Bridging the Financial Gap in Dental Care

BC Employment and Assistance (BCEA) Program
The BCEA program assists British Columbians in need and helps people move from income assistance to sustainable employment. Disability assistance is also available to Persons with Disabilities who may be unable to gain independence through employment. (Employment and Assistance Regulations and Employment and Assistance for Persons with Disabilities Regulation define a basic dental services, crown and bridgework supplement, denture supplements, emergency dental and denture supplements, and orthodontic supplement)

Dental Supplements: Different levels of coverage are provided depending on the person’s client category and age. SDPR clients entitled to basic dental services:

• Persons with Disabilities (PWD) in receipt of disability assistance (DA) $1000/2yrs
• Persons with Persistent Multiple Barriers (PPMB) in receipt of income assistance (IA) $1000/2yrs
• Spouses of PWD and PPMB recipients $1000/2yrs
• Persons in above categories who have left IA or DA and meet specific criteria to retain eligibility for health supplements $1000/2yrs
• Children <19yrs who are in a family receiving income, disability or hardship assistance and recipients of Children in the Home of a Relative (CIHR) assistance $2000/2yrs SDPR clients entitled to coverage for emergency dental services:
  • Adult income or hardship assistance recipients who are not otherwise eligible for basic dental services as noted above; and
  • SDPR recipients who are eligible for but exhausted their basic dental services 2 year limit and require emergency treatment for the relief of pain.

• Emergency: diagnostic, restorative, endodontic, periodontal, oral surgery, prosthodontic
• Basic: diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, oral surgery
• Orthodontic services, limited to children <19yrs and adults with PWD designation who meet specific criteria.
• Crown and Bridge, limited to adults with PWD or PPMB designation who meet specific eligibility criteria.
• Denture Supplement: provides access to complete dentures (initial placement) to recipients who are limited to Emergency Dental Coverage only. Specific eligibility criteria apply.

Healthy Kids
The Healthy Kids Program provides coverage for basic dental treatment, optical care and hearing assistance to children in low-income families, who are not in receipt of income assistance, disability assistance or hardship assistance.

Children under 19 years of age, in families approved for supplementary benefits by the Medical Services Plan (MSP) through the Ministry of Health, are automatically registered with the Healthy Kids Program. Children are eligible for $2000 of basic dental services every two years and access to emergency coverage for the relief of pain should they exhaust their two year limit.

Emergency: diagnostic, restorative, endodontic, periodontal, oral surgery, prosthodontic Basic: diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, oral surgery.

Alberta Health- Provincial Oral Health Action Plan.
A provincially standardized plan that provides dental prevention and treatment services to low income and underserved populations. The 5 Regional Health Zones within the province staff, manage and conduct the services. Also provides ongoing support to promote oral health and prevent oral diseases caused by poor oral hygiene for seniors in Continuing Care.

Preschool fluoride varnish treatment service:

• Free service for lower income families. Does not use means testing, rather parental self-selection based on income criteria or belonging to identified community groups.

School fluoride varnish treatment service:

• Children attending school in low income neighborhoods as determined using deprivation mapping.

School dental sealant service:

• Children attending school in low income neighborhoods as determined using deprivation mapping.

Oral health in Continuing Care:

• Residents in Continuing Care
• Dental Treatment Service for low income Albertans:

Low-income Albertans who are residents of Alberta and are without dental insurance.

• Clients may self-refer, or be referred through shelters, community services or acute care.

Dental Outreach Program (DOP) Satellite Clinics:

• Services are for all residents in geographically isolated underserved communities in northern Alberta.

• Children ages 12 months to 35 months in lower income families are eligible to receive 2 fluoride varnish applications per year.
• Children in kindergarten, grades 1 and 2 receive 2 fluoride varnish applications per year. Services are provided free of charge.
• Children in grades 1 and 2 are screened and may receive sealants of select permanent teeth. Services are provided free of charge.
• Level of assistance required to help residents have oral hygiene twice a day. Services are provided free of charge.
• Reduced-fee basic comprehensive oral health services for vulnerable Albertans. Patients with urgent dental needs who are unable to pay are not charged for their emergency treatment.
• Reduced fee basic comprehensive oral health services. Patients with urgent dental needs who are unable to pay or have no dental insurance are not charged for their emergency treatment.

