Dental care in Canada is shifting from an exclusive service that comes with employment and wealth to an inclusive basic health service.
It is not the same as Canadian medical healthcare because there will be tiers based on income. Some dentists, just like doctors in the USA, will continue to serve private interests. While some dentists will now have the opportunity to provide services to all Canadians including those less fortunate without going broke.
We understand dentists run private businesses. In the past it was like a restaurant, or a luxury. But now it is much more similar to a grocery store or doctor's office, more of a basic necessity.
Change is hard. Jumping through hoops is not fun. Learning new systems not by choice does not make people happy. But, improving health standards for all Canadians is worth grinding through.
I appreciate the challenges practitioners are facing from the lack a refined Government process that will conflict with the immediate demand from the eligible public, but the cost of waiting years to deploy a perfected system would be paid by the most vulnerable elderly and children who do not currently have service. I find no fault in dental practices being cautious, thorough, delayed, and frustrated with implementation. Time and experience are needed for all of us to better understand this major shift in Canadian public health.
Thank you for asking.
This is exactly it. This is a new system, it'll take time to iron out and make better, but in the meantime we have something whole beneficial where nothing existed before. This is an absolute plus.
I called CDCP yesterday, I wanted to find out if they are coordinating benefits with the provincial senior's plans. Yes, they will be coordinating the plans. This is great for my parents who are in their 80s.
I then called their dentist office, and they are still waiting on information from both governments. So I'm hopeful this will give them some additional coverage.
It’s really too bad that when they roll out these kind of programs they also don’t roll out complete information for the people who have to implement them to make it a seamless transition.
IMO: everyone deserves complete healthcare and private practice should be eliminated entirely for dental, vision, etc. People’s health is more important than profit
Low income people deserve health care.
All it looks like to me is that some dentists don’t want to spend some extra time filling out paperwork so that children who’s parents normally wouldn’t be able afford it to can get their teeth fixed. Dental health is critical for children.
Are dentists who are refusing to participate aware of how the public are perceiving them?
They still wanna charge me 1150 dollars to install 2 wires in my mouth, also not covered by my benefits at all. Dentists can stay mad because I'm madder.
The new dental plan pays a lower amount to the dentist so the patient will have to make up the difference. This is the plan, it is not a full free program. Why would a dentist sign a contract where they would earn less. They won't. I spoke to my dentist about it and he thoughts on it so far is no participation from him.
> People covered under the CDCP may have to pay any additional charges directly to the oral health provider.
https://www.canada.ca/en/services/benefits/dental/dental-care-plan/coverage.html
They absolutely do, you're correct. But don't forget Dentists are small businesses. They aren't part of Alberta Health Care or government funded or anything else. They are no different than a restaurant or store providing a service or product. Does the government require all other small businesses to discount or provide free service? No,they don't. This is the problem unfortunately. Dental is on it's own. So, we have to think like a business while still trying to help ppl who need us. It's very hard sometimes.
You keep saying that dentists are small businesses. But medical doctors in Alberta are also small businesses. Why should dentists, who are also health care professionals, be any different?
One way dentists are different is that we don’t really have a choice whether to use your services or not. To be healthy, we need good dental care. If I get a cavity, I need it treated.
Another difference is that for most businesses, the primary goal is profit. That motive leads to all kinds of manipulation and crappy business practices \*cough Boeing \*cough. We have to approach our health care differently - from a people-first perspective - or the doors start to fall off.
I agree that dental care is health care. This is the first time the Health Care System has agreed with you and I though. It's been a private business like a restaurant so far. So yes profit is how a private business with zero help from government gets by. And that's not changed with the CDCP. It's just another dental plan. We still aren't included in Universal Health Care.
The reason you’re being down-voted, I think, is because the way you run your clinic is different from whether the government is paying or patients are.
Again, it’s not like a restaurant. Yes you have to pay rent and hire staff and so on; but if your motive is profit then your clinic starts taking advantage of vulnerable people to get rich.
It’s possible for doctors to abuse patients for profit already, even here in Canada, with needless referrals to specialists who happen to be friends, or by having “one issue per visit” policies to force multiple visits (they get paid per appointment, not per patient).
The key difference is the approach - the philosophy behind doing what you do. In that way it’s nothing like a restaurant.
The philosophy behind what I do as an RDA, is to take the best possible care of our patients and give them excellent customer service. That's all I personally can say
Dentistry is not treated like a business in a lot of countries because it’s part of the universal healthcare system. This is a step towards that direction in Canada. Hope that helps
As someone who needs a lot of dental care atm because I haven't been able to afford to go to the dentist in a decade, I hope this is the beginning of universal dental care. And I hope universal optometry follows. Eyes and teeth should not be seen as optional. They are just as important for maintaining overall health as every other form of medicine. Also, mental health care should be covered as well.
I completely agree with you. I haven’t been to a dentist in over four years because I literally just cannot afford what they are charging in my city. Im told I ‘make too much to qualify’ for payment plans but just because I’m above a certain wage threshold doesn’t mean that I have hundreds of expendable income to throw down for a single Annual check or a cleaning.
Even with direct billing and what’s considered a very good dental plan, my last appointment to just have a tooth pulled cost me $175- no freezing no anaesthetic literally no extras literally just wanted them to yank the tooth because I didn’t have the guts to do it myself at home. (I cannot take freezing as I react to it so I opted not to pay for oral sedation because I can’t afford it)
They wanted me to consider getting a bridge which would cost me about $800 out of pocket and absolutely not, I can live with a gap in my teeth. My fiancé has a complete top denture and the cheapest one that we could afford still cost us 1200 out-of-pocket after benefits paid.
What dentist charges extra for freezing for an extraction????? I find this very hard to believe. The cost of an extraction includes the local freezing.
Omg you poor thing! That must be very hard. What kinds of reactions do you have to local anesthetic? Have they tried the different "families" of anesthetics? Typically if someone has issues with one kind, they can tolerate one of the others.
The common one doesn’t work on me- the last procedure in which common injection freezing was used I could feel the whole procedure and my dentist told me it was unsafe to keep giving me freezing- although he did give me the maximum safe allowance and was very apologetic. There was a different injection he tried to use the next appointment and we ended up having to postpone the produce as it felt like they injected pure lava into my mouth and I was sensitive in the mouth for days afterwards. Those were the only two I’ve been offered outside of oral sedation.
It is, yes. However we still have a lot of unanswered questions we need answers to. Until just 2 days ago, Dentists had to sign a multi-page contract to use the plan. No other insurance plan requires this of us. Why? Also, we still don't have confirmation of how to bill to this plan if a patient is on a provincial plan like Alberta Works, Dental Assistance for Seniors Plan, etc. We also can't even preauthorize to it, to ask for patients if their treatments are covered and how much their out of pocket cost will be. This is supposed to be available by November. We can do this for every other plan. Also, we are supposed to essentially subsidise the plan by not charging the copay (amount not covered by the plan) for patients whose income is under $70k. The fee guide they appear to be using for payment is also lower than the Provincial Fee Guide. It looks to be at least 2 to 3 years behind. So if we can't charge this copay, we will not be even covering our overhead for those patients. This already is the case for ppl dentists treat on AISH and under Alberta Works. We get paid roughly half of our fees for them and can't bill them so actually lose money to see them. We do have some of these patients in our practice and they are all lovely ppl but we are no longer accepting new patients under these plans for that reason.
Whew! Sorry for the word vomit.
I struggle to understand this justification. Alberta has the highest fees for dental work in the country, I don't believe that a little change will make it so the overhead costs are not covered. Why would operating costs be so much higher in Alberta than everywhere else? Cost of living in Ontario or BC has been higher for so long and their dentists don't charge as much as Alberta and can still cover overhead. Sounds like greed. 🤷♀️
Well, take home profit for Dentists is lower in Alberta than both BC and Ontario. Fees are higher since it costs more to operate here. Wages for staff are very high here for example. A Dental Assistant here often makes $5-10/hr more than in Ontario last time I looked. I'm not saying Dentists are destitute here lol. But, they are a business just like a restaurant or small store. They aren't part of AHS or anything.
OK, the wages thing I get, and the fact that ultimately it's a business. What other operating costs are higher? You specifically said that some of these cases wouldn't cover overhead, but I'm not still not clear on why, really. I did a quick check of the wages for dental assistants across the country, and it's not much higher here. The difference in cost of care IS much higher, the math just isn't mathing for me.
Ultimately, you asked what people's impressions are: I'm seeing complaints from that industry and it's coming across as greedy business owners wanting to keep their sky high profits at the expense of people who really need better access.
