Seniors unclear on whether they can drop their private dental insurance for national plan

Eligible seniors are now receiving letters inviting them to sign up for Canada's $13 billion national dental care plan but there's a catch.

Those who currently haveprivate dental insurance do not qualify for the national plan.

Andaccording to a government websiteexplaining the plan, anyonewho opts out of "available benefits" is "still considered to have access to dental insurance."

That seems to mean that switching from a private plan to the public plan isn't permitted. But the federal health minister's office has yet to clarify the rule.

The uncertainty has seniors with minimal private dental coverage, or thosewho purchased plans themselves, wondering whether they're being left behind.

"There's double standards," said 71-year old Richard McDonald-Donaldson, who has been paying $180 a month for a private insurance plan he purchased.

Starting in May, Canadian residents 65 and older in households that make under $90,000 annually will be able to get some or all of their routine dentistry paid for through the Canadian Dental Care Plan. Work like scalings, fillings, root canals and dentures will be covered.

But you can't qualify for the new national plan if you have existing private dental care insurance through your employer, your pension or any other organization, or through a plan you've purchased yourself.

"I thought, well, maybe I'll just drop my dental plan. It costs me a fortune. And then I'll qualify," McDonald-Donaldson said. "But apparently not so."

McDonald-Donaldson said it doesn't feel right that seniors like him should be compelled to go on paying for private coverage.

"The rules seem to prejudice the guy that went and made the effort to try and buy his own insurance to save a bit of problems later on with his teeth," he said.

"There's something wrong with that system."

CBCNews has heard frommany seniors wondering what would happen if they left their existing dental plans and sought to join the public one.

CBC News asked Health Canada and the office of Health Minister Mark Hollandto explain how dropping out of an existing private insurance planwouldaffectan individual'seligibility forthe national dental care plan, but did not receive a response.

"The Canadian Dental Care Plan is intended to help the almost nine million Canadians who do not have any access to dental insurance," a statement from Holland's office said.

Seniors with existing dental coverage feel left behind by national plan

4 months ago

Duration 2:07

Seniors with existing dental insurance won't be eligible for the new national dental program even if it is minimal or they cancel their private plans which has many of them wondering why they've been left behind.

St. Thomas, Ont. retiree Doug Carterhas a small amount of dental coverage throughhis former employer, a planhe said reimburses him only for basicdental care at the rate the procedures cost in 1988. He said he needs a tooth replaced but his insurancewon't cover it.

"It really makes me think, what am I going to do? Four thousand dollars is a lot to be out of pocket," Carter said.

"I don't think it's fair because, if you're having next to nothing in coverage, it's just taking a whole section of people and saying, 'We don't care.'"

Seniors should be allowed the option of dropping theirprivate insurance plans for the national one,Carter said,"if the plan they have is pretty bad ...In this case, this one is."

Ottawa needs to explain the rules,expert says

An expert indental care programs says Ottawa needs to provide answers.

"The policy approach may not completely cover off all the situations that are at play here," said Dr. Carlos Quionez, director of dentistry at Western University in London, Ont.

"Could it be that I can give up my plan, and then there's a waiting period that I would have to respect before I can then gain coverage through the federal plan?

"These are important questions that need to be clarified."

Quionez said if the intention is to reduce financial barriers to dental care, Ottawa should look at the problem of"under-insurance" of people with minimal private dental plans wholack the means to pay for necessary worktheir plans don't cover.

Still, any government plan is going to need set limits and rules in orderto work within its allocated funds, which inevitably will leavesome people behind, Quionez said.

"There will always be winners and losers. I know that doesn't sound kind, but that is the reality of the matter," he said.

For now, Quionez said he's advising seniors to hang on to their current private dental insurance plans until the federal government offers more clarity.

Do you have questions about howCanada's new dental care plan may affect you? Send an email to ask@cbc.ca.