A root canal or crown can be an important part of saving a damaged or infected tooth, but the cost may be a concern. The dentist in Spruce Grove can help you understand whether your treatment may qualify for support through the Canadian Dental Care Plan (CDCP). The plan covers a range of dental services, including root canal treatments and certain crowns, but coverage depends on specific rules and eligibility requirements. Some services require preauthorization before treatment begins.
Understanding how the plan works can help you know what may be covered, what you may need to pay, and what questions to ask before starting treatment.
Does the CDCP Cover Root Canals?
Yes. The Canadian Dental Care Plan in Spruce Grove may cover eligible root canal treatments when they meet the plan’s requirements. Root canal treatment is included under the plan’s endodontic services, which are used to treat teeth that are severely damaged, infected, or broken.
For a regular root canal on eligible front teeth, premolars, and first or second molars, preauthorization is usually not needed. However, some treatments, such as a repeat root canal or treatment on certain wisdom teeth, may need preauthorization first.
When Might a Root Canal Be Covered?
Coverage is not based only on having tooth pain. The tooth must meet the CDCP’s requirements for treatment.
The plan may consider:
- The type and location of the tooth
- Whether the tooth can be restored
- Your oral health condition
- Whether other dental problems need to be treated
- The specific root canal procedure being requested
This means an assessment is important before assuming a treatment will be covered.
Does the CDCP Cover Dental Crowns?
Yes, some crowns may be covered, but there are specific rules. Dental crowns in Spruce Grove are considered a major dental service under the CDCP and need preauthorization.
The plan may cover certain single crowns for eligible adults when the tooth meets the required conditions.
Covered crown types may include:
- Cast metal crowns
- Porcelain or ceramic fused to metal crowns
- Porcelain or ceramic crowns
Coverage depends on the CDCP rules, how often the service can be covered, and whether preauthorization is approved.
Why Might a Tooth Need a Crown After a Root Canal?
A root canal therapy in Spruce Grove removes infected or damaged tissue from inside a tooth. After treatment, some teeth may need additional protection because a large amount of tooth structure has been lost.
A crown may be considered when the tooth is extensively damaged and meets the CDCP’s requirements. The plan states that an endodontically treated tooth must have healed before a crown request can be considered.
A dentist near you can examine the tooth and explain whether a crown may be appropriate after root canal treatment.
What Does Preauthorization Mean for Crowns?
Preauthorization means the dental provider sends information about the proposed treatment to the CDCP before the treatment is provided. The plan then reviews the request against its coverage rules.
For crowns, the request may need information such as:
- Details about the tooth
- Dental images
- The treatment plan
- Information showing that the tooth meets the coverage requirements
Approval is not automatic. The CDCP reviews each request based on its policies and the information provided.
What Should You Check Before Treatment?
Before starting dental crowns in Spruce Grove, ask about the expected treatment cost and how much the CDCP is expected to cover.
You can ask:
- Does this treatment meet CDCP requirements?
- Does the treatment need preauthorization?
- What amount does the CDCP cover?
- Will there be any additional charges?
- What amount will need to be paid directly?
Your provider can also submit an estimate to Sun Life to help confirm active coverage and the expected amount covered before treatment.
Make Your Dental Care Plan Clearer!
Understanding what your dental plan may cover can help you prepare for treatment and avoid unexpected costs. Before moving forward with a root canal or crown, a dental assessment can help clarify your treatment needs, available options, and expected expenses. Book an appointment with Queen Street Dental to discuss your dental concerns, review your treatment plan, and get clear guidance on the next steps for your care.
FAQs
Does the CDCP cover every root canal?
No. Root canals are included, but the tooth and procedure must meet the plan’s eligibility rules. Some procedures also require preauthorization.
Does the CDCP cover all crowns?
No. Only certain crowns that meet the plan’s requirements may be considered, and crown treatment requires preauthorization.
Can a crown be covered after a root canal?
It may be. The treated tooth must meet the CDCP’s crown requirements, and an endodontically treated tooth must have healed before crown coverage is considered.
Do you have to pay anything if the CDCP covers the treatment?
Possibly. You may have a co-payment or additional charges depending on your income, the CDCP-established fee, and the provider’s fee.