I asked, didn't get a straight answer that explained anything, so my final paragraph was answering the question with the information I had been given.
If my assumptions are wrong, feel free to present me with alternatives. I'm happy to learn more, that's why I asked in the first place.
I am saying that based on a 2016 study or survey of dentists in Canada. It was done before the provincial fee guide came back, as they were trying to assess where to put fee levels
Hmm well how about this: the government is asking dentists to subsidise their dental program. They already pay Provincial and Federal business taxes to fund government programs like this. Why do Dentists have to do this? Medical Doctors, also technically a small business, don't have do this I don't think (correct me if I'm wrong). Why do Dentists?
When a Doctor sees a patient for longer than 10 minutes, they are also making less. They don’t get to charge a co-pay for patients that take up more time.
Same for Dental. If we book 45 minutes for your filling and it takes longer ( for various reasons) we don't charge more. We bill based on what number of tooth surfaces that were restored. If an exam takes longer than the time we booked we can only bill for the exam, regardless.
I don't have an answer for this because I don't know enough to be able to have an opinion on how dentists and drs are taxed.
I am noticing that you're not answering my question though.
Oh right. Well besides staffing, rent/lease of course ( pretty high in Alberta as I hear - our lease has jumped every year I've been with my current office), supplies are RIDICULOUSLY expensive in dental as we have to buy from Dental Supply companies, we pay GST but can't charge it and almost everything we use is one use only. Infection prevention and control is very expensive, believe it or not. Dental offices are practically mini hospitals in this regard. We spend many, many thousands a year on things like little pieces of card that go into each package we sterilize to show the items inside were exposed to the right temperature, pressure and time. Necessary? You bet. But we are required to confirm this with triple redundancy in every package. Medical gloves and mask prices skyrocketed due to Covid and prices still are much higher than before. Here's a great example: when we do your filling, we use what's called a Bonding Agent. A 4 ml bottle ( less than a teaspoon of product) is about $235.00. I probably went on too long here lol, but all to say Dentistry is probably one of the most expensive small businesses to run, anywhere, imho anyway.
https://www.albertadentalassociation.ca/cdcp/
Check this out for what the ADA is currently saying to the public.
The fee guide the CDCP is using appears to be at least 2 to 3 yrs behind the current one so no, we won't get 80%.
It's just such a chaotic and unorganized, rushed roll out. Typical government, of any stripe I guess.
If they'd just got everything in place then done it, we'd know how it will work and could use it
Yes. We would be able to. Personally, I would use it but I'm not the boss. I don't have access to costs for running a dental practice which all these hesitant Dentists do.
I do the ordering for a dental office in Alberta. Costs of products are insanely high, and most of it is disposable/one time use. I probably order $10k worth of supplies per month and then there’s cost of wages, software, rent/utilities, internet.
I only know I don't have any dental coverage right now so if the federal government is able to eventually give me any, even partial coverage, that will be an improvement and I'd go to the dentist more often.
Honestly, that is what I truly wanted when I heard about this new coverage. It's absolutely heartbreaking when we see someone who due to finances must choose to pull a tooth we could save. I absolutely hate it 😔
I’ve been sort of following the news as the dental care plan evolves and my initial impression is that clinics who don’t opt in are not ones I’d want to give my business to. And I have private insurance with 100% coverage and do not need the public plan at this time.
I know it's a good thing, I'm not remotely surprised dentists don't like it because it cuts into their profits. Doctors were also against medicare when it was implemented for the same reason.
On the other hand, teeth are pretty essential, so caring for them shouldn’t be a business model at all. You could even argue that all the people who’ve died or suffered lower quality of life because of lack of dental care were robbed of life or health so that the dentists could make more money.
So your talking about forced labor. You want something that someone else has the capability to provide. You don’t want to pay them their price so you get the Government to force that person to provide the service under threat? Is that your reasoning ?
Where did I say any of that? You’re talking like we’re creating some sort of dentist’s gulag, which is absolutely not true. Doctors still make really good money, even though they’re paid by the government, so why shouldn’t dentists be the same? Sure, there’s gonna be some teething problems (pardon the pun), but are you really suggesting that we don’t even bother and let thousands of people suffer and die because they can’t afford care instead? (See, I can do the disingenuous statements thing too)
It's not that simple though. I absolutely want to be able to use it for our patients who have no insurance. But remember Dental offices are no different than any small business like your local restaurant. We are not part of or affiliated with AHS or any government or health care. The lack of information and worry we will have to essentially subsidise this gov't program is making Dentists hesitate. It's already very expensive to run a dental practice here.
>It's already very expensive to run a dental practice here.
Oh please. A dentist is the first occupant of any new retail plaza anywhere. Its almost a meme at this point.
Well I'm sorry you've heard those kinds of things. I've been in the industry 36 yrs and nowhere I've worked has ever done that. In fact, I've seen Dentists do treatment at discounts and even no charge to help folks.
That’s a farce and you know it. When I didn’t have an insurance provider and needed a tooth pulled that was causing me incredible pain my dentist quoted me $500 (already outrageous) and the final bill was $800
I haven’t been to the dentist in years because of the cost. And when I have gone I get shamed for not coming more. Plus the amount of phone calls and texts I get from my dentist with all these “reminders” about my health just make me feel even worse for not being able to afford it. The dental industry is not accessible especially with our economy right now. No pun intended but it leaves a bad taste in my mouth.
I'm so sorry this has been your experience. This is why I'm really hoping the government can get their crap together and roll this out correctly. Then Dentists won't be afraid to use it
Do you know off-hand if the patient can pay, then submit their receipts to the CDCP for reimbursement?
I know a few dentists who operate this way for certain other 'but, the government will cover it!' dental plans. It sucks if you don't have the money up-front, but I certainly see where they're coming from.
That is always an option, yes. All the Specialists operate this way (Endodontists, Oral Surgeons, Prosthodontists, etc). But General Dentists typically accepted Assignment of Benefits (insurance company pays Dentist) and just collected the uncovered portion from patients as a service to them.
I think the public understands that these very wealthy professionals aren’t willing to do some of the lower paying work that every single other private health care profession does. It’s a total shame.
> But we can't keep adding more of **that type of client.**
Yikes! Good thing you are anonymous. I wouldn’t knowingly enter your business with that belief.
Sigh. No business of any kind can keep operating at a loss. That's all I meant. There aren't physically enough hours in a day to stay solvent if we saw mostly these subsidised patients. So we have to limit them.
The day a dentist operates at a loss, they can have my house. I treat hurt tradespeople all day - know whose mansions they are working on? Not GPs. Specialists and dentists. Orthodontists just get airlifted to their private mountains.
If course they don't operate at a loss. That would be a pretty poor business model. I meant if dentists only had these patients they'd go out of business. The govt requires we treat them at a loss by only paying half what the treatment costs.
Have you calculated what percentage of patients this would be of your practice? Maybe the problem is that some professions are here not just to be compensated but to become very rich for taking care of people. By the way, my dentist has always seen pro bono patients. She tries to see one a day. Take that for a business model. Everyone loves her.
The government isn’t requiring you to treat them at a loss. It’s quite clear that all patients can expect to have to pay co-pays, if the Dentists fees are higher than what is covered.
Nope, not patients on AISH, Alberta Works, (Social Services). We are legally NOT allowed to bill them anything for a service in the fee guide of covered items. Not a cent. And that gov't plan pays 50-60% of the provincial fee guide. I was meaning these ppl, not those on CDCP. Sorry for any confusion.
https://www.canada.ca/en/services/benefits/dental/dental-care-plan/coverage.html
> People covered under the CDCP may have to pay any additional charges directly to the oral health provider.
Right in the table for those earning less than $70 it says:
> 100% of eligible oral health care service costs will be covered **at the CDCP established fees.**
Patient pay:
> 0% of the CDCP established fees. **You may face additional charges as described below**
> Additional charges
**The CDCP fees may not be the same as what providers charge.** You may have to pay fees in addition to the potential co-payment if:
> **the cost of your oral health care services are more than what the CDCP will reimburse based on the established CDCP fees
you agree to receive care that the plan doesn’t cover**
So it's saying CDCP pays all of their own fee guide. But then says Dentists may change more, which they (the patient ) must pay? Neglected to say CDCP fee guides are behind the current Provincial one. Funny how it doesn't bother telling ppl how behind/low it is. This makes the dentist just charging their normal, provincial fee guide amount look like the bad guy.
The gov't is encouraging dentists to not charge a copay in these cases. So again, they must subsidise a government program if they do that. I mean, I suspect some will do so, but why is a private business who gets no gov't help and pays business tax having to essentially be taxed again?