Alberta Health- Oral and Maxillofacial Devices and Services Program
Funding for select dental and oral surgical health service deemed medically necessary. The OMDS Program is the payer of last resort; all private dental insurance benefits must be utilized prior to funding being requested.

Dental services are in relation to severe oral/facial conditions caused by birth defects, jaw abnormalities (tumors), major facial trauma or temporomandibular joint (TMJ) disorder.

Services may include:

• Orthodontics, prosthodontics, dental implants and presurgical work-up fees.
• Services do not include routine dental services such as cleaning, fillings and extraction of wisdom teeth.

Community and Social Services- Income and Employment Supports.
Supports for individuals and families to pay for basic expenses. Applicants who request health benefits must meet all eligibility conditions, including asset and income rules of the IS program, or the income rules of the ACHB or AAHB program as applicable.

Income Support:

1. Expected to work (ETW)
2. Barriers to full time employment ( BFE)
3. Learners

on a month-to-month basis and list eligible household members. Basic dental services follow those outlined under Alberta Adult Health Benefit. Benefits are for the duration of the training program via a Health Benefits Card for learner and partner/spouse, if applicable. Basic dental services follow those outlined under Alberta Adult Health Benefit. Eligible children are enrolled in the Alberta Child Heath Benefit Program.

Alberta Adult Health Benefit (AAHB)
Health benefits including dental benefits available to low income Albertans. The program covers health benefits for Albertans in lowincome households who are pregnant or have high ongoing prescription drug needs. This health plan includes children who are 18 or 19 years old if they are living at home and attending high school.

Eligible clients must live in Alberta, be a Canadian citizen or have permanent resident status, meet income guidelines and not be in receipt of other provincial or federal government health benefits. If recipient/household members have coverage through another health benefits plan, that plan must be used first.

Benefits are for the year and are obtained via a Health Benefits Card. Covers basic services including examinations, x-rays, teeth cleaning, extractions, fillings and dentures.

Alberta Child Health Benefit (ACHB)
Health benefits including dental benefits available to low income Albertans to provide care for children. This health plan is for children up to 18 years of age. Children age 18 or 19 years old and living at home while attending high school also qualify.

Eligible clients must live in Alberta, be a Canadian citizen or have permanent resident status, meet income guidelines and not be in receipt of other provincial or federal government health benefits. If recipient/household members have coverage through another health benefits plan, that plan must be used first.

Benefits are for the year and are obtained via a Health Benefits Card. Covers basic services including examinations, x-rays, teeth cleaning, extractions, and fillings.

Assured Income for the Severely Handicapped (AISH)
Financial and health benefits including dental benefits for eligible Albertans with a permanent medical condition that prevents them from earning a living.

Eligible clients must be at least 18 years old, must live in Alberta, be a Canadian citizen or have permanent resident status, meet income guidelines and not reside in a correctional or mental health facility. A partner or spouse and dependent children may also be eligible.

Benefits are obtained via a Health Benefit Card. Services include check-ups, cleaning teeth, x-rays, fillings, extractions, dentures, other dental services

Family Support for Children with Disabilities
Funding for dental care based on each child’s needs related to their disability.

Parents are responsible for typical dental care costs. A dentist must provide information verifying which dental treatments or procedures are directly attributable to the child’s disability

Dental or orthodontic costs and procedures deemed necessary and attributable to their child’s disability. This includes:

• General anesthetic to complete routine dental care for children with severe behavior or sensory issues.
• Children requiring multiple fillings and extractions related to congenital anomalies and malformations.

Children’s Services- Child guardianship, foster care and kinship care
To provide dental care to children in foster care, guardianship or kinship care.

Dental services are covered under the child’s PHN or under the child’s Treatment Service Card (TSC), or for a First Nations child, through their treaty number

Dental services are covered under the Treatment Services Card (TSC). Caregivers need to check with the dental office to ensure that services are covered prior to the appointment.

Child, Youth and Family Enhancement Act (CYFEA)
Supplementary dental coverage to children in the custody and/or under the guardianship of a director under the Child, Youth and Family Enhancement ACT.

Children in custody or under guardianship of the act up to age 20.

Services include check-ups, cleaning teeth, x-rays, fillings, extractions, dentures, other dental services.

Senior and Housing- Dental and Optical Assistance for Seniors
Help to cover cost of basic dental and optical services for eligible seniors.

