What is the Ontario Seniors Dental Care Program?
In November 2019, the government launched the Ontario Dental Senior Care Program. The ODSCP covers basic dental services for low-income seniors in Ontario in an effort to reduce dental related emergency room visits. The budget was announced to be over 90 million yearly.
2. Who is eligible for the Ontario Dental Seniors Care Program?
Senior dental program eligibility:
65 years or older
Net annual income less than $19 300 (single senior) or combined income of $32 3000 (senior couple)
No access to any other form of dental coverage (private insurance, Ontario Disability Support Program, Ontario Works or Non-Insured Health Benefits program)
3. How do you apply for Ontario Dental Seniors Care Program?
Eligible applicants must complete an Application Form which can be found at: https://seniors.accerta.ca/application/en
The application form includes the following information: name, social insurance number (in order to verify annual income from latest tax return), date of birth, telephone number, mailing address, and signature consenting to the programs terms.
If the applicant is married, the above information must also be including in order to verify that the combined spousal income fulfills the program requirements.
The application will be mailed to:
Ministry of Health
Ontario Seniors Dental Care Program
Station P, P.O. Box 159
Toronto ON M5S 2S7
All approved applicants will receive a dental card in the mail. The benefit card will be valid from August 1 to July 31 of the following year. If there are any problems with the application, applicants will be contacted by a program coordinator.
4. Which dental services are covered?
The following basic dental services and examples of code series that are covered under this program
ie. Complete exam (01103) Recall exam (01202), Specific exam (01204), Emergency exam (01205)
ie. Polishing/prophy (11101) Scaling (11112), Fluoride varnish (12113) etc.
Restorative services (fillings)
ie. White filling codes (23321, 23311,23111…) etc.
ie. Periapical (02111) and Bitewing (02142) etc.
Oral surgery services to remove teeth or abnormal tissue.
ie. Simple extraction (71101), Complicated extractions (71201) etc.
ie. Nitrous oxide (92411 etc)
Endodontic services to treat infection and pain(e.g., root canals)
ie. Pulpectomy (32311), Root canals (33111) etc.
Periodontal services to treat gum conditions and diseases.
Dentures are also covered to a certain extent.
For more information on dental service codes and how to interpret them, please visit the following articles: https://dentalcodelookup.ca/how-to-interpret-canadian-dental-codes/, https://dentalcodelookup.ca/the-10-most-commonly-used-codes-for-the-general-dentist
5. Where can patients receive dental services?
An important point to know about this program for health care providers is that seniors who have coverage through the ODSCP program are not able to receive coverage for these services in private dental clinics. As it stands, ODSCP covered patients must receive dental services through their local public health unit, partner Community Health Centers or partner Aboriginal Health, Access Centers. Although the program may expand to offer services through dentists in private practice in the future.
A list of public health units in your area can be found at: http://www.health.gov.on.ca/en/common/system/services/phu/locations.aspx
For more information on this program, please visit the following sites:https://www.ontario.ca/page/dental-care-low-income-seniors, https://www.wechu.org/dental/ontario-seniors-dental-care-program