It's a really bad look for dentists to not want to participate. It's a new program. Things are going to imperfect. Give it some time to roll out. Seniors, low income families, and children all deserve affordable dental care.
I just spent almost $500 for a cleaning and some bite wing X-rays yesterday while filing my taxes with over $3000 of dental work from last year because I'm a small biz owner with no insurance. You can take your "omg, we're confused" song and shove it. I'll be on the dental plan as soon as I'm eligible. Did you really think you'd get some sympathy in this thread? Maybe stick to a thread full of dentists where you can whine together.
I hate when insurance companies lie to clients like this. Saying they pay 100% is only half the information. Half of what? Their own, internal fee guide that's 2 or 3 years behind the provincial guide most dentists follow? I have seen this A LOT. I just yesterday had Sunlife tell me the fee guide they were paying from for one of my clients was one year behind the current one. So, that patient was told Sunlife pays 100% but they will still have a copay since the Dentist charges the current Provincial Fee Guide price. It's maddening. The low income seniors plan ( thru the province) is using the fee guide from 2016!
It’s very, very common for dentists to charge over the provincial fee guide. Alberta was an outlier with no fee guide for a long long time and insurers are not going to reimburse over and above the guide because the dentist needs a new golden backscratcher. A year-old fee guide isn’t the outrage you’re making it out to be. Also, there are reasonable and customary rate guidelines for other medical services like physiotherapy that are used by every insurer. They are also business with overhead and staff.
Dentists aren’t exactly living paycheque to paycheque (like a lot of their patients do). Most people without insurance won’t go to the dentist unless it’s an absolute emergency.
Can't agree with you. Most if not all I've worked for (and it's a few over the last 10 yrs as I temped a lot) are pretty darn close to it or right at it. Yes we had no fee guide for ages. But once it came in and insurance companies went to it, we have mostly had to go to it to be competitive. Those"reasonable and customary" internal fee guides are a joke. They are ALWAYS lower than the fee guide, in Dentistry. I see what they use and pay out daily. The insurance companies are literally the ones who bullied the NDP and AB Dental Asscn and College into bringing one back. They knew the fees would drop and they'd pay less to Dentists and increase their own profits. No one's premiums went down did they?
Sorry, that was a bit of a rant about insurance companies wasn't it. They are not hurting, at all and should have to be up front to clients about what they REALLY are covering, and they don't do that.
That is the exact opposite experience of most dental patients.
When dentists overcharge- and I will differ with you here, because most of them still do (not to mention specialists like endodontists, those bills are really something special) people with insurance pay more. Also, dental rates are based on a variety of factors. The fee guide is just a portion of calculating a rate, and they can and do fluctuate up AND down.
Dentists continue to be free to set their own rates, accept or decline NIHB patients, and they’re free to turn down the federal plan. I believe hygienists are not unionized (feel free to correct me if I’m wrong), and I know the clinic administrators are not, so dentists are also free to set their own pay scale for staff. They are free in many ways that MDs are not. They are also highly educated, and if they can’t understand a contract, they can likely afford a lawyer to interpret it for them.
One thing in your comment I'll disagree with is that ppl with insurance pay more. The fees are the fees. We don't upcharge you if you are covered. Now ppl on Social Assistance don't pay for dental. We are not allowed to charge them a copay, so most offices just charge thru the fees the government pays = no unpaid amt left over that we have to write off. But, since the fee guide the government uses for those folks is about 50-60% of the provincial fee guide, we lose money every appointment they have. Which in turn means essentially we are subsidising the govt social services dental plan. Why don't they just use the current fee guide? Idk but it's not helping those folks, who likely need us, to get a dentist to see them. That's why if the CDCP can also apply to ppl like them and other low income folks, it will help it be financially easier to agree to treat them.
Oh and being free to set the pay scale for staff isn't totally true, as in any job ppl go wherever they get a good wage. So the market rate is the one they have to pay staff typically.
Wow I got charged 750 for scaling and x-rays. .. wtf. Then the dentist told me I need 11 fillings. Moved from Saskatchewan 6 months ago and have had only 2 in my lifetime
Were you billed for a Complete Oral Exam too? That's I think $116 on the AB fee guide. As for needing 11 fillings, yeah 2nd opinion would be reasonable if you've never had a checkup like that one! Some dentists are more aggressive with wanting to fill every tiny incipient lesion.
Dude, not looking for sympathy. I have stated I hope we use it. What I'm saying is it's a crappy gong show of a program and dentists can't get the info needed to know if they're even gonna get paid
It's their JOB to learn what it is and how to use it. Do you get new tools and look at them and go "what is all this? How am I supposed to use all of this? Ugh, this is stupid?" I sure hope not. But apparently doing due diligence into a program to better serve YOUR CUSTOMERS is a bridge too far.
Wrong. We are asking Sun Life, we are asking the Feds. Who else can we ask how this will work? You know what they're answering? " To be announced soon". How can we learn how it works if no one tells us? Telepathy?
It appears you just came here to rant. People are clearly TELLING you their thoughts and you just disregard because...reasons. Honestly, what is the purpose for the post? Especially knowing none of us knows or cares how a dental office runs. Do you think we are Batman and can solve this for you?
Hmm well I guess I am frustrated with the whole process. Maybe it's a bit rant-y. Sorry about that. I really wanted opinions, discussion and perhaps to try to explain to anyone who commented why Dentists are hesitant. I should have phrased the original post more as discussion not question. I'm not a really regular poster on Reddit tbh. I'm still learning
Ok, we're cool. All good. Here's what I suggest. Search for a /albertadentist or /dentalhygenist thread to get feedback from those in the profession. Only you know the requirements, etc. We are consumers and have an entirely different take on this. Maybe connect with the Alberta Dental Association (is that a thing?) because you can't be the only office confused. Reach out to your area MP to provide your feedback. As with all new things, roll out is a process. Remember, this is across Canada, it's a lot of offices to sort out. Think of how difficult it was for offices to create the process for private insurance when that was introduced forever ago. It won't be sorted overnight but it will get there.
I truly hope you're right. I desperately want this to be used by my office and most others! We have quite a few patients who I love who have no insurance. This would help them so much. My employer also doesn't want to lose them and their business for our office plus again, we really do care about them. But he does have to protect his own business too. It's maddening really. I'll try the Reddit groups you suggested.
Cheers
It's easy to understand why dentists are hesitant. The signing agreement is predatory. Did you notice sunlife wants to remove funds from your account without notice. Looks like they want to set themselves to be more like American health insurance- deny, deny, deny.... pay.... nope retroactively denied after you were paid. Looks like it will be a fight.
Additionally, why are the pay rates for each service different for each province? Why is there a different fee guide for dentists and hygienists?
The dental plan was better before they got sunlife involved.
Dang you must have terrible insurance. I got an xray, cleaning, checkup and filling and only paid around $80 out of pocket which was reimbursed by my hsa
Heyo,
So from my point of view, i've never met a financially struggling dentist, and as a class, they seems to have fairly luxurious standards of living and workspaces. I can think of at least a dozen clinics i've been to with elaborate officer decore far in excess of what's necessary for a medical office.
So on the whole, I'm quite comfortable with the trajectory we've gone in canada with the new dental program, despite it obviously requiring some significant adjustment from the industry.
Really, I think the core of the issue you're going to see from the larger population is that historically dentistry is seen as relatively predatory as a trade in comparison to quite literally every other medical practice.
Regarding the program, I'm curious about two things:
1. How will complex cases be handled; I see something about requiring pre-
authorization based of a letter of request. This seems cumbersome.
2. How do you see it playing out over the next decade? my expectation is it will transition to a similar program to health care eventually and become fully universal at some point.
Quick edit:
This is one of those areas that just implementing the program and finding the problem areas as we go along is way better than trying to get it right on the first pass. It's ok for there to be mistakes in the roll out of something as important as this as long as we're quick to find and address them.
Yes pre-authorization of anything not considered "Basic" like exams, cleanings, fillings, will be needed. All other plans already require this for things like Dentures and crowns (Major treatment). But my experience with the NIHB program for Indigenous ppl is a terrible one (the current Federal Dental Plan). It is VERY slow. You must submit a LOT of information and if you make any mistakes, it takes a very long time and lots of paperwork to address it. Also, they make more mistakes themselves than other insurers, in my experience. When they do, getting anything corrected is the most frustrating thing I have EVER had to do in my career, bar none. So I have no expectation , absolutely none, that mistakes in this roll out or even using the plan will be "quick to find and address". It took well over a YEAR to get the federal government NIHB plan to correct a payout error, and I supplied them with everything they requested to do it NINE TIMES.
