Knowing the cost first
Cost is a worry for many people, and it is often the question they are most reluctant to ask. It is a fair one, and you are welcome to ask it at any time. Here is how it generally works: before treatment, we go over what it is expected to cost, usually in writing, with each item listed. Then you decide.
Where the numbers come from
Each dental procedure has a code, and the Ontario Dental Association publishes a suggested fee for every code in a guide it updates yearly. We follow that guide. It is the same reference insurance companies use when they work out what to reimburse.
Some treatments, such as crowns, veneers and nightguards, also carry a lab fee, because a dental lab makes them for you. We use high quality local dental labs.
Reading an estimate
An estimate from us shows three things for each line: the procedure, its fee, and, if you have a plan, what your insurer is expected to pay. The last column is your share. Estimates are usually sent to you as well, so you can read them over in your own time.
For anything substantial, such as a crown or bridge, we can send the estimate to your insurer and wait for their reply, so your share is confirmed and not assumed. We are happy to do this for you.
Everyone's Insurance Plans are Different
- Plans pay a percentage, and the percentage for major work is usually lower than for check-ups and fillings.
- Most plans stop paying once a yearly dollar limit is reached.
- Some services are covered only so often: a cleaning every six or nine months, a full set of x-rays every few years.
These are terms of your plan, set by your employer and the insurer. We are happy to look them up for you, but we cannot change them.
One fee guide for everyone
The fee for a procedure at this office does not depend on who is paying. Insured through work, covered by a government program or paying yourself, you are charged the suggested fee in the current Ontario Dental Association guide.
Students whose plan is run by Alumo are charged from the same guide. We belong to Alumo's dental network, so a set discount is then taken off for its members; the student plans page has the details.
What differs is how much of that fee your coverage pays. Some plans calculate their payment from a guide that is a year or two old. Some government programs, the Canadian Dental Care Plan included, have a fee list of their own that is set below the guide for many services. In both cases the plan pays what it allows, and the balance is charged to you.
We do what we can to check this with you before treatment. The balance is usually the last figure on your estimate, and for larger treatment we can ask your insurer to confirm its payment before a date is booked.
Why the same treatment can cost different amounts
It can seem odd when the same treatment costs different amounts. A fee reflects the work involved, and that varies from tooth to tooth. A filling on one surface is a different code from a filling on three.
A molar has more canals to treat than a front tooth in root canal therapy. A wisdom tooth lying under the gum takes longer to remove than one that has come through.
That is why we examine before we quote, and you are welcome to ask about any line of your estimate.
Without insurance
If you do not have insurance, you are charged the same fees and given the same estimate. Payment for your share is made on the day your treatment is done. The federal Canadian Dental Care Plan may apply if you have no access to a dental plan.