Financial worry shouldn't stand between you and quality dental care. At Dental Sedation Ottawa, we make insurance simple. We bill directly to virtually all major Canadian insurers, verify your coverage before treatment begins, and advocate for coverage of medically necessary sedation services. Whether you have private dental insurance, the Canadian Dental Care Plan (CDCP), or are exploring payment options, our team helps you understand your benefits and maximize every dollar.
Four Steps to Transparent, Hassle-Free Billing
We Work with Virtually All Major Canadian Dental Insurance Providers
Direct billing means we submit your insurance claim electronically and receive payment directly from your insurance company. You only pay your portion (deductible, co-payment, or any amounts exceeding your coverage limits) at the time of service. There's no waiting months for reimbursement or dealing with complicated claim forms yourself.
This service saves you time, reduces stress, and ensures you receive your maximum benefits without the hassle of managing paperwork.
Our electronic claims processing means faster processing (often within 24-48 hours), immediate confirmation of coverage amounts, reduced errors and claim rejections, and real-time benefit tracking. For more complex treatments requiring manual review, claims may take 7-10 business days for processing.
Most dental insurance plans follow similar structures, though specific details vary by provider and plan type. Understanding these basics helps you make informed decisions about your treatment.
Basic Preventive Services (Usually 80-100% Coverage): Routine exams and checkups, Professional cleanings (usually 2 per year), Fluoride treatments, X-rays (with frequency limitations), Sealants for children. These services are typically covered at the highest percentage because insurance companies recognize that prevention saves money long-term by avoiding more expensive restorative work.
Minor Restorative Services (Usually 60-80% Coverage): Fillings, Simple extractions, Root canal therapy (anterior teeth), Periodontal scaling and root planing. Coverage percentages vary by plan, and annual maximums apply to cumulative costs across all procedures.
Major Restorative Services (Usually 50% Coverage): Crowns and bridges, Dentures (complete and partial), Implants (if covered at all—many plans exclude implants). Major services typically have the lowest coverage percentage and count toward your annual maximum quickly.
Orthodontics (Usually 50% Coverage, Separate Lifetime Maximum): Braces and clear aligners, Usually limited to dependent children, Separate lifetime maximum (commonly $1,500-$3,000), Not covered under most adult plans.
Most insurance plans have an annual maximum—the total amount your insurer will pay toward your dental care within a calendar year or benefit year. Common maximums range from $1,000 to $3,000 per person annually. Once you reach your annual maximum, you're responsible for 100% of additional costs until your benefits reset. This is why we help you prioritize treatment and maximize your benefits each year.
Some plans require you to pay a deductible (typically $25-$100) before insurance coverage begins. The deductible usually applies once per calendar year per person or family.
New insurance plans often have waiting periods before certain services are covered: No waiting period for preventive services (usually covered immediately), 3-6 months for minor restorative services, 6-12 months for major restorative services. If you're switching jobs or insurance providers, ask about waiting periods so you can plan treatment accordingly.
One of the biggest sources of anxiety around dental treatment is cost uncertainty. We eliminate that worry through comprehensive pre-treatment verification.
Before any treatment begins, we contact your insurance provider to confirm exactly what your plan covers. We identify your deductible amount, annual maximum, coverage percentages for different treatment categories, any waiting periods or limitations, and whether pre-authorization is required for major treatments.
You'll receive a detailed written estimate showing the full cost of recommended treatment, what your insurance will pay, what your responsibility is, and payment options for any balance. This transparency means you can make informed decisions about your care without financial surprises.
One of our specialties is advocating for insurance coverage of sedation services. While not all insurance plans automatically cover sedation dentistry, many plans DO cover sedation when it's medically necessary—and we know how to make that case.
Sedation may be covered under your plan if you have documented severe dental phobia (defined as paralyzing anxiety preventing necessary dental care), need complex oral surgery with extended treatment duration, are a young child requiring extensive treatment who cannot safely cooperate with lighter sedation, have developmental disabilities or autism spectrum disorders making traditional care impossible, have severe medical conditions (seizure disorders, severe gag reflex) requiring complete unconsciousness, or have special anesthesia requirements due to medical status.
Our team provides comprehensive documentation, pre-operative medical clearance letters, and clinical justification specifically worded for insurance approval. We regularly obtain coverage for sedation services that patients assumed would not be covered. We also handle predetermination requests for major cases, getting written approval from your insurer before treatment to ensure no financial surprises.
We believe you deserve to understand exactly what you're paying and why. Our pricing is always transparent, with no hidden fees or surprise charges.
After we verify your insurance coverage, we provide a written fee estimate that clearly breaks down the cost of each service, identifies which services are covered and at what percentage, shows your estimated out-of-pocket cost, and explains any services not covered by insurance.
We stand by our estimates. If your treatment cost changes (for example, because complexity increases during the procedure), we contact you before proceeding with additional work. Our anesthesiologists also provide detailed quotes for sedation services—typically $1,000-$1,800 depending on duration and complexity, though most insurance plans cover 50-80% when medically necessary.
Smart planning helps you maximize your benefits and minimize out-of-pocket costs
Expertise That Saves You Time and Money
We're proud to be an accepted provider for the Canadian Dental Care Plan (CDCP). If you're eligible for CDCP coverage, we can bill your benefits directly through the program.
The CDCP covers eligible individuals aged 65 and over, people with disabilities (aged 18-64) who meet specific criteria, and residents of federally administered first nations communities. Coverage includes basic preventive services, restorative care, and in some cases, medically necessary sedation.
Our team coordinates CDCP benefits with any additional private dental insurance you may have, ensuring you maximize all available coverage. We handle all CDCP paperwork and submissions electronically, making the process seamless.
Ready to understand your benefits and move forward with treatment?.
We welcome patients from throughout Ottawa including Kanata, Nepean, Orléans, Stittsville, Manotick, and Greely, as well as Eastern Ontario communities (Rockland, Embrun, Russell, Winchester, Kemptville, Carleton Place, Arnprior, Renfrew, Pembroke, Cornwall, Hawkesbury) and West Quebec (Gatineau, Aylmer, Hull, Chelsea, Wakefield, Buckingham).