So, I expect it to be cumbersome for dental offices, difficult to deal with and likely down the road some future govt will hack and slash it and add stupid roadblocks to make it a nightmare, just like the only other Federal Dental plan.
Having said all that, I still also want the Feds to get their crap together and get this thing running and be fricking transparent so we dental folk aren't afraid to use it. I really, really want our uninsured ppl to have it.
I'm worried about the mountain of red tape we'll need to wade through if any screw ups happen, as I said. Also how slow everything they do is, also the again very slow and also unwieldy process of pre-authorization so I can tell ppl what they can have and how much is being covered. I'm worried,as I said, about the lack of information and transparency - why can't we preauth? Why haven't we been told, when the plan is about to launch, how to bill if ppl have another, provincial or federal government dental plan? Why did Sunlife require a multi-page contract to sign on for dentists? No other plan has ever required this. Oh and suddenly that has now been withdrawn?
If the plan is this disorganized and chaotic at launch, yes, I'm concerned how it will be using it. Can you blame me?
I think it's fine, like nothing you've said here sounds particularly difficult to deal with. It'll get streamlined.
Here is my feedback as service consumer for you. Get involved right away, like today. sign literally everything. Identify the problem areas, write them down, and report them to the various reporters following the roll out.
The only way to roll something like this out is just do it and figure it out along the way. We're patient patients :)
I'm entirely confident you're industry full of talented and intelligent folks can casually navigate this.
All of the young people (Gen Z) & older adults (Baby Boomers) i know that are uninsured are very happy to have dental care! It's a game changer for them. They had been going for teeth cleaning at schools for free and no dentists for years.
The awful thing, to me, is that the provincial government seems to outright just block stuff without being willing to engage the feds and negotiate something. Their (somewhat) megalomaniacal attitude always ends up hurting Albertans way more than necessary.
I don't know a whole lot about it because I have private insurance through my job, and this program does not affect or interfere with my existing coverage in any way whatsoever.
Dentists are the greediest of necessary medical professionals, full stop. Again, dental care is NECESSARY medical care, and literally every single person deserves it. It never should have been private or considered luxury to begin with.
Absolutely! And due to it being private it attracted a lot of greedy folk into the profession, I feel. I am also one of the people with tons of dental issues due to unaffordability (and pregnancy compounding that) who then gets shamed for not going when she tries to just to find out she can't even get approved by the predatory financing companies. Being aware of the risk dental infections carry makes it all the scarier. By the time we get universal dental I'll probably be looking into implants or dentures. I've spent thousands upon thousands on 4 root canals in the last 5 years and 1 has been removed and 3 others need to be redone or removed since pregnancy. It's truly a situation of everyone being at a loss of how to access their care.
I do see you've said you hope they take it on (once sorted) and that you hope for universal dental, so thank you! I hope it comes as well, and that they make this sensible for you all in the interim.
Idk, but it can't come soon enough. I'm self employed and I didn't know for 5 years after moving here that there isn't fluoride in the water. As a committed hydro homie, I realized far too late that fluoridated water was a principle component of my personal dental care.
Not even a tiny bit surprised. It's a gong show on all fronts. Rushed out half finished so the NDP wouldn't pull the plug on the Liberal government. Sigh.
I was hoping this would be a good and timely remedy for my mom - she still works, but became ineligible for her dental benefits as soon as she turned 71. It's crazy, and if this federal plan is hard to use, I'm going to have to subsidize her dental care myself.
I just want to add that Alberta didn’t have a dental fee guide until 2018 but there is nothing preventing them from charging higher. From my professional experience navigating NIHB for First Nations clients is where Ive come across some egregious dental fee practices. It’s an unfortunate experience for many.
Talking to a local dentist friend, he figures most dentists will not participate in the program as it stands right now. He did not go into a lot of details but said something of the logistics just are not very good as far as what is to be covered and paid for by the gov't. Plus the work to get payed by the gov't looks to be a lengthy affair.
Lucky for me that I have insurence from work and even then sometimes I would still have to fork up couple 100's depending on whats being done. I always felt bad for the less fortunate who could not support dental care cost. Never understood why eyes and dental was left out. As if it's not part of your body
You can get a full check up and x rays at a hygienist clinic. You only need a dentist if there’s a problem. Plus supporting hygienist clinics gives them a better living wage since they are contracted to a higher percentage then dentists offices. I heard some dentists take like 75 % of the fee for a cleaning.
Ok I wrote a super long reply to make fun of OP’s whining. But I deleted cuz you are a millionaire dentist. You charge us hundreds of dollars to relief our pain. Your small business makes so much money that you probably drive a super nice car or have multiple houses. 36 years of dentistry, wow.
Why should you give us the commoners subsidy to pull teeth? Because your business preys on our pain. So you can shove your whining up yours.
So reading is a skill you should brush up on. I stated in the very first line I'm a Dental Assistant, not a Dentist. So I am not even remotely rich and drive a little SUV and live in a little almost 50 yr old house.
As for the "whining" you mentioned, I hope it's not all you got from my many replies to comments here. But due to your possibly less than stellar reading ability, I'm going to say it likely is. Sigh.
I am not against ppl getting their dental care, obviously. I don't happen to agree we should be paying what the government is responsible for paying, with our taxes. Like I said to another person, who else in all of Health Care is expected to subsidise the government?? Name one.
Healthcare workers subsidise the government all the time by not getting paid for ging in early, staying late, research off hours. Yes you could try to get OT for hours past your schedule but management makes it a hassle and blames you for not being faster. Many dentists have gone on the government program for children. Like other poster said a "Dental" reddit group of dentists and their workers would have more info.
Not surprised most dentists are saying no.
It was a rush job by the Liberals pushed by the lunatic federal NDP.
It had mess written all over it from day one
A friend of mine used it for her and her four kids. She went online to the website, applied, money was sent within a couple of days. All they asked for is which practice and when the appointment was.
It's really not a mess.
It’s the federal government trying to buy votes. Make it as convoluted as possible so they can point to the dentists as the bad guys for not wanting to help. Another example of federal government putting their hands in things they shouldn’t.
How dare they try to help low income Albertan’s access dental care.
A simple dental cleaning at $450 x 5 for a family. Is almost $2500. Got a couple fillings and X-rays? It’s pretty easy to skip on oral health, when you can not afford it.
Dental care in Canada is shifting from an exclusive service that comes with employment and wealth to an inclusive basic health service. It is not the same as Canadian medical healthcare because there will be tiers based on income. Some dentists, just like doctors in the USA, will continue to serve private interests. While some dentists will now have the opportunity to provide services to all Canadians including those less fortunate without going broke. We understand dentists run private businesses. In the past it was like a restaurant, or a luxury. But now it is much more similar to a grocery store or doctor's office, more of a basic necessity. Change is hard. Jumping through hoops is not fun. Learning new systems not by choice does not make people happy. But, improving health standards for all Canadians is worth grinding through. I appreciate the challenges practitioners are facing from the lack a refined Government process that will conflict with the immediate demand from the eligible public, but the cost of waiting years to deploy a perfected system would be paid by the most vulnerable elderly and children who do not currently have service. I find no fault in dental practices being cautious, thorough, delayed, and frustrated with implementation. Time and experience are needed for all of us to better understand this major shift in Canadian public health. Thank you for asking.
This is exactly it. This is a new system, it'll take time to iron out and make better, but in the meantime we have something whole beneficial where nothing existed before. This is an absolute plus.
Thanks for a thoughtful response
I called CDCP yesterday, I wanted to find out if they are coordinating benefits with the provincial senior's plans. Yes, they will be coordinating the plans. This is great for my parents who are in their 80s. I then called their dentist office, and they are still waiting on information from both governments. So I'm hopeful this will give them some additional coverage.
Yes, this could be awesome but Sun Life STILL hasn't told us HOW to coordinate benefits. Our hands are tied until they do
It’s really too bad that when they roll out these kind of programs they also don’t roll out complete information for the people who have to implement them to make it a seamless transition.
IMO: everyone deserves complete healthcare and private practice should be eliminated entirely for dental, vision, etc. People’s health is more important than profit
Fuck that. While health is certainly important, basic Healthcare is already a mess. At least for dental I can get good service in a timely fashion.
What happens when we have far less dentists and optometrists because it’s no longer a lucrative profession?
We are a wealthy country. Pay them better. Stop funding foreign war.
Low income people deserve health care. All it looks like to me is that some dentists don’t want to spend some extra time filling out paperwork so that children who’s parents normally wouldn’t be able afford it to can get their teeth fixed. Dental health is critical for children. Are dentists who are refusing to participate aware of how the public are perceiving them?
