Dental insurance in Ontario: Sun Life, Manulife and Green Shield compared
Three insurers dominate private dental coverage in Ontario. Their individual plans share the same four tier structure, yet they differ sharply on annual maximums, waiting periods and how quickly coverage grows after the first year. Here are the published figures side by side.
Read this before the tables
Everything below applies to individual plans bought directly from an insurer. Coverage through an employer works differently. Group plans are negotiated contract by contract, so two people holding a Sun Life card can have completely different maximums, percentages and exclusions. The only reliable source for a group plan is your own benefits booklet or member portal.
Insurers revise these plans. Confirm any figure with the insurer before acting on it.
The four tiers every plan uses
All three insurers sort dental work into the same categories. The category a procedure falls into decides the reimbursement percentage, and that is the biggest single factor in what you get back.
| Category | Typical procedures | Usual reimbursement | Availability |
|---|---|---|---|
| Basic and preventive | Exams, cleanings, x-rays, fluoride, fillings, simple extractions | 60% to 100% | Year 1 |
| Comprehensive basic | Root canals, scaling and root planing, denture repairs | 60% to 80% | Varies by tier |
| Major | Crowns, onlays, bridges, dentures | 50% to 60% | Often year 3 |
| Orthodontic | Braces, aligners, retention | 50% to 60% | Top tiers only |
Reimbursement is calculated against the insurer's own fee schedule rather than against the dentist's invoice. Where the two differ, the gap is yours. The ODA fee guide explains how that schedule is set in Ontario, and the dental procedure codes list shows how each treatment is identified on a claim.
Entry, mid and top tier compared
One plan from each insurer at each level, using the figures each company publishes.
| Plan | Preventive | Annual max, year 1 | Major work | Ortho | Recall |
|---|---|---|---|---|---|
| Sun Life PHI Basic | 60% | $500 | Not covered | Not covered | 9 months |
| Sun Life PHI Standard | 70% | $750 | Not covered | Not covered | 9 months |
| Sun Life PHI Enhanced | 80% | $750 | 50%, $500, after 1 year | 60%, $1,500 lifetime, after 2 years | 9 months |
| Manulife FollowMe EnhancedPlus | 80% | $700 | Not covered | Not covered | Not published |
| Manulife FollowMe Premiere | 80% | $800 | Year 2 at 60% | Year 2 at 60% | Not published |
| Manulife Flexcare ComboPlus Enhanced | 100% of first $500, then 60% | $920 | Year 2 at 60%, year 3 at 80% | Year 2 at 60% | 6 months |
| Green Shield LINK 1 | 80% | $600 | Year 3 at 50% | Not covered | 9 months |
| Green Shield LINK 2 | 80% | $750 | Year 3 at 50% | Not covered | 9 months |
| Green Shield LINK 3 | 80% | $1,000 | Year 3 at 50% to 60% | Year 3, 60%, $2,000 lifetime | 6 months |
Sun Life sells dental as an add on to a Personal Health Insurance plan rather than on its own. Manulife FollowMe is written for people leaving a group plan. Green Shield LINK plans are guaranteed issue, with no health questions.
First year dental maximum, ranked
The annual maximum caps your total reimbursement for the year. It matters more than the percentage, because a plan paying 100% of a $400 ceiling still stops at $400.
For context, two cleanings and a recall exam in Ontario typically run $300 to $450 before any fillings. Routine maintenance alone consumes most entry tier plans.
Coverage grows, and that is the catch
Individual plans escalate. Year one is deliberately thin, and the headline number an insurer advertises is often the year three figure. Anyone buying a plan to deal with a problem already in their mouth should look at the first column rather than the last.
Green Shield LINK 1
Major work unlocks only in year three, at 50%.
Green Shield LINK 3
The highest individual ceiling of the three insurers.
Manulife FollowMe Premiere
Major restorative and ortho begin in year two at 60%.
Sun Life PHI Enhanced
Flat preventive ceiling. Restorative and ortho sit in separate pools.