Clients must be age 65 years or older, reside in Alberta for at least 3 months, be a Canadian citizen or permanent resident and meet financial guidelines. Services are either partially or fully funded for allowable procedures based on qualifying income.

Ministry of Health- Supplementary Health (SH) and Family Health Benefits (FH).

Provides coverage for dental services for persons nominated by the Ministry of Social Services and Justice. Includes children <18 of low income working families who meet the standards of an income test or are receiving the Saskatchewan Employment Supplement.

Coverage includes a range of basic dental services (preventive, restorative, exodontia and prosthetic) required to maintain good dental health.

Medical Services Plan

Insured surgical dental services are those that are medically necessary and must be carried out in a hospital or office-based setting.

In Saskatchewan, routine dental services are not covered. The Ministry of Health does cover the following:

• Dental services listed in the ‘Saskatchewan Payment Schedule for Insured Services Provided by A Dentist or a Dentist Holding a Specialist License’.
• Limited oral surgery procedures required to treat certain conditions that may be caused by accidents, infection, or congenital problems.
• Limited orthodontic or nasoalveolar molding services for cleft palate in children and infants when referred by a physician or dentist.
• Extractions of teeth in limited circumstances, such as when medically required before undertaking certain surgical procedures related to the heart, chronic renal disease, head or neck cancer, total joint replacement by prosthesis, stem cell transplants and within 15 years of specific cancer radiation treatment where recommendations from the radiation oncologist and dentist have been followed.
• Adjunct services, such as consultations, when medically required.
• Dental implants are covered in exceptional situations where no other method of treatment is appropriate. Coverage is limited to circumstances related to tumours and congenital defects (cleft palate and metabolic disorders). Coverage will require a specialist in oral maxillofacial surgery to submit a written request for prior-approval from the Ministry of Health. The specialist must include detailed information and rationale to support the request. Coverage is limited to the initial cost to provide dental implants and does not extend to ongoing maintenance costs. Dental implants for trauma, postsurgical temporomandibular joint disorder (TMJ) or cosmetic purposes will not be covered.

Enhanced Preventive Dental Services (EPDS)

0-5 years of age Grades 1,2,7 & 8 children identified as high risk

An upstream intervention intended to supplement existing efforts to help improve children’s oral health by increasing access to care, preventive services and early education for children at risk. These services focus on oral health assessments, referrals and follow-up services, fluoride varnish, and dental sealants in grades 1, 2, 7 and 8 students in high risk schools

Regional Health Authorities- SHA additional programming

Children 0-16; prenatal women; vulnerable adults, long term care residents. Eligibility criteria varies across service networks

The SHA dental programs and dental public health clinic’s deliver dental health education, diagnostic, preventive, restorative dental services and referral services to eligible people in SHA. These services also include the use of silver diamine fluoride (SDF) and atraumatic restorative treatment (ART). The SHA has implemented Better Oral Health in Long Term Care programs in areas throughout the province. This includes assessments, referrals, preventive services, daily care, and staff education; in some areas private practice dentists provide dental treatment in SHA homes. *services vary across service networks SHA conducts dental public health surveillance via a dental screening of grade 1 and 7 students every 5 years. This is to monitor oral health status with the Canadian Oral Health Framework; it also supports program planning based on community oral health status/needs (across all SHA)

Athabasca Health Authority Community Dental Program/COHI

Children ages 0 -7 First Nation children living on reserve, pregnant women, parents and caregivers. School age children ages 4 to 16 (grades Pre K to 7)

To improve the oral health of all children of the basin by promoting prevention and health promotion for all ages. Enhanced Dental services offered to all school aged children brushing program, fluoride varnish program, one on one oral health education, provide basic dental treatment, offer dental health education to all grades.

Health Services – Dental Program

Those receiving Employment Income Assistance (EIA) – adults and families up to age 65 - Single Parents General Assistance - Persons with Disabilities - Children in Care

Basic diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, oral surgery services.

Manitoba Health- Medical Program

Services performed by oral and maxillofacial surgeons or licensed dentists when hospitalization is required; provides orthodontic benefits in cases of cleft lip and palate for persons registered by 18yrs, when provided by an orthodontist.

Various oral surgical, oral medicine and pathology, dental technical, and orthodontic procedures.

