Are Dental Implants Covered by Insurance in Canada? Your Comprehensive Guide
Dental implants have helped many Canadians by filling missing teeth with something that really looks and works like real teeth. But with prices reaching thousands of dollars, most people have one big question: Are dental implants covered by insurance in Canada? That’s what we’re going to answer today—no complicated talk, just simple answers. If you’re not sure how to pay for new teeth and want to know if insurance helps, stay with us. This guide covers everything, step by step.
Table of Contents
Introduction: Why You Need This Guide
Let’s be honest: dental implants are pricey. Most Canadians want to know if insurance can help with the bill. But the answer isn’t easy. It depends on your insurance, your needs, where you live, and more. This guide is here to help you understand your choices and protect your wallet. I’ve talked to dentists, insurance workers, and real patients to make sure you get simple, honest advice—so you can feel good about your smile.
What Are Dental Implants and Why Do People Want Them?
Dental implants are small posts—made from strong metal, usually titanium—that dentists put in your jawbone. After some healing, these posts hold your new tooth in place, like anchors. The process uses things called an abutment and a crown, so your tooth looks and works like a real one. Many Canadians pick implants because:
- They look real
- You can eat and talk better
- They last a long time, sometimes forever
- They help your jaw stay healthy
But here’s the truth: This kind of dental work is expensive—anywhere from $3,000 to $6,000 for each tooth, and it can cost more if you need extra things like bone repairs. That’s why people ask, “Is there insurance for this?”
The Short Answer on Insurance Coverage in Canada
If you want the fast answer, here it is: Dental insurance in Canada normally does NOT fully pay for dental implants. Some plans pay a little, some pay nothing. But don’t give up—you may still get some money back, depending on your coverage.
Here’s the main idea:
- Group plans (like work insurance): These have the best chance to pay for part of the bill—maybe half, maybe a bit more, up to a yearly limit.
- Individual plans (the kind you get yourself): These are pickier and may only pay a small part… or none at all.
- Provincial health plans: Almost never pay for implants.
- Full coverage is rare. Partial coverage happens more often.
So, if you hope insurance will pay everything, you might need to lower your hopes.
What Makes Dental Implant Insurance Coverage So Complicated?
Here’s where most people get puzzled. Insurance plans in Canada look at dental implants two ways:
- Medically necessary: If you lost a tooth from an accident or sickness, your plan is more likely to help pay.
- Cosmetic: If you want implants mostly for how your teeth look, and there’s no big health problem, insurance usually says, “No, that’s not covered.”
Even when insurance does help, there are lots of “ifs”:
- Yearly limits: Most plans only pay up to a set amount, like $2,000 each year.
- Deductibles: You pay the first $50–$200 before insurance pays anything.
- Co-insurance: Insurance pays part, you pay the rest.
- Pre-authorization: Most plans want to see your dentist’s plan and a special “code” before saying yes.
It can make anyone confused. But knowing these rules can really help you save.
Types of Dental Insurance in Canada
If you’re unsure about plans, you’re not alone! There are two main types:
1. Employer/Group Dental Plans
Most Canadians with dental insurance get it through work. These plans, run by companies like Sun Life, Manulife, Blue Cross, Greenshield Canada, or Canada Life, are better for big things like implants—but the details change from plan to plan.
Good things:
- Sometimes pay 70–80% for “major” dental work
- Bigger yearly limits
- Shorter wait times
Downsides:
- Still a cap each year
- Rules depend on your boss and your workplace plan
2. Individual Dental Insurance
You buy this yourself. It mainly helps with checkups, cleanings, and small repairs—but is not good for big dental work.
Good things:
- Good for people who work for themselves or are retired
Downsides:
- May not cover implants at all
- Lower yearly limits
- Usually has a longer wait period before you can use it for big things
Key Factors That Affect Your Implant Coverage
Every plan has details, but these main things decide what you’ll get:
Your Policy Details
See if implants are listed under major restorative services (that’s insurance talk for big jobs like bridges, crowns, and yes—implants). Your booklet or online account should show this.
- Yearly Limits: Most are between $1,500 and $2,500 per year. When that’s used up, you pay the rest.
- Deductibles & Co-insurance: If your plan pays 70%, and you also pay the first $100, the total can add up fast.
- Component Coverage: Some plans split what’s covered. For implants, sometimes they pay for the crown but not the post, or just one part.
Pre-Authorization Requirements
Always—always—ask your dentist to send the price and x-rays to your insurance for approval before you start. If you skip this, you might have to pay the whole bill yourself.
Waiting Periods
Just started a new plan? You may need to wait 6–12 months before it pays for big jobs.
Medical Necessity
When your dentist writes “medically needed” on the claim, and explains it well, you might get more money back. Have your dentist include Canadian Dental Association (CDA) codes and lots of notes.
Regional Differences
Live in Ontario? Alberta? Quebec? While provincial health plans do not pay for implants, some programs for low-income people (like ODSP in Ontario) might help with dentures, tooth pulling, or only if there’s a very serious need for implants.
Who are the Major Insurance Providers, and What Do They Offer?