Waiting periods
A waiting period is the gap between the policy start date and the date a benefit becomes claimable. Premiums are payable throughout.
| Insurer | Preventive | Restorative and major | Orthodontic |
|---|---|---|---|
| Sun Life PHI | 3 months | 1 year | 2 years |
| Manulife Flexcare | None | Year 2 at 60%, year 3 at 80% | Year 2 at 60% |
| Green Shield LINK and ZONE | None | Year 3 | Year 3, top tier only |
Manulife and Green Shield structure the delay as a rising percentage rather than a hard wait, which amounts to the same restriction under a different label. Sun Life states it as an explicit waiting period.
Recall frequency decides how often you can go
Most entry and mid tier individual plans reimburse a recall exam and cleaning every nine months rather than every six. A patient booking on a six month rhythm will have every second visit declined.
| Interval | Plans | Visits reimbursed over 3 years |
|---|---|---|
| Every 6 months | Manulife Flexcare ComboPlus Enhanced, Green Shield LINK 3 | 6 |
| Every 9 months | Sun Life PHI Basic, Standard and Enhanced, Green Shield LINK 1 and LINK 2, Manulife Flexcare Starter and Basic | 4 |
Over three years that is a two visit difference, often worth more than the gap in annual maximums between the same plans.
Seven questions to ask
- What is the annual maximum in year one?Not the year three figure in the advertisement.
- Is the percentage applied to the full fee or to a capped band?Manulife Flexcare pays a high percentage on a small first band, then drops sharply.
- When does major work become claimable?Year three is common, and a crown needed now falls outside it.
- Is the recall interval six months or nine?This changes how you book for the next three years.
- Which fee schedule is used?Reimbursement follows the insurer's schedule, which can sit below the current Ontario guide.
- Is acceptance guaranteed or medically underwritten?Guaranteed issue plans skip the health questions and cap the benefit lower in exchange.
- Do the premiums over three years exceed the benefit?An entry plan with a $500 ceiling rarely pays for itself.
If you have no coverage at all
Private insurance is not the only route. The Canadian Dental Care Plan covers eligible residents without access to private dental insurance, subject to income thresholds. It carries no waiting period and no annual maximum of the kind described above, though it reimburses at established CDCP rates and a co payment may apply.
Holding one of the private plans on this page generally makes a person ineligible for the CDCP, so the two are a choice rather than a stack. See the list of North York clinics accepting CDCP patients.
Common questions
Which of the three has the highest dental maximum?
Among the individual plans each insurer publishes, Green Shield LINK 3 reaches the highest ceiling at $1,750 per person once year three begins. Manulife FollowMe Premiere reaches $1,500. The Sun Life preventive ceiling stays at $750, with separate pools for restorative and orthodontic work.
Why is my coverage different from these figures?
Coverage obtained through an employer is governed by that employer's contract, and the numbers here do not describe it. Group plans commonly run $1,000 to $2,500 per person per year with different percentages and exclusions. Your benefits booklet or member portal is the only accurate source.
Can I claim a crown in the first year?
On the plans listed here, no. Sun Life applies a one year wait to restorative work, Manulife pays nothing for major restorative in year one, and Green Shield makes major services available from year three. Buying a plan to fund work already diagnosed does not generally succeed.
Does the insurer pay what my dentist charges?
The percentage applies to the insurer's own fee schedule. Where a practice charges above that schedule, the difference is billed to the patient on top of the co payment. Ask the office for a predetermination before any substantial treatment so the figure is confirmed in writing first.
Is a plan with no health questions worth taking?
Guaranteed issue plans such as Green Shield LINK and Manulife Flexcare ComboPlus Starter accept applicants without medical underwriting, and they offset that by capping the benefit. The $400 dental ceiling on the Starter plan is the clearest example. They suit someone declined elsewhere rather than someone with a choice.
Can I hold private insurance and the CDCP together?
Access to private dental insurance generally disqualifies a person from the Canadian Dental Care Plan. Anyone weighing an individual plan against CDCP eligibility should check the current federal criteria before buying.
- Sun Life, Personal Health Insurance plan pages for Basic, Standard and Enhanced
- Manulife, FollowMe plan details and the Flexcare plan comparison chart for Ontario
- Green Shield Canada, Health Assist LINK and ZONE benefit and coverage details