Legislation

This section is an excerpt from the Ontario Works Act, 1997 prescribed by the Province of Ontario.

OW Act

8. Benefits may be provided for,

(a) a recipient or a dependent;

(b) a person eligible to receive income support under the Ontario Disability Support Program Act, 1997 or a dependent; and

(c) members of the prescribed classes of persons.

OW Regs.

55. (1) The following benefits shall be paid with respect to each of the members of a recipients benefit unit if the administrator is satisfied that he or she meets the criteria for them and income assistance is being paid on his or her behalf:

1. An amount for health benefits equal to the sum of,

(ii) the cost for dental services and vision items and services for dependent children if those services and that cost have been approved by the Minister (Amended June 1, 1998),

59. (1) A delivery agent may, pay or provide one or more of the benefits set out in subsection (2) to or on behalf of a person referred to in section * of the Act in the amount determined by the administrator.

(2) For the purposes of subsection (1), the benefits are the following:

1. The cost of dental services.

Highlights

Employment and Social Services Dental Programs consist of three components.

1. Emergency Dental Program for Adults in receipt of Ontario Works

  • This is a discretionary benefit.
  • The program is administered by the Great West Life Assurance Company.
  • This is a limited emergency program geared to adult social assistance recipients, 18 years of age and older.
  • An emergency is defined as “an immediate circumstance where the patient appears in immediate suffering, requires care and immediate appropriate treatment is instituted to correct the problem”.
  • Eligibility records for each OW client and his/her dependents are provided to Great West Life on a daily basis.
  • Coverage takes effect on the date the person becomes eligible to receive OW.
  • Coverage terminates on the earlier of :
    • 1.the date the program terminates, or
    • 2.the last day of the month in which OW ceases.
  • If a dental procedure is not included in the dentists’ Administrative Guide, it is not a covered procedure and will not be authorized by Great West Life.
  • Pre-determination of treatment is not required under the Emergency Dental Program.

2. Denture Program for recipients of Ontario Works (OW) and Ontario Disability Support Program (ODSP)

  • This is a discretionary benefit.
  • The program is administered by the Great West Life Assurance Company.
  • The program provides a basic denture program that covers dentures, denture repairs and relines.
  • Eligibility records for each OW client and ODSP recipient and his/her dependents is provided to Great West Life on a daily basis.
  • Coverage takes effect on the date the person became eligible to receive OW or ODSP.
  • Termination of coverage occurs on the earlier of:
    • 1.the date this program terminates, or
    • 2.the last day of the month in which OW and ODSP ceases.
  • Pre-determination of treatment is required under the Denture Services Program.

3. Dental Services provided to Children in Receipt of Social Assistance

Effective January 2016, Ontario Works dental services to dependent children (0 – 17) of recipients on Ontario Works will be provided under the Healthy Smiles Ontario program. Healthy Smiles Ontario is a free dental program that covers regular visits to a licensed dental care provider, such as a dentist or dental hygienist. It covers a full range of preventative and early treatment dental services including regular check-ups, cleaning, fillings, x-rays and scaling.

The program is administered by Accerta and is a comprehensive dental plan designed by the Province.

4. For Dental Services (including Dentures) for people not receiving Ontario Works assistance

  • Seniors are to be referred to Public Health which may charge the person for partial lab fees (dentures).
  • Children can receive treatment through Healthy Smiles Ontario (HSO) at 1-844-296-6306.
  • In all other cases, city residents may seek an eligibility assessment through the Ontario Works program.

Read a summary of dental services for people receiving Ontario Works or Ontario Disability Support Program assistance

Read a summary of dental services for low-income residents not on social assistance