Healthy Smile Happy Child (HSHC)

At risk children, families, caregivers in rural and urban populations.

Educational resources, prevention.

Mount Carmel Dental Clinic

Individuals and Families with or without insurance that fall under the LICO (Low Income cut off before taxes) for Canada.

Routine dentistry – extractions (basic, single, no impacted wisdom teeth); New patient examination, emergency specific exam Dental hygiene – cleanings, scaling, oral health instructions, fluoride, SDF; Spacers for children and night guards for adults Referrals to other services not covered.

Winnipeg Regional Health Authority (WRHA) – S.M.I.L.E. plus

Children under 18 years from low-income families without private dental insurance.

Preventive and basic treatment services, referrals for more complex care.

Manitoba Health and Seniors Care- Public Health – Oral Health

Province wide

Education, prevention, policy, community water fluoridation.

Ministry of Health- Healthy Smiles Ontario

Dental program that provides free preventive, routine, and emergency dental services for children and youth 17 years old and under from low-income households.

Check-ups, Cleaning, Fillings (for a cavity), Xrays, Scaling, Tooth extraction, urgent or emergency dental care (including treatment of a child’s toothache or tooth pain).

Ontario Seniors Dental Care Program (OSDCP)

The Ontario Seniors Dental Care Program is a government funded dental care program. It provides free, routine dental services for low-income seniors who are 65 years of age or older, residents of Ontario, meet the income requirements: an annual net income of $22,200 or less for a single senior or a combined annual net income of $37,100 or less for a couple, and have no other form of dental benefits, including private insurance or dental coverage under another government program such as Ontario Works, Ontario Disability Support Program or Non-Insured Health Benefits.

Coverage includes: Checkups, including scaling, fluoride and polishing, repairing broken teeth and cavities, x-rays, removing teeth or abnormal tissue (oral surgery), anesthesia, treating infection and pain (endodontic services), treating gum conditions and diseases (periodontal services).

Ministry of Children, Community and Social Services- Ontario Works.

Program eligibility is based on an assessment of financial need; determined according to family size, income, assets, and shelter costs.

Dental benefits for dependent children aged 17 and under are provided by the Ministry of Health’s Healthy Smiles Ontario Program. Dependent children whose Ontario Works is being provided by a designated First Nations Ontario Works delivery partner have access to mandatory dental benefits under Ontario Works (the MCCSS dental schedule is often used). Ontario Works recipients 18 years of age and older may apply for funding to cover the cost of dental services as a health-related discretionary benefit through Ontario Works.

Ontario Disability Support Program

Basic coverage for ODSP recipients and spouses 18 years of age and older. Some additional services are available under the Dental Special Care Plan (DSCP) if a person’s disability, prescribed medications or medical treatment affect their oral health.

Basic diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic and oral surgery services. DSCP services can include additional recall exams, teeth cleaning, fluoride treatments, custom fluoride appliances, bruxism appliances, crowns and some periodontal surgery

Assistance for Children with Severe Disabilities (ACSD) Program

Dental benefits for children receiving ACSD are provided by the Ministry of Health’s Healthy Smiles Ontario (HSO) Program.

Basic diagnostic, preventive, restorative, endodontic, periodontal, prosthodontic, oral surgery services HSO’s dental schedule includes a Dental Special Care Plan (DSCP) which provides coverage for additional services and/or limitations for Ontario Disability Support Program (ODSP) and Assistance for Children with Severe Disabilities (ACSD) clients whose medical and/or psychosocial condition, or prescribed medication or medical treatment impacts their oral health and/or dental treatment. Or whose oral health impacts their medical and/or psychosocial condition and/or their medical treatment. The DSCP provides more frequent services such as recall exams, scaling/root planning and additional services such as bruxism appliances and grafts.

