2 business days at times.

So let’s say for example your treatment plan ends up costing you $1,000 dollars and your insurance company covers 80% of that. You would pay us the $1,000 dollars, preferably using a rewards card to incur reward points, and in a few business days, you would receive $800 dollars back. If your insurance covers 100% of the treatment plan, then you’ll get your entire $1,000 dollars back. Absolutely, nothing to lose, in fact, there’s something to gain in the process.

There are a few advantages to non-assignment, one of them being getting free reward points on your favourite rewards card. Here’s why the Ontario Dental Association encourages it in their own words:

 

WHY THE ODA OPPOSES ASSIGNMENT

The ODA is opposed to assignment of benefits and actively encourages dental plan sponsors to make their dental plans “non-assignment” plans. Many people wonder why the ODA would oppose a process that many find convenient.

The answer lies in the fact that “non-assignment” dental plans can be less expensive than those that allow assignment, simply because the act of a patient paying for their dental care makes them financially involved in their oral health care. This provides very a good incentive for the patient to use their dental plan wisely. Dental claim reimbursement is much faster than it was years ago, and patients are finding that when they pay the dentist directly their reimbursement cheque is received quickly; greatly minimizing the time they are out of pocket. It is not unusual to see the dentist on Monday and have the reimbursement cheque before the end of the week, thanks to electronic claims submission.

Also, many dentists accept credit cards, which typically have a monthly billing cycle. If complex treatment is necessary, dentists can arrange a payment schedule that allows a patient to budget for expenses and get reimbursement that is more conveniently timed.

Active decision-making about oral health care by patients and meaningful involvement in the financial matters of dental care, including the dental plan, is an important part of achieving excellent oral health care.

Patients with Dental Insurance

At The Tooth Corner, we accept all forms of insurance, both private and government. It’s important for you to be in the know as to which services are covered by your insurance, and how much is covered. Most insurance plans cover up to 80% of general dentistry, oral hygiene, and emergency services. Treatment plans that are cosmetic in nature, such as whitening, implants, veneers, and braces are not typically covered, but you should always double check.

Types of Private Insurance Plans We Accept

For your convenience, below you’ll find the most popular private insurance plans available today and we accept them all. If you don’t see your insurance logo below, don’t be alarmed, we still accept it. We take them all.

Government Insurance Plans We Accept

Some of our offices MAY NOT ACCEPT some of the government insurance plans although the majority do. Please call your dental location of interest to double check. The plans offered to eligible Canadian residents in Ontario are five:

  1. Ontario Works Adult Dental Emergency Program
  2. Ontario Disability Support Program (ODSP)
  3. Healthy Smiles Ontario Program (HSO)
  4. Interim Federal Health Program (IFHP)
  5. Non-Insured Health Benefits (First Nations & Inuit)

Ontario Works Adult Dental Emergency Program

The Tooth Corner accepts the Ontario Works Adult Dental Emergency Program and is eager to help OW patients take care of their dental needs. Make sure you bring your Ontario Works paperwork with you when you book your appointment.

What services are covered under the Ontario Works program?

The Ontario Works adult dental emergency program covers basic treatment for dental problems that are considered an emergency. This could involve one or more areas of your mouth. Basic services include fillings, as well as extractions and, are covered completely by the program. Some services require government approval and should be discussed with our reception staff for further information. Generally, if the service you need falls into this category, we will send an estimate out for you. However, the government approval process can take up to four weeks. If you are in pain, prescription medication will often be provided for comfort while the approval process is in place.

Do I have to fill out the government insurance form and send it in myself?

No, our reception staff will gladly submit the paperwork for you. It is our goal to make the process as simple and hassle-free as possible so that you can feel better again.

Are Ontario Works patient appointments booked differently than other appointments?

No, appointments are booked the same regardless of the type of insurance (or no insurance at all).

How often can I come in for an emergency appointment?

The Ontario Works adult dental emergency program generally allows for one emergency checkup every three months.

How do I get approval for an Ontario Works emergency visit?

You can call our office for more information.

Ontario Disability Support Program (ODSP)

This program offers dental services for those approved for the program due to certain eligible disabilities.

Does The Tooth Corner accept ODSP patients?

Although many dentists in Mississauga do not accept the ODSP dental care program, at The Tooth Corner, we’re a dental office that’s glad to do so and in fact, we look forward to assisting all ODSP patients. Just bring your ODSP card with you when you come in and we’ll take care of the rest.

What dental services are covered for my family as part of the ODSP program?

ODSP covers a plethora of services at 100%. This includes things like checkups, xRays, fillings, dental cleanings, root canals and extractions Procedures like dentures, however, are not covered fully. Typically, about 60% of the costs are covered by the program.

Do I have to fill out the paperwork myself?

No, we’ll take care of all that for you, just give us a call to get started.

Do you treat children under ODSP as well?

Yes we do. We’re really good with children and have a lot of experience treating them. We also offer full sedation (sleep dentistry) for younger children with dental anxiety.

Healthy Smiles Ontario (HSO)

The Healthy Smiles Program is an Ontario government-funded basic dental program providing preventive and early treatment services for children and youth in low-income families, who are 17 years of age or under.

If eligible, your children will get regular dental services at no cost to you.

We can help answer your questions and guide you and apply on your behalf.

What services are covered by HSO?

Healthy Smiles Ontario provides routine, preventive, and emergency and essential treatment services to eligible children and youth. Services covered for clients may vary depending on the oral health of the child/youth.

An examination or assessment by a qualified dental provider will determine the type and frequency of services a child or youth may need.

Covered Services Include:

Examinations/assessments
Radiographs (X-rays)
Preventive Services (Cleanings)
Restorative Services (Fillings)
Endodontic Services (Root Canals)
Periodontal Services
Prosthodontic Services
Oral Surgery Services (Extractions)
Anesthesia (Sleep Dentistry)

Interim Federal Health Program (IFHP)

The Tooth Corner is an IFHP or Interim Federal Health program registered health-care provider.

Who is eligible for IFHP?

The Interim Federal health program covers certain health benefits for protected people, including resettled refugees, refugee claimants, and certain other groups until they become eligible for provincial or territorial health insurance.

What dental services are covered under IFHP?

For a complete list of covered services please download the IFHP Dental Benefit Grid here.

Non-Insured Health Benefits (First Nations & Inuit)

The Non-Insured Health Benefits program (NIHB) is specifically for Canadian First Nations and Inuit people. It is provided by the Canadian government and you get an ID card upon qualification.

The Tooth Corner accepts Non-Insured Health Benefits (NIHB) patients

The Tooth Corner is always glad and eager to assist and take care of First Nations and Inuit patient’s needs. As a dental office in Mississauga operating for many years, we are extremely familiar with the program and are happy to answer any questions you may have pertaining to it.

The NIHB program fully covers check-ups, x-rays, oral cleanings, fillings, root canals, extractions, crowns, dentures and more. For intricate services like Crowns and root canals we have to secure prior approval, granted, it’s a pretty straightforward process. In addition, sleep dentistry is also covered for adults under the Non-Insured Health benefits program.

If you are part of the Non-Insured Health Benefits (NIHB) program and would like to set up an appointment or have any questions, please don’t hesitate to call us directly.

Patients without Dental Insurance

At the Tooth Corner, we offer patients without dental insurance, who are undergoing more expensive procedures like cosmetic dentistry for example, comfortable, zero-interest payment plans. Please contact our office for more details, and don’t worry, there’s no catch!

 

Some Popular Insurance Providers