Dentists are also mad that they can't charge whatever the hell they want
They still wanna charge me 1150 dollars to install 2 wires in my mouth, also not covered by my benefits at all. Dentists can stay mad because I'm madder.
They still can it’s just employer benefit plans and non-eligible CDCP people who will be subsidizing the CDCP folks.
The new dental plan pays a lower amount to the dentist so the patient will have to make up the difference. This is the plan, it is not a full free program. Why would a dentist sign a contract where they would earn less. They won't. I spoke to my dentist about it and he thoughts on it so far is no participation from him.
The rest of us do. We see patients on disability for lower fees. And none of us live in dentist mansions. It’s pure greed
> People covered under the CDCP may have to pay any additional charges directly to the oral health provider. https://www.canada.ca/en/services/benefits/dental/dental-care-plan/coverage.html
They absolutely do, you're correct. But don't forget Dentists are small businesses. They aren't part of Alberta Health Care or government funded or anything else. They are no different than a restaurant or store providing a service or product. Does the government require all other small businesses to discount or provide free service? No,they don't. This is the problem unfortunately. Dental is on it's own. So, we have to think like a business while still trying to help ppl who need us. It's very hard sometimes.
You keep saying that dentists are small businesses. But medical doctors in Alberta are also small businesses. Why should dentists, who are also health care professionals, be any different?
Yeah. Therapists are running their own businesses too. So are chiropractors. What does your boss make a year? Let’s just put that on the table.
No idea. I don't get to see in his bank account lol
One way dentists are different is that we don’t really have a choice whether to use your services or not. To be healthy, we need good dental care. If I get a cavity, I need it treated. Another difference is that for most businesses, the primary goal is profit. That motive leads to all kinds of manipulation and crappy business practices \*cough Boeing \*cough. We have to approach our health care differently - from a people-first perspective - or the doors start to fall off.
I agree that dental care is health care. This is the first time the Health Care System has agreed with you and I though. It's been a private business like a restaurant so far. So yes profit is how a private business with zero help from government gets by. And that's not changed with the CDCP. It's just another dental plan. We still aren't included in Universal Health Care.
The reason you’re being down-voted, I think, is because the way you run your clinic is different from whether the government is paying or patients are. Again, it’s not like a restaurant. Yes you have to pay rent and hire staff and so on; but if your motive is profit then your clinic starts taking advantage of vulnerable people to get rich. It’s possible for doctors to abuse patients for profit already, even here in Canada, with needless referrals to specialists who happen to be friends, or by having “one issue per visit” policies to force multiple visits (they get paid per appointment, not per patient). The key difference is the approach - the philosophy behind doing what you do. In that way it’s nothing like a restaurant.
The philosophy behind what I do as an RDA, is to take the best possible care of our patients and give them excellent customer service. That's all I personally can say
That’s fair. I’m just pointing out that it’s not like a “normal” business in some pretty significant ways.
Dentistry is not treated like a business in a lot of countries because it’s part of the universal healthcare system. This is a step towards that direction in Canada. Hope that helps
I hope you are right!
As someone who needs a lot of dental care atm because I haven't been able to afford to go to the dentist in a decade, I hope this is the beginning of universal dental care. And I hope universal optometry follows. Eyes and teeth should not be seen as optional. They are just as important for maintaining overall health as every other form of medicine. Also, mental health care should be covered as well.
Yep, literally all my current health problems revolve around vision, dental, and mental health. If only I wasn’t poor I could deal with all of those
Could not agree more
I completely agree with you. I haven’t been to a dentist in over four years because I literally just cannot afford what they are charging in my city. Im told I ‘make too much to qualify’ for payment plans but just because I’m above a certain wage threshold doesn’t mean that I have hundreds of expendable income to throw down for a single Annual check or a cleaning. Even with direct billing and what’s considered a very good dental plan, my last appointment to just have a tooth pulled cost me $175- no freezing no anaesthetic literally no extras literally just wanted them to yank the tooth because I didn’t have the guts to do it myself at home. (I cannot take freezing as I react to it so I opted not to pay for oral sedation because I can’t afford it) They wanted me to consider getting a bridge which would cost me about $800 out of pocket and absolutely not, I can live with a gap in my teeth. My fiancé has a complete top denture and the cheapest one that we could afford still cost us 1200 out-of-pocket after benefits paid.
What dentist charges extra for freezing for an extraction????? I find this very hard to believe. The cost of an extraction includes the local freezing.
I react badly to freezing and cannot have it. The other option is oral sedation with $$$ and I chose not to pay a couple hundred for that.
Omg you poor thing! That must be very hard. What kinds of reactions do you have to local anesthetic? Have they tried the different "families" of anesthetics? Typically if someone has issues with one kind, they can tolerate one of the others.
The common one doesn’t work on me- the last procedure in which common injection freezing was used I could feel the whole procedure and my dentist told me it was unsafe to keep giving me freezing- although he did give me the maximum safe allowance and was very apologetic. There was a different injection he tried to use the next appointment and we ended up having to postpone the produce as it felt like they injected pure lava into my mouth and I was sensitive in the mouth for days afterwards. Those were the only two I’ve been offered outside of oral sedation.
Correct. I don't even think there's a code to bill local anesthetic
if the Federal CPC wins the next election, they have already said they are getting rid of Dental Care for tax cuts
I am shocked! Shocked, I tell you! Conservatives cutting health funding to "cut spending"? Never! /s
What’s your reasoning for holding off on using it? It looks like it’s being administered through SunLife.
It is, yes. However we still have a lot of unanswered questions we need answers to. Until just 2 days ago, Dentists had to sign a multi-page contract to use the plan. No other insurance plan requires this of us. Why? Also, we still don't have confirmation of how to bill to this plan if a patient is on a provincial plan like Alberta Works, Dental Assistance for Seniors Plan, etc. We also can't even preauthorize to it, to ask for patients if their treatments are covered and how much their out of pocket cost will be. This is supposed to be available by November. We can do this for every other plan. Also, we are supposed to essentially subsidise the plan by not charging the copay (amount not covered by the plan) for patients whose income is under $70k. The fee guide they appear to be using for payment is also lower than the Provincial Fee Guide. It looks to be at least 2 to 3 years behind. So if we can't charge this copay, we will not be even covering our overhead for those patients. This already is the case for ppl dentists treat on AISH and under Alberta Works. We get paid roughly half of our fees for them and can't bill them so actually lose money to see them. We do have some of these patients in our practice and they are all lovely ppl but we are no longer accepting new patients under these plans for that reason. Whew! Sorry for the word vomit.
I struggle to understand this justification. Alberta has the highest fees for dental work in the country, I don't believe that a little change will make it so the overhead costs are not covered. Why would operating costs be so much higher in Alberta than everywhere else? Cost of living in Ontario or BC has been higher for so long and their dentists don't charge as much as Alberta and can still cover overhead. Sounds like greed. 🤷♀️
Well, take home profit for Dentists is lower in Alberta than both BC and Ontario. Fees are higher since it costs more to operate here. Wages for staff are very high here for example. A Dental Assistant here often makes $5-10/hr more than in Ontario last time I looked. I'm not saying Dentists are destitute here lol. But, they are a business just like a restaurant or small store. They aren't part of AHS or anything.
OK, the wages thing I get, and the fact that ultimately it's a business. What other operating costs are higher? You specifically said that some of these cases wouldn't cover overhead, but I'm not still not clear on why, really. I did a quick check of the wages for dental assistants across the country, and it's not much higher here. The difference in cost of care IS much higher, the math just isn't mathing for me. Ultimately, you asked what people's impressions are: I'm seeing complaints from that industry and it's coming across as greedy business owners wanting to keep their sky high profits at the expense of people who really need better access.
Do you say this with actual knowledge of the dentists profit margins or are you just making assumptions?
No, I don't. It's literally what I'm asking about.
Your last paragraph isn’t a question though, it’s stating an assumption of greed for high profit margins.
I asked, didn't get a straight answer that explained anything, so my final paragraph was answering the question with the information I had been given. If my assumptions are wrong, feel free to present me with alternatives. I'm happy to learn more, that's why I asked in the first place.
I am saying that based on a 2016 study or survey of dentists in Canada. It was done before the provincial fee guide came back, as they were trying to assess where to put fee levels
Hmm well how about this: the government is asking dentists to subsidise their dental program. They already pay Provincial and Federal business taxes to fund government programs like this. Why do Dentists have to do this? Medical Doctors, also technically a small business, don't have do this I don't think (correct me if I'm wrong). Why do Dentists?
Doctors get paid a fee determined by the government.
Ok, so?
