In the Best Interest

of your Dental Health

OHIP Dental Coverage and

Free Dental Care Ontario
in 2022
Written by Dr. Joanne Baldos and Dr. Adam
Szymczak | Jul 13, 2022 1:00:00 PM

Who gets OHIP Dental

Coverage in Ontario?

OHIP dental coverage is a type of free

dental care in Ontario for all Ontario
residents.

The Ontario Health Insurance Plan (OHIP)

covers ALL Ontario residents for medical
procedures, however, the free dental care
under OHIP is limited to oral surgery
performed in a hospital and ONLY in
limited situations such as:

correcting birth defects (eg.cleft-lip

and palate)
surgery for diseases of the jaw (eg.
cysts and tumours)
correcting damage to the jaws and
face as a result of an accident (eg.
fractured jaw)

Most people think of the above services

as medical OHIP services, but in fact,
they fall under OHIP dental coverage as it
is dentists that provide those treatments
and OHIP is billed for those services.

OHIP dental coverage does NOT

include regular dental care such as
checkups, cleanings, fillings, x-rays,
root canals and tooth removal. ( under
rare circumstances and with prior
approval by OHIP, tooth removal may fall
under OHIP dental coverage)

Some hospitals have dental clinics,

however, OHIP dental coverage does not
apply to regular dental care.

For regular dental care, a hospital-based

dental clinic will charge you the same way
as a private dental clinic.

Most people who have dental insurance

in Ontario have coverage through an
employer-sponsored dental plan, also
called "private dental insurance" because
it's paid for by "private money."

However, those most in need can qualify

for free dental care paid for by the
government. This dental coverage can be
called "public dental insurance" as it's
paid by "public money", a.k.a. taxes.

Free Dental Care Programs in

Ontario in 2022

(in addition to OHIP Dental

Coverage)

In addition to OHIP, there are 7

government-funded dental care programs
in Ontario.

The 4 Ontario government-funded dental

care programs are:

1. (OSDCP): Ontario Seniors Dental Care

Program: free dental care for seniors in
Ontario

2. (HSO): Healthy Smiles Ontario: free

dental care for kids

3. (ODSP): Ontario Disability Support

Program: free dental care for adults that
are disabled

4. (OW): Ontario Works: free dental care

for low-income adults

Unlike OHIP dental coverage which you

access automatically using your OHIP
card, to qualify for the above free dental
programs you need to apply first. These
programs cover emergency and regular
dental care.

There are also 3 federal government-

funded dental care programs
(Government of Canada), which of course
are available to Ontario residents as well:

5. (IFHP): Interim Federal Health Program:

 free dental care for resettled refugees

6. (NIHB): Non-Insured Health Benefits:

free dental care for eligible First Nations
people

7. (VAC): Veterans Affairs Canada: free

dental care for Canadian veterans

How do I qualify and apply for

free dental care?

Each of the 7 free dental care programs

has different criteria for qualifying and has
separate processes to apply. Read below
for details regarding each one of the
programs:

1. (OSDCP): Ontario Seniors

Dental Care Program:

(free dental care for seniors in

Ontario)

On Nov. 20, 2019, the Ontario

government officially launched the
Ontario Seniors Dental Care Program
(OSDCP) which aims to deliver regular
dental services for low-income seniors.

The government was motivated by 2

facts to commit $90 million every year to
OSDCP:

every year there are over 60,000

emergency HOSPITAL visits for
infection and pain as a result of
PREVENTABLE dental conditions
such as gum disease and tooth
decay
lack of regular dental care has a
significant effect on overall health
and quality of life

The government hopes this program

will cut emergency hospital wait times
and improve the overall well-being of
seniors by providing regular dental
care such as checkups, cleanings,
fillings, x-rays, root canals and tooth
removal. (dentures will be covered
partially)

The dental services will be provided

through Public Health Units, some
Community Health Centres and
Aboriginal Health Access Centres. This is
unlike the other 3 free dental care
programs which are delivered by
participating private dental clinics. 

OSDCP is not accessible through your

regular dentist!

Who can get free dental care for

seniors through the Ontario
Seniors Dental Care Program
(OSDCP)?

To qualify for OSDCP you must:

be at least 65 years old

be an Ontario resident
have an annual income of $22,200 or
less (single person); for a couple:
combined annual income of $37,100
or less
NOT have other dental benefits

OSDCP should not be confused with

OHIP dental coverage for seniors.