Most work plans in Canada are from a few big companies. Here’s what you should know:
Sun Life
Often covers implants as “major dental” for group plans. How much they pay and the limit depends on your work plan.
Manulife
It’s similar—some group plans help pay for implants. Manulife’s own plans for individuals mostly do not.
Blue Cross, Greenshield Canada, and Canada Life
These companies have both group and individual coverage. Some work plans pay for part of implants. But you REALLY have to check your own plan—there is no “one-size-fits-all.”
Tip: Always get a clear plan from your dentist and call your insurance company with the codes.
I once saw a patient use a health spending account at work to help pay for an implant. He put the cost across two years, stayed under his yearly limit each time, and got back more insurance money that way. Planning helps a lot!
Do Provincial Health Plans Help With Implants?
People ask this a lot. Here’s the short answer: provincial health plans (like OHIP in Ontario or Alberta Health) do not pay for dental implants. They say it’s not a basic need.
There are a few rare times when they’ll help:
- If you get a low-income program like ODSP in Ontario, you might get help with simple dental care (like pulling teeth, dentures), but not implants unless there’s a serious health reason.
- Senior dental programs in some areas help with cleanings and simple bridges—but almost never with implants.
For most people, government help is very limited.
How Do You Get the Most Out of Your Insurance?
Here comes the good part—what can you do to get more from your plan?
Get a Clear Plan
Have your dentist make a plan, with codes and prices listed (post, abutment, crown, and any bone grafts). Share this with your insurer before you start.
Pre-Authorization is Important
Don’t skip this! Send in your plan for approval. This way, you know how much insurance will pay (if any) and won’t get a bad surprise.
Watch Your Yearly Limit
If the cost is more than your yearly max, see if you can space the work over two years. For instance, put in the implant in December, place the crown in January. That way you get more back from insurance.
Use Spending Accounts
Does your work offer a health spending account or flexible spending account? These can help pay for implants, often before taxes.
Try Other Choices
If coverage isn’t enough, ask your dentist about bridges or dentures. Some plans pay more for these.
What If Insurance Won’t Pay? Other Ways to Afford Implants
So your insurer said no, or the help isn’t enough? Here’s what I’ve seen help real people:
Dental Clinic Payment Plans
Ask your dental office if they let you pay monthly. Many do!
Medical Loans or Credit
Some lenders in Canada offer help for health and dental bills.
Personal Savings
Some people save up, or use tax write-offs (sometimes you can claim part of your dental work as a medical expense on your taxes).
Use Good Dental Labs
Working with a china dental lab or a digital dental lab can sometimes make part of the treatment cheaper, especially for big or tough cases.
Common Terms Explained Simply
Insurance talk can sound like a secret language. Here’s what their words mean, in plain English:
| Term | Meaning in Simple English |
|---|---|
| Major Restorative | Big dental work like implants, bridges, dentures |
| Annual Maximum | The most insurance will pay for you in a year |
| Deductible | First money you pay before insurance helps |
| Co-insurance | The percent you still have to pay |
| Waiting Period | How long you wait before the plan pays for big stuff |
| Pre-Authorization | You need to get approval before treatment |
| CPT/CDA Code | Each dental job has its own code for insurance |
Learning these makes your policy booklet easier to read!
Your Step-by-Step Plan to Check Your Coverage
Follow these steps so you know the real deal—before you sit in the chair.
- “Are implants covered?”
- “What percent will you pay?”
- “What is my yearly max?”
- “Do I need pre-approval?”
FAQ
Q: My friend’s plan paid for implants, why won’t mine?
Every plan is different. It depends on your job, your insurance plan, and what you pay each month. Don’t guess—always check.
Q: Why do I have to wait 12 months for coverage?
Many plans add “wait times” to stop people from buying insurance, getting one big job, and then quitting.
Q: My dentist says I need a bone graft. Will insurance help?
Some plans pay for bone work as part of getting an implant, but many don’t. Ask for codes and check before you start.
Q: Can I ask insurance to look again after they say no?
Yes! Your dentist can send more notes or write a letter about why you need the work. Sometimes, a second try works.
Q: Are there cheaper ways to get implants?
Asking about labs or clinics for better implant dental laboratory prices may help lower some of your costs.
Summary: What You Should Remember
- Most dental insurance in Canada only pays for part of dental implant costs. Full payment is rare.
- Group plans (from work) give you a better shot than buying your own.
- Yearly limits and “extras” mean you’ll pay some out of pocket.
- Pre-approval is key. Get insurance to agree before you start.
- Provincial health plans won’t pay for implants, but some special programs might help with other things.
- If insurance isn’t enough, look into payment plans, health spending accounts, or find affordable lab options like a zirconia lab.
- Take time to read your rules, call your insurer, and plan first—so your new teeth don’t cost you too much!
Dr. Joe Dental and our research team checked this article for being accurate and useful.
Don’t let insurance confusion stop you from getting the care you need. Ask lots of questions, do your homework, and talk to your dentist. A bit of work now can save you from big bills and headaches later!
