OHIP Dental Coverage Milton: Complete Guide for 2026

Many Milton families ask the same question: does OHIP cover dental appointments? The short answer is no. The Ontario Health Insurance Plan does not pay for routine checkups, cleanings, or fillings. However, several government dental programs now help Canadians receive affordable dental coverage in Milton and across the province. This complete guide explains what’s covered under OHIP, what services are covered through federal and provincial dental plans, and how eligible Canadian residents can access dental care without high out-of-pocket costs. Clearview Dental Clinic is here to help Milton families understand every option available to them.

What Does OHIP Cover for Dental Care in 2026?

OHIP provides broad health services coverage for Ontario residents, but dentistry falls outside most of that coverage. The plan pays for physician visits, hospital stays, lab tests, and ambulance services. Dental services covered by OHIP are limited to hospital-based procedures only.

The only dental procedures OHIP covers are those performed in a hospital when they are medically necessary. These include reconstructive surgery after trauma, tumour removal, tooth extractions that require pre-approval, and fracture repairs. Dental implants and other restorations may also be covered when they are part of a hospital-based oral surgery. Routine exams, X-rays, cleanings, and fillings are not included.

This gap leaves many families searching for other ways to help with dental costs. The good news is that both the federal and provincial governments now offer programs that can fill this gap.

The Canadian Dental Care Plan (CDCP) in 2026

The Canadian Dental Care Plan is a federal program designed to make dental care more accessible for Canadian residents who do not have private coverage. It is now fully available across Canada, including Ontario, and is administered by Sun Life on behalf of the federal government.

An important point: the CDCP is not intended to replace existing dental benefits or private insurance. It is designed to reduce financial barriers for Canadians who have no dental benefit through an employer group plan or other source. If you already have coverage, this program is not for you.

Who Is Eligible for the Canadian Dental Care Plan?

To be eligible for CDCP in 2026, you must meet three conditions. You must have filed your 2024 tax return, have an adjusted family net income below $90,000, and have no access to existing dental coverage through an employer or other source. Canadians of all age groups may be eligible, including seniors, working adults, and youth. To check your eligibility and begin the application process, log in to your Service Canada account or visit the Government of Canada website.

What Does the CDCP Cover?

The CDCP covers a wide range of oral health services that OHIP does not. Covered services include oral exams, dental cleanings and scaling, diagnostic X-rays, fillings, root canal therapy, dentures and denture repairs, and emergency dental care. Some extra dental treatments such as periodontal scaling may also be covered depending on your provider and treatment plan.

How Much Will You Pay?

Your out-of-pocket cost depends on your household income. Here is how the co-payment structure works:

• Under $70,000: No co-payment — you get full coverage up to the CDCP fee guide
• $70,000 to $79,999: 40% co-payment — you pay for a portion of each visit
• $80,000 to $89,999: 60% co-payment — you are responsible for paying a larger part of the cost

Keep in mind that some dentists charge fees above the federal fee guide. When this happens, you pay the difference. The CDCP does not always cover the full cost of treatment, so ask your dentist about their fees before booking. Coverage must be renewed annually. If you do not renew your coverage, your benefits end on June 30, 2026.

Ontario Provincial Dental Programs

Beyond the federal CDCP, Ontario dental programs serve specific groups across the province. These government dental programs fill important gaps for seniors, children, and residents receiving social assistance.

Ontario Seniors Dental Care Program (OSDCP)

This program provides free routine oral health care for low-income seniors aged 65 and older. Single seniors with an income of $22,200 or less qualify. Couples with a combined income of $37,100 or less also qualify. The program covers checkups, cleanings, fillings, extractions, and other standard treatments.

Healthy Smiles Ontario (HSO)

Healthy Smiles Ontario offers free essential dental care for children and youth aged 17 and under from low-income families. The program pays for preventive care, routine treatments, and emergency visits. For Milton families with young children, this program can help keep your teeth healthy from an early age and prevent dental problems before they grow into bigger issues. Families can get care at any participating dental office in the province.

Ontario Works and ODSP Dental Coverage

Recipients of Ontario Works and the Ontario Disability Support Program can access basic dental coverage. This essential oral health coverage includes checkups, cleanings, fillings, and extractions. It helps ensure that Ontarians receiving support maintain their dental health without added financial stress.

What If You Don’t Qualify?

Not every Milton resident qualifies for the CDCP or provincial dental plans. If your household income exceeds $90,000 or you have private dental coverage through an employer, these programs will not apply to you.

You still have options. Private dental insurance plans are available through insurance providers and often offer greater coverage than government programs. These plans typically cover a percentage of preventive, basic, and major dentistry services. You can also pay out of pocket at your chosen family dentistry clinic. University and college students in Ontario often have coverage through student union plans, generally covering $700 to $850 per year.

No matter your coverage situation, regular dental visits remain important. Preventive care catches problems early and saves you money over time. Investing in routine dentistry protects your oral health and your budget.

How to Check Your Eligibility

Checking whether you are eligible for the Canadian Dental Care Plan takes just a few steps. First, confirm that your 2024 tax return has been filed. Next, calculate your adjusted family net income. Then check whether you have private dental insurance through an employer, spouse, or parent. If you have children under 18 or are 65 and older, also review provincial programs like Healthy Smiles Ontario or the OSDCP.

Your Service Canada account and the Government of Canada website both offer tools to confirm eligibility.

Why Preventive Dental Care Matters

Regular dental visits do more than keep your teeth clean. They allow your dentist to spot cavities, gum disease, and oral health care issues before they become serious. Early detection leads to simpler treatments, lower costs, and better long-term outcomes.

Children benefit from consistent dentistry because it builds lifelong healthy habits. Seniors benefit because aging increases the risk of decay and gum disease. Providing exceptional dental care at every stage of life is what family dentistry is all about.

Schedule a Visit With Your Milton Dental Team

Understanding your dental coverage options does not have to be difficult. Whether you may be eligible for the CDCP, a provincial program, or private insurance, the right dental team makes all the difference. Clearview Dental Clinic in Milton offers friendly, professional dentistry for Canadians of all ages. Dr. Kiran Kapadia and her team help patients understand their coverage and get the care they deserve. If you are looking for trusted dental coverage in Milton and a clinic that puts your family first, contact Clearview Dental Clinic to schedule a visit. Whether you need preventive or restorative dental today or in the future, our Milton team is ready to help.

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