OHIP dental coverage for seniors is the

same as for everyone else in Ontario.
OHIP will cover  only for major jaw
surgeries done in hospital.

How do I apply for the Ontario

Seniors Dental Care Program?

There are 3 ways to apply:

1) Pick up an application from your local

public health unit.

2) Download and print the application:

HERE. ( you will need Adobe Acrobat
Reader version 10.0 or higher)

3) Complete the “online application

form”. In addition to filling out the “online
application," you will still need to print,
sign and mail in the consent section of
the application.

Complete the paperwork and mail the

documents to:

Ministry of Health
Ontario Seniors Dental Care Program
Station P, P.O. Box 159
Toronto, ON

M5S 2S7

Once the application is approved, you will

receive a Healthy Smiles Ontario dental
card in the mail. If there is a problem with
your application you will be contacted by
phone and/or mail.

2. (HSO): Healthy Smiles

Ontario:

(free dental care for kids)

What is Healthy Smiles Ontario?

Healthy Smiles Ontario is free dental care

for kids and youth 17 years old and
younger.

Healthy Smiles Ontario was created on

Jan.1, 2016, by combining multiple
publicly funded free dental care
programs, namely:

Ontario Works dental benefits

for kids
Ontario Disability Support
Program dental benefits for kids
Assistance for Children with
Severe Disabilities dental
benefits program
( CINOT) Children in Need of
Treatment
Preventive services provided by
local public health units

Does Healthy Smiles Ontario

Cover Braces?

Healthy Smiles Ontario does NOT cover

braces. It also does not cover other
cosmetic services such as veneers and
teeth whitening. Dental implants are also
not covered.

How do I apply for Healthy Smiles

Ontario (HSO)?

To apply for free dental care for kids

under HSO, your child must:

be 17 years old or younger

live in Ontario
live in a low-income household:
1 child household; household
income must be $24,930 or
lower
2 children household;
household income must be
$26,817 or lower
3 children household;
household income must be
$28,703 or lower

Kids 17 and under are automatically

enrolled in Healthy Smiles Ontario when
they or their family receive: Ontario
Works, Temporary Care Assistance,
Assistance for Children with Severe
Disabilities or the Ontario Disability
Support Program.

A child who has dental insurance

coverage CAN apply and be eligible for
HSO as long as the above criteria are
met.

There are 3 ways to obtain an application

and apply:

A) Pick up an application from your local

public health unit or a Service Ontario
location.

B) Download and print the application:

HERE.

( you will need Adobe Acrobat Reader

version 10.0 or higher)

C) Complete the “online application

form”.

In addition to filling out the “online

application," you will still need to print,
sign and mail in the consent section of
the application.

Complete the paperwork and mail the

documents to:

Healthy Smiles Ontario

33 King Street West
PO Box 645
Oshawa, ON
L1H  8X1

Once your application is approved, you

will receive a dental card in the mail. If
there is a problem with your HSO dental
insurance application you will be
contacted by phone and/or mail.

What does Healthy Smiles

Ontario cover?

Healthy Smiles Ontario covers regular

dental care such as:

checkups
cleanings
fillings
x-rays
root canals
tooth removal
gum surgery
some tooth replacement options
sedation
emergency dental services

Full details about Healthy Smiles Ontario:

HERE.

3. (ODSP): Ontario Disability

Support Program:

( free dental care for adults that

have a substantial physical or
mental disability)

Children of parents receiving ODSP will

be automatically enrolled in Healthy
Smiles Ontario: free regular dental care
for kids. Please contact your case worker.

The ODSP provides basic dental services

to ODSP recipients and their spouses:

exams
cleanings
fillings
root canals
tooth removal 

People who are eligible to receive

Transitional Health Benefits are also
eligible for this free dental care.

On April 1, 2019, the Ministry of Children,

Community and Social Services (MCCSS)
will no longer issue paper dental cards for
adult ODSP recipients. Ontario dentists
will need to register using the
AccertaWorX online tool to verify patient
eligibility for the ODSP dental program
before providing dental care.

Dental Special Care Plan:

In addition to basic dental services,

ODSP recipients and eligible spouses
may receive
services under the Dental Special Care
Plan which provides enhanced benefits
for those whose dental needs result from
disability, prescribed medications or
medical treatment that affects oral health.
For example:

Radiation of head/ neck

Diuretics
Diabetes
HIV/AIDS
Developmental disabilities (such as
Down Syndrome)

A dentist must apply for the Dental

Special Care Plan on behalf of the patient