Dawson Dental - Scarborough

As the CDCP is not a fully subsidized program, we want to be transparent that there may be some out-of-pocket costs when you receive treatment. These additional costs stem from three factors: 1. The fees covered by the CDCP are generally lower than the recommended fees for dental care in the province or territory where you live. 2. Those with an adjusted family net income between $70,000 and $89,999 will have a co-payment, meaning only a set percentage of fees will be covered. 3. Not all dental services will be covered by the CDCP. We will be sure to make any anticipated out-of-pocket costs clear to you before you receive treatment. We believe the subsidization that patients will receive as part of the CDCP will help remove significant financial barriers to accessing dental care.

Certain services, such as deep sedation, are not covered in all cases. If a provider believes the treatment is medically necessary, they can submit a preauthorization request on behalf of the patient. Approval of the preauthorization request is based on the recommendations of the dental care professional and considers the patient's dental and medical history. Treatments requiring preauthorization are listed below. Specialist dental examination Crowns Posts and cores Moderate sedation, deep sedation and general anesthesia Major surgical procedures Orthodontic services when clinically necessary (starting in 2025) For further information on services covered, please visit the Government of Canada website.

CDCP requires annual renewal to confirm that patients continue to meet all eligibility requirements. Renewing ensures you avoid any gaps in your dental coverage. Once you receive your tax assessment, you can renew your coverage online here or through your My Service Canada Account (MSCA). Be sure to submit your renewal application early to prevent any potential lapse in coverage. If your renewal is approved, you’ll get a letter confirming your coverage and any updates. If your coverage has changed based on your net family income, the letter will include details about the changes to your coverage. Just bring it to your next dental visit so your provider is up to date.

Absolutely! Our dentists will work with you to review treatment options and provide a cost estimate for the treatment plan before proceeding. Submitting a pre-determination to your plan provider will provide an estimate of what your dental plan will cover prior to treatment. Note: A dentist can only provide an estimate. As with any medical-based procedure treatment planning can change over the course of treatment; this can have an influence on cost.

Dawson Dental follows the Ontario Dental Association’s Suggested Fee Guide for basic and routine services, which is updated annually. When your employer and insurance carrier determine the amount of money your dental plan will pay for services covered under the plan, they consider the specific circumstances of your company and its employees. They consider such factors as company funds available for employee benefits, the nature and extent of use of the dental plan by the employees, and which version of the ODA Suggested Fee Guide is used by the insurance carrier. Some employers may use a current issue of the guide, while others may use past issues of the guide. That said, there may be a difference between the price your dentist may charge you and the amount covered by your dental plan.

Yes, we offer direct billing for most major insurance providers. We know your time is valuable, so we handle the paperwork and submit your claim on your behalf. Payment is due at the time of service, and your insurer will reimburse you directly according to your coverage.

Generally, a dental plan will only cover a portion of the cost of any treatment service, the patient is responsible for any charges not covered by the plan, this is called the co-payment. Your dentist has a legal and regulatory requirement to collect the co-payment from all patients.

No. The waiving of a co-payment is insurance fraud and is against the law. Your dentist could be heavily fined or even lose their license. When you and your dentist sign the claim form that goes to the insurance company, you are stating which services were provided and how much, in total, was charged. The insurance company pays its share based upon the assumption that you will do the same.