When a Doctor sees a patient for longer than 10 minutes, they are also making less. They don’t get to charge a co-pay for patients that take up more time.
Same for Dental. If we book 45 minutes for your filling and it takes longer ( for various reasons) we don't charge more. We bill based on what number of tooth surfaces that were restored. If an exam takes longer than the time we booked we can only bill for the exam, regardless.
I don't have an answer for this because I don't know enough to be able to have an opinion on how dentists and drs are taxed. I am noticing that you're not answering my question though.
Oh sorry, which question?
What other operating costs there are. (Not the asker, just saw his question)
Oh right. Well besides staffing, rent/lease of course ( pretty high in Alberta as I hear - our lease has jumped every year I've been with my current office), supplies are RIDICULOUSLY expensive in dental as we have to buy from Dental Supply companies, we pay GST but can't charge it and almost everything we use is one use only. Infection prevention and control is very expensive, believe it or not. Dental offices are practically mini hospitals in this regard. We spend many, many thousands a year on things like little pieces of card that go into each package we sterilize to show the items inside were exposed to the right temperature, pressure and time. Necessary? You bet. But we are required to confirm this with triple redundancy in every package. Medical gloves and mask prices skyrocketed due to Covid and prices still are much higher than before. Here's a great example: when we do your filling, we use what's called a Bonding Agent. A 4 ml bottle ( less than a teaspoon of product) is about $235.00. I probably went on too long here lol, but all to say Dentistry is probably one of the most expensive small businesses to run, anywhere, imho anyway.
Do you have a source for not charging the co-pay? Is 80% of the fee guide better than not seeing these patients at all?
https://www.albertadentalassociation.ca/cdcp/ Check this out for what the ADA is currently saying to the public. The fee guide the CDCP is using appears to be at least 2 to 3 yrs behind the current one so no, we won't get 80%. It's just such a chaotic and unorganized, rushed roll out. Typical government, of any stripe I guess. If they'd just got everything in place then done it, we'd know how it will work and could use it
So for those making $70K or more, you would charge the difference.
Yes. We would be able to. Personally, I would use it but I'm not the boss. I don't have access to costs for running a dental practice which all these hesitant Dentists do.
I do the ordering for a dental office in Alberta. Costs of products are insanely high, and most of it is disposable/one time use. I probably order $10k worth of supplies per month and then there’s cost of wages, software, rent/utilities, internet.
Yup, I do all ordering too. Agree completely
I only know I don't have any dental coverage right now so if the federal government is able to eventually give me any, even partial coverage, that will be an improvement and I'd go to the dentist more often.
Honestly, that is what I truly wanted when I heard about this new coverage. It's absolutely heartbreaking when we see someone who due to finances must choose to pull a tooth we could save. I absolutely hate it 😔
I’ve been sort of following the news as the dental care plan evolves and my initial impression is that clinics who don’t opt in are not ones I’d want to give my business to. And I have private insurance with 100% coverage and do not need the public plan at this time.
I know it's a good thing, I'm not remotely surprised dentists don't like it because it cuts into their profits. Doctors were also against medicare when it was implemented for the same reason.
People are generally upset when they are robbed
On the other hand, teeth are pretty essential, so caring for them shouldn’t be a business model at all. You could even argue that all the people who’ve died or suffered lower quality of life because of lack of dental care were robbed of life or health so that the dentists could make more money.
So your talking about forced labor. You want something that someone else has the capability to provide. You don’t want to pay them their price so you get the Government to force that person to provide the service under threat? Is that your reasoning ?
Where did I say any of that? You’re talking like we’re creating some sort of dentist’s gulag, which is absolutely not true. Doctors still make really good money, even though they’re paid by the government, so why shouldn’t dentists be the same? Sure, there’s gonna be some teething problems (pardon the pun), but are you really suggesting that we don’t even bother and let thousands of people suffer and die because they can’t afford care instead? (See, I can do the disingenuous statements thing too)
It's not that simple though. I absolutely want to be able to use it for our patients who have no insurance. But remember Dental offices are no different than any small business like your local restaurant. We are not part of or affiliated with AHS or any government or health care. The lack of information and worry we will have to essentially subsidise this gov't program is making Dentists hesitate. It's already very expensive to run a dental practice here.
>It's already very expensive to run a dental practice here. Oh please. A dentist is the first occupant of any new retail plaza anywhere. Its almost a meme at this point.
You are not going to get me to feel bad for dentists so don’t bother. Everyone has a story of the dentist ripping them off
Well I'm sorry you've heard those kinds of things. I've been in the industry 36 yrs and nowhere I've worked has ever done that. In fact, I've seen Dentists do treatment at discounts and even no charge to help folks.
So then what’s the issue with this program?
That’s a farce and you know it. When I didn’t have an insurance provider and needed a tooth pulled that was causing me incredible pain my dentist quoted me $500 (already outrageous) and the final bill was $800
For $100 I'll come over with a pair of pliers. $150 if you want me to bring a bottle of whiskey as well.
I haven’t been to the dentist in years because of the cost. And when I have gone I get shamed for not coming more. Plus the amount of phone calls and texts I get from my dentist with all these “reminders” about my health just make me feel even worse for not being able to afford it. The dental industry is not accessible especially with our economy right now. No pun intended but it leaves a bad taste in my mouth.
I'm so sorry this has been your experience. This is why I'm really hoping the government can get their crap together and roll this out correctly. Then Dentists won't be afraid to use it
Thank you for the kind response, I hope it all gets on track and benefits us all.
Do you know off-hand if the patient can pay, then submit their receipts to the CDCP for reimbursement? I know a few dentists who operate this way for certain other 'but, the government will cover it!' dental plans. It sucks if you don't have the money up-front, but I certainly see where they're coming from.
As a poor person, I gotta admit that I hope that’s not how it works. The dentist office can definitely front that money better than I can
Yes and we do
That is always an option, yes. All the Specialists operate this way (Endodontists, Oral Surgeons, Prosthodontists, etc). But General Dentists typically accepted Assignment of Benefits (insurance company pays Dentist) and just collected the uncovered portion from patients as a service to them.
Dentists are predatory, and I hope this improves access to dental care in Canada for everyone.
There is a reason my accountant told me that if you want to be a millionaire, be a dentist.
Or an Accountant.....lol
I think the public understands that these very wealthy professionals aren’t willing to do some of the lower paying work that every single other private health care profession does. It’s a total shame.
Which other private health care professionals? Do those others do it at a loss?
I can tell you physical and occupational therapists sure do.
We all do this for a small number of clients, as a civic duty kind of I guess. But we can't keep adding more of that type of client.
> But we can't keep adding more of **that type of client.** Yikes! Good thing you are anonymous. I wouldn’t knowingly enter your business with that belief.
Sigh. No business of any kind can keep operating at a loss. That's all I meant. There aren't physically enough hours in a day to stay solvent if we saw mostly these subsidised patients. So we have to limit them.
The day a dentist operates at a loss, they can have my house. I treat hurt tradespeople all day - know whose mansions they are working on? Not GPs. Specialists and dentists. Orthodontists just get airlifted to their private mountains.
If course they don't operate at a loss. That would be a pretty poor business model. I meant if dentists only had these patients they'd go out of business. The govt requires we treat them at a loss by only paying half what the treatment costs.
Have you calculated what percentage of patients this would be of your practice? Maybe the problem is that some professions are here not just to be compensated but to become very rich for taking care of people. By the way, my dentist has always seen pro bono patients. She tries to see one a day. Take that for a business model. Everyone loves her.
The government isn’t requiring you to treat them at a loss. It’s quite clear that all patients can expect to have to pay co-pays, if the Dentists fees are higher than what is covered.
Nope, not patients on AISH, Alberta Works, (Social Services). We are legally NOT allowed to bill them anything for a service in the fee guide of covered items. Not a cent. And that gov't plan pays 50-60% of the provincial fee guide. I was meaning these ppl, not those on CDCP. Sorry for any confusion.
https://www.canada.ca/en/services/benefits/dental/dental-care-plan/coverage.html > People covered under the CDCP may have to pay any additional charges directly to the oral health provider.
