Are Dentures Covered by OHIP?

Good oral health is crucial to positive well-being. But sometimes, financial concerns make people hesitant about going to the dental office and receiving the care they need.

At Hayven Dentures in St. Catharines and Niagara Falls, Ontario, we specialize in custom denture solutions. One question we often receive is whether dentures are covered by OHIP. This post will answer this question and more.

What Is OHIP?

In Ontario, residents receive healthcare and medical assistance. The Ontario Health Insurance Plan (OHIP) dental care plan is a dental care aid for Ontario residents. However, it has limited coverage. It can be used for oral surgeries performed in the hospital for the following:

  • Treating damage to the jaw and facial structure following an accident
  • Correcting deformities from birth, such as having a cleft palate
  • Treating cysts and tumors or jaw diseases
  • Medically required tooth extractions

The Ministry of Health updates the OHIP list of services every 10 years. But, in general, only conditions that warrant surgical treatments and will have to be treated in an inpatient facility, accompanying an overnight stay, are covered by OHIP.

Otherwise, for instance, if the procedure is performed in an outpatient facility and doesn’t require confinement, then it is normally not covered.

In special instances, OHIP may offer coverage, such as when an outpatient procedure must be continued in a hospital because the patient has fragile health and has been receiving long-term care. However, the OHIP plan will not cover everything. The professional fees of the external providers are not covered.

What Dental Procedures Aren’t Covered by OHIP?

Any surgery or procedure provided by dentists is covered under the OHIP dental care plan. OHIP is billed for these procedures. But some procedures must be approved first.

Regular dental care, such as routine dental hygiene cleanings and standard procedures like billings and tooth extractions, isn’t included. It’s very rare for these treatments to be covered. Dentures are not covered either.

What Are Other Dental Care Plans Available for Ontario Residents?

We, at Hayven Dentures, can help you determine which procedures your dental insurance will cover. If you have OHIP but the procedure you require isn’t covered, you may have other insurance plans we can check your coverage for.

There are several other free dental care programs funded by the government for the residents of St. Catharines, Niagara Falls, and the rest of the Ontario community. One of which is the Ontario Seniors Dental Care Program (OSDCP), which can cover dentures partially.

The OSDCP aims to provide dental care services to low-income seniors through public health units, so regular dentists or private dental practices aren’t among the participants. You or a family member may still find this coverage beneficial in other cases.

Learn More About Potential Payment Options for Denture Services

We’re happy to answer your questions related to financing and insurance for your denture needs. Start with a free consultation on our denture services. Call us today to request an appointment.

Hayven Dentures offers fully customizable denture solutions. Our professional team invests in continued education to better assist patients.

We’re honored to be recognized by our patients as the best denturist and best denture clinic in the Niagara region, being the recipient of the 2021 St. Catharines Review Reader's Choice Award: Diamond and the 2022 Niagara Falls Review Reader's Choice Award: Platinum.