Oral Surgery Services in Hospitals

Everyone

• Exams
• Local or general anesthesia
• X-rays
• Removal of cyst or tumor
• Drainage of abscess
• Reduction of fracture
• Repair of a soft tissue tear
• Treatment of inflammation of bone tissue
• Treatment of the temporomandibular joint
• Treatment of salivary glands
• Extractions not covered

Dental Services for Children

<10yrs

• Annual and emergency exams
• Local anesthesia
• X-rays
• Dental restoration (amalgam posterior and composite anterior)
• Endodontic (root canal treatment, apexification, pulpotomy (primary teeth / permanent teeth if general anesthesia)
• pulpectomy (primary teeth only)
• Oral surgery services
• Prefabricated crowns

Dental Services for Social Assistance For Children Recipients And Dependants

>10 yrs

Idem: Dental services

>12 yrs

Addition of oral hygiene instruction, dental prophylaxis

<13 yrs

Addition of root canal treatment on a permanent tooth

12-15 yrs

Addition of topical fluoride application

>16 yrs

Addition of scaling

During the waiting period (12 months)

Emergency services only

After 24 months of waiting period

Addition of acrylic removable prosthodontics (complete and partial) (each 8 years), relining (each 5 years), denture repairs

Québec Elementary and Secondary School Dental Sealant And Cavity Prevention Program

Students identified at high risk of dental caries in elementary school (kindergarten, 1st and 2nd year) and high school (2nd grade).

Dental sealants and fluoride varnishes, oral hygiene education

Québec Oral Health Care And Daily Care Program For Residents Of Public Long-Term Care Facilities

People living in public or agreement private Long term care centres

• Annual and emergency exams
• Prevention
• X-rays
• Dental restoration
• Endodontic treatments
• Oral surgery services
• Acrylic and metalacrylic removable prosthodontics

Department of Social Development- Healthy Smiles, Clear Vision

Children of families in receipt of Social Assistance and children of low income families are eligible to receive dental services even if the parent(s) do not receive Social Assistance.

The dental program covers basic items, such as regular exams, Xrays, restorations, extractions, preventative treatments such as sealants and fluoride treatments. There is a yearly maximum of $1,000 for dental coverage.

Health Services Dental Program

This program assists clients of this department who are over the age of 19 with coverage for specific dental benefits that are not covered by other agencies or private health insurance plans. Benefits are negotiated with the New Brunswick Dental Society and the New Brunswick Denturists Society. This program is available to:

• Clients of this department and their dependents 19 years of age and older.
• Individuals who have special health needs and who qualify for assisted health care under Section 4.4 of the Family Income Security Act and Regulations.

Benefits covered under this program are:

• Exam, x-rays Dentures and repairs, Specific types of fillings

This program does not cover:

• Orthodontic services and appliances
• Fluoride treatment
• Sealants
• Root canals on posterior teeth
• Oral surgeries not specified in the contract with the NB Dental Society Clients are eligible for a maximum of $1,000 per year, excluding emergency and prosthetic services. Clients will be charged up to a 30 per cent participation fee for dental services and 10 per cent participation fee for dentures and denture repairs. Once a treatment plan has been determined the dental professional will advise of the amount payable. The participation fee is paid directly to the dental professional and may be required before dental services are provided.

Department of Health- Insured Surgical-Dental Services

Insured surgical-dental services are prescribed under the Medical Services Payment Act.

Various oral and maxillofacial procedures.

Cancer Related Osseointegrated Implants and Oral Prosthetics Program (COIOPP)

Dental work related to head or neck cancer – by prior approval only.

Dental extractions, dental implants, obturators, various prostheses.

Department of Community Services- Employment Support and Income Assistance

Available to all eligible ESIA recipients, spouses, and dependents not covered by MSI. If there is private health coverage, that is billed first andprogram will cover any remaining unpaid balance as long as it is an approved service.

ESIA recipients, spouses, and dependents not covered by MSI. If there is private health coverage, that is billed first and program will cover any remaining unpaid balance as long as it is an approved service. Coverage may be provided in accordance with the approved contracted service under the following circumstances: 1. for the relief of pain; 2. for control of prolonged bleeding; 3. for treatment of swollen tissue; 4. for provision or repair of broken dentures; and/or 5. for dental problems identified as barriers to employment. Emergency dental care, some diagnostic, restorative, prosthodontic, endodontic, and oral surgical services Assistance pays 80% of 2014 Dental and Denturists Rate Schedules, 20% patient, can be means tested.

Disability Support Program

All participants of DSP can apply for a Dental coverage as per the Special Needs Policy.

Emergency dental care, some diagnostic, preventive, restorative, prosthodontic, endodontic, and oral surgical services DSP policy allows for coverage of dental procedures up to 100% of the 2014 fee guides for the Nova Scotia Dental Association and the Denturist Society of Nova Scotia.