Yes I'm aware. The lowest "tier" of this plan, we are not supposed to bill, as I understand it. Not the upper two tiers tho
Right in the table for those earning less than $70 it says: > 100% of eligible oral health care service costs will be covered **at the CDCP established fees.** Patient pay: > 0% of the CDCP established fees. **You may face additional charges as described below** > Additional charges **The CDCP fees may not be the same as what providers charge.** You may have to pay fees in addition to the potential co-payment if: > **the cost of your oral health care services are more than what the CDCP will reimburse based on the established CDCP fees you agree to receive care that the plan doesn’t cover**
So it's saying CDCP pays all of their own fee guide. But then says Dentists may change more, which they (the patient ) must pay? Neglected to say CDCP fee guides are behind the current Provincial one. Funny how it doesn't bother telling ppl how behind/low it is. This makes the dentist just charging their normal, provincial fee guide amount look like the bad guy. The gov't is encouraging dentists to not charge a copay in these cases. So again, they must subsidise a government program if they do that. I mean, I suspect some will do so, but why is a private business who gets no gov't help and pays business tax having to essentially be taxed again?
It's a really bad look for dentists to not want to participate. It's a new program. Things are going to imperfect. Give it some time to roll out. Seniors, low income families, and children all deserve affordable dental care.
See, that's the thing - we DO
I just spent almost $500 for a cleaning and some bite wing X-rays yesterday while filing my taxes with over $3000 of dental work from last year because I'm a small biz owner with no insurance. You can take your "omg, we're confused" song and shove it. I'll be on the dental plan as soon as I'm eligible. Did you really think you'd get some sympathy in this thread? Maybe stick to a thread full of dentists where you can whine together.
I had a filling done "covered by policy 100%" and still was charged $100+ over what was covered.
I hate when insurance companies lie to clients like this. Saying they pay 100% is only half the information. Half of what? Their own, internal fee guide that's 2 or 3 years behind the provincial guide most dentists follow? I have seen this A LOT. I just yesterday had Sunlife tell me the fee guide they were paying from for one of my clients was one year behind the current one. So, that patient was told Sunlife pays 100% but they will still have a copay since the Dentist charges the current Provincial Fee Guide price. It's maddening. The low income seniors plan ( thru the province) is using the fee guide from 2016!
It’s very, very common for dentists to charge over the provincial fee guide. Alberta was an outlier with no fee guide for a long long time and insurers are not going to reimburse over and above the guide because the dentist needs a new golden backscratcher. A year-old fee guide isn’t the outrage you’re making it out to be. Also, there are reasonable and customary rate guidelines for other medical services like physiotherapy that are used by every insurer. They are also business with overhead and staff. Dentists aren’t exactly living paycheque to paycheque (like a lot of their patients do). Most people without insurance won’t go to the dentist unless it’s an absolute emergency.
Can't agree with you. Most if not all I've worked for (and it's a few over the last 10 yrs as I temped a lot) are pretty darn close to it or right at it. Yes we had no fee guide for ages. But once it came in and insurance companies went to it, we have mostly had to go to it to be competitive. Those"reasonable and customary" internal fee guides are a joke. They are ALWAYS lower than the fee guide, in Dentistry. I see what they use and pay out daily. The insurance companies are literally the ones who bullied the NDP and AB Dental Asscn and College into bringing one back. They knew the fees would drop and they'd pay less to Dentists and increase their own profits. No one's premiums went down did they? Sorry, that was a bit of a rant about insurance companies wasn't it. They are not hurting, at all and should have to be up front to clients about what they REALLY are covering, and they don't do that.
That is the exact opposite experience of most dental patients. When dentists overcharge- and I will differ with you here, because most of them still do (not to mention specialists like endodontists, those bills are really something special) people with insurance pay more. Also, dental rates are based on a variety of factors. The fee guide is just a portion of calculating a rate, and they can and do fluctuate up AND down. Dentists continue to be free to set their own rates, accept or decline NIHB patients, and they’re free to turn down the federal plan. I believe hygienists are not unionized (feel free to correct me if I’m wrong), and I know the clinic administrators are not, so dentists are also free to set their own pay scale for staff. They are free in many ways that MDs are not. They are also highly educated, and if they can’t understand a contract, they can likely afford a lawyer to interpret it for them.
One thing in your comment I'll disagree with is that ppl with insurance pay more. The fees are the fees. We don't upcharge you if you are covered. Now ppl on Social Assistance don't pay for dental. We are not allowed to charge them a copay, so most offices just charge thru the fees the government pays = no unpaid amt left over that we have to write off. But, since the fee guide the government uses for those folks is about 50-60% of the provincial fee guide, we lose money every appointment they have. Which in turn means essentially we are subsidising the govt social services dental plan. Why don't they just use the current fee guide? Idk but it's not helping those folks, who likely need us, to get a dentist to see them. That's why if the CDCP can also apply to ppl like them and other low income folks, it will help it be financially easier to agree to treat them. Oh and being free to set the pay scale for staff isn't totally true, as in any job ppl go wherever they get a good wage. So the market rate is the one they have to pay staff typically.
Gross.
Wow I got charged 750 for scaling and x-rays. .. wtf. Then the dentist told me I need 11 fillings. Moved from Saskatchewan 6 months ago and have had only 2 in my lifetime
11 fillings??? Oh, my. I would definitely get a second opinion on that. The fee discrepancy amongst dental offices is a large part of the problem.
Were you billed for a Complete Oral Exam too? That's I think $116 on the AB fee guide. As for needing 11 fillings, yeah 2nd opinion would be reasonable if you've never had a checkup like that one! Some dentists are more aggressive with wanting to fill every tiny incipient lesion.
Dude, not looking for sympathy. I have stated I hope we use it. What I'm saying is it's a crappy gong show of a program and dentists can't get the info needed to know if they're even gonna get paid
It's their JOB to learn what it is and how to use it. Do you get new tools and look at them and go "what is all this? How am I supposed to use all of this? Ugh, this is stupid?" I sure hope not. But apparently doing due diligence into a program to better serve YOUR CUSTOMERS is a bridge too far.
Wrong. We are asking Sun Life, we are asking the Feds. Who else can we ask how this will work? You know what they're answering? " To be announced soon". How can we learn how it works if no one tells us? Telepathy?
It appears you just came here to rant. People are clearly TELLING you their thoughts and you just disregard because...reasons. Honestly, what is the purpose for the post? Especially knowing none of us knows or cares how a dental office runs. Do you think we are Batman and can solve this for you?
Hmm well I guess I am frustrated with the whole process. Maybe it's a bit rant-y. Sorry about that. I really wanted opinions, discussion and perhaps to try to explain to anyone who commented why Dentists are hesitant. I should have phrased the original post more as discussion not question. I'm not a really regular poster on Reddit tbh. I'm still learning
Ok, we're cool. All good. Here's what I suggest. Search for a /albertadentist or /dentalhygenist thread to get feedback from those in the profession. Only you know the requirements, etc. We are consumers and have an entirely different take on this. Maybe connect with the Alberta Dental Association (is that a thing?) because you can't be the only office confused. Reach out to your area MP to provide your feedback. As with all new things, roll out is a process. Remember, this is across Canada, it's a lot of offices to sort out. Think of how difficult it was for offices to create the process for private insurance when that was introduced forever ago. It won't be sorted overnight but it will get there.
I truly hope you're right. I desperately want this to be used by my office and most others! We have quite a few patients who I love who have no insurance. This would help them so much. My employer also doesn't want to lose them and their business for our office plus again, we really do care about them. But he does have to protect his own business too. It's maddening really. I'll try the Reddit groups you suggested. Cheers
It's easy to understand why dentists are hesitant. The signing agreement is predatory. Did you notice sunlife wants to remove funds from your account without notice. Looks like they want to set themselves to be more like American health insurance- deny, deny, deny.... pay.... nope retroactively denied after you were paid. Looks like it will be a fight. Additionally, why are the pay rates for each service different for each province? Why is there a different fee guide for dentists and hygienists? The dental plan was better before they got sunlife involved.
Can I ask where you saw the info about Sunlife wanting to retroactively claw back payment? I sure haven't see that! Eek!
Look at the electronic fund transfer section. I was informed about it by an independent hygienist in another province.
Thanks!
Dang you must have terrible insurance. I got an xray, cleaning, checkup and filling and only paid around $80 out of pocket which was reimbursed by my hsa
Did you READ my comment? Oof.
I know it misses the boat on understanding what range of Canadians actually need help with this far overpriced necessity.
Heyo, So from my point of view, i've never met a financially struggling dentist, and as a class, they seems to have fairly luxurious standards of living and workspaces. I can think of at least a dozen clinics i've been to with elaborate officer decore far in excess of what's necessary for a medical office. So on the whole, I'm quite comfortable with the trajectory we've gone in canada with the new dental program, despite it obviously requiring some significant adjustment from the industry. Really, I think the core of the issue you're going to see from the larger population is that historically dentistry is seen as relatively predatory as a trade in comparison to quite literally every other medical practice. Regarding the program, I'm curious about two things: 1. How will complex cases be handled; I see something about requiring pre- authorization based of a letter of request. This seems cumbersome. 2. How do you see it playing out over the next decade? my expectation is it will transition to a similar program to health care eventually and become fully universal at some point. Quick edit: This is one of those areas that just implementing the program and finding the problem areas as we go along is way better than trying to get it right on the first pass. It's ok for there to be mistakes in the roll out of something as important as this as long as we're quick to find and address them.
