Are Dental Implants Covered by Insurance in Ontario?

Private dental insurance plans in Ontario typically divide coverage into three categories: basic (cleanings, fillings, x-rays), basic-major (root canals, extractions) and major restorative (crowns, bridges, dentures, implants). Implants almost always fall under major restorative, which is where most plans apply their lowest reimbursement percentage — commonly 50 percent — and their annual or lifetime maximums.

However, many older employer plans were written before implants became commonplace and exclude them by name, covering only the crown portion as a prosthetic tooth while excluding the surgical placement of the implant post. Read your policy under the major restorative section carefully, or call your insurer before booking treatment to ask specifically: does this plan cover the surgical placement of a dental implant and the abutment, or only the crown?

• 50% coverage of eligible fees is the most common implant benefit in Ontario group plans.
• Annual maximums of $1,000–$2,500 per year apply — and implant treatment may exhaust your entire annual benefit in one procedure.
• Lifetime maximums on implants specifically appear in some plans, capping total implant reimbursement at $1,500–$3,000 per tooth.
• Waiting periods of 12–24 months may apply for major restorative work if your plan is new.
• Pre-determination — always submit a pre-determination form before starting treatment so you know exactly what your insurer will pay.

The federal Canadian Dental Care Plan launched in 2024 to provide dental coverage for households with an adjusted net family income below $90,000 that do not have access to private dental insurance. The CDCP covers a range of services based on the federal fee schedule, and coverage for certain prosthetic services — including implant-related work — is included, though the specific fees paid and eligibility criteria evolve as the program matures.

Patients who qualify for the CDCP and are considering dental implants in Markham should bring their CDCP benefit card to their consultation. Our clinic is enrolled to bill the CDCP directly, and we will perform a benefit check before recommending a treatment plan so you know upfront what the program will pay toward implant surgery, bone grafting and the final crown.

Because dental implant treatment naturally unfolds in stages — consultation and imaging, then implant placement surgery, then the final crown — it is often possible to schedule procedures across two calendar years to take advantage of annual maximums twice. For example: implant placement surgery in November or December of one year, then the abutment and crown placement in January or February of the following year. Each claim draws on a separate annual maximum.

Our treatment coordinator at Smile Dental Arts Centre is experienced in helping patients time their appointments to align with insurance renewal dates. This is entirely legitimate — you are simply scheduling clinically appropriate stages of treatment when they happen to coincide with plan year boundaries. Patients who plan this way can recover an additional $1,000–$2,500 in benefits compared to those who rush through treatment in a single year.

Even with insurance, most patients have an out-of-pocket balance after implant treatment. Our clinic addresses this in two ways: in-house payment plans that allow you to pay the balance in monthly installments with no interest for up to 12 months, and referrals to dental financing companies that offer extended terms of 24–60 months. Monthly payments on a single-tooth implant at these terms are often comparable to what a patient would spend on coffee or a gym membership.

Some patients also explore their RRSP or TFSA, or use a health spending account (HSA) from a self-directed employer plan, to pay for dental implants with pre-tax or already-sheltered funds. The Ontario Dental Association recommends patients review all available benefit structures before assuming they will carry the entire cost out of pocket.

• In-house payment plans: spread treatment cost over 6–12 months with no interest.
• Third-party dental financing: terms from 24 to 60 months; interest rates vary by provider.
• Health spending accounts (HSA): employer-provided HSAs are often forgotten sources of dental funds.
• CDCP pre-determination: always check your CDCP benefit before treatment to know exact coverage.
• Split billing across calendar years: maximise two annual maximums for multi-stage implant treatment.

A pre-determination (sometimes called prior authorisation) is a request your dental office sends to your insurer describing the planned treatment using standardised codes. The insurer responds — usually within 10–14 business days — with an estimate of what it will pay based on your current benefit year balance, your plan limits and the fee schedule it uses. This is an estimate, not a guarantee, but it is close enough to plan around.

Our treatment coordinators submit pre-determinations on behalf of every implant patient before scheduling surgery. If the response reveals your plan does not cover implants at all, we will discuss alternative treatment plans or financing. If it confirms coverage, we factor the insurer payment into your treatment cost estimate so you see exactly what remains. There are no surprises in our billing process.

Eligible dental expenses not reimbursed by insurance qualify as medical expenses for the federal Medical Expense Tax Credit (METC). For the 2025 tax year, the METC allows you to claim qualifying medical expenses exceeding the lesser of 3 percent of your net income or $2,635. Dental implant costs — including the surgery, bone grafting and crown — are all eligible. Keep all receipts and submit them with your T1 return in the spring following treatment.

The tax credit does not eliminate the cost, but for a patient in the 26 percent marginal bracket who spent $5,000 on implants, the credit could return $600–$800 in tax savings. Patients with large medical expense years — such as when several family members have significant treatments — often find the METC particularly valuable. Consult a tax professional to optimise your claim.

At Smile Dental Arts Centre, we handle the insurance paperwork so you do not have to. From submitting your pre-determination to directly billing your insurer on the day of treatment, our administrative team manages every step. We also provide a written estimate that shows the full treatment cost, your expected insurance contribution and your balance — clearly, before you make any decisions.

Ready to understand exactly what your plan covers for dental implants in Markham? Book a consultation with Dr. Neda Kadivar. We will review your current benefit card, run a benefit check, and give you a transparent financial picture of your options before any treatment begins.