Child and Family Youth Services – includes Children in Care, Youth supported via Youth Services, and Subsidized Adoption.

In care of the Minister of Community Services the cost of all required dental work required for children in care up to age 19 or 21, when not covered by MSI.

Diagnostic, preventive, treatment services. Orthodontic work requires additional consideration by the Director of Children in Care (braces, etc.).

Department of Health and Wellness- Children’s Oral Health Program (COHP)

Birth to end of the month of the 14th birthday; children are required to access private coverage first, program pays balance.

Diagnostic, preventive, and treatment services Community-based prevention.

Cleft Palate/Craniofacial Program

Cleft Palate/Craniofacial Team registered, but does not guarantee eligibility Those craniofacial anomalies that directly influence growth and development of dentoalveolar and craniofacial structures.

Various oral surgical and dental procedures beyond the eligibility under COHP.

Maxillofacial Prosthodontics Program

Those whose maxillofacial prosthodontic needs result from congenital facial disorders, cancer, trauma, and neurological deficit.

Various oral surgical and prosthodontic services.

Individuals with Special Needs

Anyone deemed mentally challenged by a medical authority, and whose dental needs may necessitate hospitalization.

Various oral surgical and dental procedures beyond he eligibility under COHP Subject to a 10% premium when delivered in private practice, and 30% premium when in-hospital

Oral and Maxillofacial Surgery

Anyone whose dental needs may necessitate hospitalization

Various oral surgical and dental procedures.

In-Hospital Surgical Dental Services

All P.E.I. residents

Medically necessary dental care as defined by the Canada Health Act R.S.C., 1985, c. C-6 and provided under the Health Services Payment Act, R.S.P.E.I. 1988, c. H-2 (Amend 33)

Provincial Dental Care Program

A payer-of-last resort program available to all families receiving financial assistance as well as those families that meet the income threshold. Potentially eligible population is 26,400 Financial Assistance recipients – 100% 100% Market Based Measure – 100% coverage 110% Market Based Measure – 80% coverage 120% Market Based Measure – 60% coverage 130% Market Based Measure – 40% coverage 140% Market Based Measure – 20% coverage.

Annual and emergency dental exam, Cleaning, Sealants, Fluoride application (limited to children and those over 55 years of age), Root Canal Treatment – limited to special circumstances Extraction, Dentures (new dentures limited to one in 10 years and individuals may be required to pay lab fees) In-hospital dental care services limited to children and Access-Ability Support Clients.

School Oral Health Preventative Dental Program

All children aged 3- 17 years

• Preventative Services
• Assessment of risk toward developing oral diseases
• Oral health education
• Topical fluoride
• Dental sealants
• Cleaning of teeth.

Children aged 3 – 17 years (coverage limited to children who are not covered by any private dental insurance plan)

Dental Treatment Services Basic dental services including:

• Annual dental check-up and x-rays
• Restorative dental services, fillings, and root canal treatment on front teeth
• Extraction

In-hospital Dental Specialist Services Program

Children without a private dental insurance plan who have medical and/or behavioural problems, which require that a paediatric dental specialist treated them.

In-hospital provision of CDCP covered services.

Cleft Palate Orthodontic Treatment Funding Program

Children who require orthodontic treatment because of a cleft palate.

Orthodontic treatment (must commence before age 18 years).

Long Term Care Facilities Dental Program

Residents of long term care facilities (private and public) in P.E.I.

Annual screening and referral of residents Preventative services such as scaling fluoride varnish Denture cleaning and labelling In-service education for resident care workers

Income Support

13-17 yrs; for families in receipt of Income Support.

• Two year cycle for examination and x-rays (bitewings)
• Some diagnostic (Emerg. exams and Periapical x-rays); basic restorative; oral surgery (extractions)
• Some additional services require Prior Approval
• Fees are paid based on 90% of NLDA Fee Schedule (2014)
• No preventive component
• Some diagnostic, restorative, oral surgical services
• Emergency examination and extractions only for recipients >17 yrs *Low Income Youth Program has the parameters as for Income Support but no adult component.

Low Income Youth Program

13-17 yrs for families whose are enrolled in the Newfoundland and Labrador Prescription Drug Program (NLPDP) (low income).