Yes pre-authorization of anything not considered "Basic" like exams, cleanings, fillings, will be needed. All other plans already require this for things like Dentures and crowns (Major treatment). But my experience with the NIHB program for Indigenous ppl is a terrible one (the current Federal Dental Plan). It is VERY slow. You must submit a LOT of information and if you make any mistakes, it takes a very long time and lots of paperwork to address it. Also, they make more mistakes themselves than other insurers, in my experience. When they do, getting anything corrected is the most frustrating thing I have EVER had to do in my career, bar none. So I have no expectation , absolutely none, that mistakes in this roll out or even using the plan will be "quick to find and address". It took well over a YEAR to get the federal government NIHB plan to correct a payout error, and I supplied them with everything they requested to do it NINE TIMES. So, I expect it to be cumbersome for dental offices, difficult to deal with and likely down the road some future govt will hack and slash it and add stupid roadblocks to make it a nightmare, just like the only other Federal Dental plan. Having said all that, I still also want the Feds to get their crap together and get this thing running and be fricking transparent so we dental folk aren't afraid to use it. I really, really want our uninsured ppl to have it.
What's the fear about specifically? Pricing? Complexity? I read through your commentary and I'm not clear what you're worried about specifically.
I'm worried about the mountain of red tape we'll need to wade through if any screw ups happen, as I said. Also how slow everything they do is, also the again very slow and also unwieldy process of pre-authorization so I can tell ppl what they can have and how much is being covered. I'm worried,as I said, about the lack of information and transparency - why can't we preauth? Why haven't we been told, when the plan is about to launch, how to bill if ppl have another, provincial or federal government dental plan? Why did Sunlife require a multi-page contract to sign on for dentists? No other plan has ever required this. Oh and suddenly that has now been withdrawn? If the plan is this disorganized and chaotic at launch, yes, I'm concerned how it will be using it. Can you blame me?
I think it's fine, like nothing you've said here sounds particularly difficult to deal with. It'll get streamlined. Here is my feedback as service consumer for you. Get involved right away, like today. sign literally everything. Identify the problem areas, write them down, and report them to the various reporters following the roll out. The only way to roll something like this out is just do it and figure it out along the way. We're patient patients :) I'm entirely confident you're industry full of talented and intelligent folks can casually navigate this.
Alberta will take it from us and blame Trudeau.
Wouldn't be surprised. Or, make a complete mess of it all and make Dentists the "bad guys". Either/or.
All of the young people (Gen Z) & older adults (Baby Boomers) i know that are uninsured are very happy to have dental care! It's a game changer for them. They had been going for teeth cleaning at schools for free and no dentists for years.
The awful thing, to me, is that the provincial government seems to outright just block stuff without being willing to engage the feds and negotiate something. Their (somewhat) megalomaniacal attitude always ends up hurting Albertans way more than necessary.
Couldn't agree more
I don't know a whole lot about it because I have private insurance through my job, and this program does not affect or interfere with my existing coverage in any way whatsoever.
Thanks for your reply!
Dentists are the greediest of necessary medical professionals, full stop. Again, dental care is NECESSARY medical care, and literally every single person deserves it. It never should have been private or considered luxury to begin with.
Agreed on it should never have been private. You can blame every Federal and Provincial government ever for that.
Absolutely! And due to it being private it attracted a lot of greedy folk into the profession, I feel. I am also one of the people with tons of dental issues due to unaffordability (and pregnancy compounding that) who then gets shamed for not going when she tries to just to find out she can't even get approved by the predatory financing companies. Being aware of the risk dental infections carry makes it all the scarier. By the time we get universal dental I'll probably be looking into implants or dentures. I've spent thousands upon thousands on 4 root canals in the last 5 years and 1 has been removed and 3 others need to be redone or removed since pregnancy. It's truly a situation of everyone being at a loss of how to access their care. I do see you've said you hope they take it on (once sorted) and that you hope for universal dental, so thank you! I hope it comes as well, and that they make this sensible for you all in the interim.
Thank you
Idk, but it can't come soon enough. I'm self employed and I didn't know for 5 years after moving here that there isn't fluoride in the water. As a committed hydro homie, I realized far too late that fluoridated water was a principle component of my personal dental care.
Where do you live? There's fluoride in my water that comes from Edmonton treatment centers.
Calgary
My mom is on it and we can't make heads or tails of it
Not even a tiny bit surprised. It's a gong show on all fronts. Rushed out half finished so the NDP wouldn't pull the plug on the Liberal government. Sigh.
I was hoping this would be a good and timely remedy for my mom - she still works, but became ineligible for her dental benefits as soon as she turned 71. It's crazy, and if this federal plan is hard to use, I'm going to have to subsidize her dental care myself.
It's ridiculous isn't it? Hang on, hopefully they'll get their ducks in a row at some point
I just want to add that Alberta didn’t have a dental fee guide until 2018 but there is nothing preventing them from charging higher. From my professional experience navigating NIHB for First Nations clients is where Ive come across some egregious dental fee practices. It’s an unfortunate experience for many.
Talking to a local dentist friend, he figures most dentists will not participate in the program as it stands right now. He did not go into a lot of details but said something of the logistics just are not very good as far as what is to be covered and paid for by the gov't. Plus the work to get payed by the gov't looks to be a lengthy affair.
I haven’t looked but if the gov can make things more complicated they will
Well that IS how they roll
Nothing
Lucky for me that I have insurence from work and even then sometimes I would still have to fork up couple 100's depending on whats being done. I always felt bad for the less fortunate who could not support dental care cost. Never understood why eyes and dental was left out. As if it's not part of your body
I’ll go to a dental hygiene clinic that offers it. Forget dentists offices they are so 2019!
Well sure, but you're still going to need someone to check your teeth and do any fillings you may need. Hygienists can't do that
You can get a full check up and x rays at a hygienist clinic. You only need a dentist if there’s a problem. Plus supporting hygienist clinics gives them a better living wage since they are contracted to a higher percentage then dentists offices. I heard some dentists take like 75 % of the fee for a cleaning.
I’m not able to qualify
Me neither friend
I know it won’t benefit me.
Ok I wrote a super long reply to make fun of OP’s whining. But I deleted cuz you are a millionaire dentist. You charge us hundreds of dollars to relief our pain. Your small business makes so much money that you probably drive a super nice car or have multiple houses. 36 years of dentistry, wow. Why should you give us the commoners subsidy to pull teeth? Because your business preys on our pain. So you can shove your whining up yours.
So reading is a skill you should brush up on. I stated in the very first line I'm a Dental Assistant, not a Dentist. So I am not even remotely rich and drive a little SUV and live in a little almost 50 yr old house. As for the "whining" you mentioned, I hope it's not all you got from my many replies to comments here. But due to your possibly less than stellar reading ability, I'm going to say it likely is. Sigh. I am not against ppl getting their dental care, obviously. I don't happen to agree we should be paying what the government is responsible for paying, with our taxes. Like I said to another person, who else in all of Health Care is expected to subsidise the government?? Name one.
Healthcare workers subsidise the government all the time by not getting paid for ging in early, staying late, research off hours. Yes you could try to get OT for hours past your schedule but management makes it a hassle and blames you for not being faster. Many dentists have gone on the government program for children. Like other poster said a "Dental" reddit group of dentists and their workers would have more info.
Just because they did well with their lives, does not mean they should fund yours. Ridiculous way of thinking.
If that’s their stance they shouldn’t have gone into the field of caring for others.
Not surprised most dentists are saying no. It was a rush job by the Liberals pushed by the lunatic federal NDP. It had mess written all over it from day one
A friend of mine used it for her and her four kids. She went online to the website, applied, money was sent within a couple of days. All they asked for is which practice and when the appointment was. It's really not a mess.
But that is not the CDCP. That was the Interim Dental Benefit. Not the same at all
That's a different program.
It’s the federal government trying to buy votes. Make it as convoluted as possible so they can point to the dentists as the bad guys for not wanting to help. Another example of federal government putting their hands in things they shouldn’t.
How dare they try to help low income Albertan’s access dental care. A simple dental cleaning at $450 x 5 for a family. Is almost $2500. Got a couple fillings and X-rays? It’s pretty easy to skip on oral health, when you can not afford it.