What is Co-payment? Can my dentist wave my co-payment?

August 5, 2014

These are commonly asked questions by patients with dental insurance plan. Belows are the officical answers by Canadian Dental Association:

 

Co-payment—also called co-insurance—is the portion of the bill that is your own responsibility. It's the most common way for dental plans to limit their costs, thereby providing various plans with an assortment of benefits and price points for the purchaser to choose.

 

No. The waiving of a co-payment is insurance fraud and is against the law. Your dentist could be heavily fined or even lose their license.

When you and your dentist sign the claim form that goes to the insurance company, you are stating which services were provided and how much, in total, was charged. The insurance company pays its share based upon the assumption that you will do the same.

 

My thought:  All dentists know the legal risk of not collecting co-payment. If a  dentist promises not collect it, it is not  a good sign of trustworthy dentist. It is also a risk for patients, could receive compromise service or a part of insurance fraud.  

March is the fraud prevention month by Canadian government. Benefits Canada magazine has developed a checklist of fraud prevention tips for benefits plan members, which includes

"Don’t trust healthcare providers who regularly waive your co-payment or deductible".

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