Adult Dental Program

Beneficiaries must be enrolled in the Foundation, Access and 65+ programs of NLPDP. These are all needs based and are deemed our most financially vulnerable.

• Three year cycle for all basic services (to include routine exam and diagnostic bitewings) and a eight year cycle for denture services
• Fillings to an annual maximum of $300, extractions and dentures
• Some restrictions apply
• Fees are paid based on 90% of NLDA Fee Schedule (2014) except for dentures which have set fees for standard services and are not part of the negotiated Dental Program agreement.

Insured Surgical Dental Services

Valid MCP card Services listed in the Surgical Dental Payment Schedule Provided in a publicly funded facility (hospital).

Various oral surgical and dental procedures as listed in the Surgical Dental Payment Schedule.

Department of Health and Social Services- Social Assistance Aid for Health Care Services

Persons receiving social assistance and their household members.

Basic and major services $1,500 per fiscal year.

Extended Health Care Benefits

Seniors 65 and older and their spouses who are 60 and older.

Basic and major services $1,400 every two years per beneficiary.

Children’s Dental Program- Children’s School-Based Dental Program

Children in kindergarten to grade 8 in Whitehorse and children in kindergarten to grade 12 in rural areas where no resident dentist is present.

Basic and major services

Preschool Dental Program

Newborn children to 5 years of age.

Health Care Insurance Plan

All residents

In-hospital surgical-dental services.

Department of Health and Social Services- Non Insured Health Benefits

Registered First Nations and Recognized Inuit

Emergency, diagnostic, restorative, endodontic, periodontal, prosthodontics, oral surgery, orthodontic services

Métis Health Benefits (MHB)

Extended Health Benefits (EHB) Seniors Dental Plan

Individuals who are >60yrs and non-Native or Métis

Emergency, diagnostic, restorative, endodontic, periodontal, prosthodontics, oral surgery services

Indigent Health Benefits (IHB)

Individuals receiving income assistant payments from Education, Culture, and Employment and are not covered under the NIHB program

Short-term clients are eligible for emergency benefits only Long-term clients are eligible for NIHB coverage

EHB for Cleft Lip and Palate

Individuals who require a hospital stay to receive service.

Various oral surgical and dental procedures.

Oral Health Professional Program

Children, the prenatal population, residents of long term care facilities, and emergencies in adults

Emergency, preventive, restorative, periodontal, and community health interventions

Community Fluoride Varnish Program

Children

Fluoride varnish

Oral Health Toolkits in Long Term Care

Resident of an NWT long term care facility

Long term care: individualized oral health toolkit and individualized oral health care plan determined by an oral health professional.

Oral Health Supplies for all NWT Residents

Resident of the NWT

4 toothbrushes/year + toothpaste and dental floss freely available to all NWT residents

Oral Health Community Events

Open to the general public in seven communities hosting events

Oral health promotion and education, oral health supplies, activities and resources, oral health community facilitator training and capacity building.

Early Childhood and School Daily Brushing Programs

Program available to all licensed daycares, day homes, and schools in the NWT; participation on a voluntary basis.

Guided daily toothbrushing activity for children, oral health supplies and storage, program guidelines booklet for staff.

Department of Health and Social Services - Contracted Dental Services

Registered First Nations and Inuit

Emergency, diagnostic, restorative, endodontic, periodontal, prosthodontic, oral surgery, orthodontic services

Dental Therapy Program

Children and emergencies in adults

Emergency, preventive, restorative, periodontal, and oral surgery services; community health interventions

Prevention Programs

Everyone

Oral health education, screening and preventive services provided through Children’s Oral Health Project.

Seniors Extended Health Benefits

>60yrs and not eligible other private or public coverage; $1000 annual max

Emergency, diagnostic, restorative, endodontic, periodontal, prosthodontic, oral surgery services

In-Hospital Surgical Dental Services

Services requiring the unique capabilities of a hospital for their performance

Various oral surgical and dental procedures; oral surgeons are brought to Nunavut on a regular basis, but for medically complicated situations, patients are flown south GA services for children up to and including age 12. Services are provided both in Nunavut, and in southern locations.

Children’s Oral Health Project

Ages 0-12 years

Screening, Fluoride Varnish, SDF, sealants, Glass ionomer restorations, extractions, OHI, referrals. In community oral health coordinators provide ongoing surveillance and preventive services, OHI