Do you have a low income and need help paying for dental services to repair your child’s cleft palate?
The New Brunswick Cleft Palate Program provides financial assistance to families of children 18 and under born with a cleft palate or with similar conditions for dental treatments. It is for families that do not have health insurance coverage.
Treatment is based on the individual needs of the child. It is divided into:
- Initial treatment: Services such as consultation, feeding appliance, obturator and orthodontic records, including examinations, x-rays, and treatment planning.
- Orthodontic: Includes braces and appliances that may be required before braces.
- Prosthodontic: Work that may be needed to replace missing teeth.
There are no fees for this program. Treatment must be pre-authorized to be covered.
Only services from New Brunswick providers are eligible, with a few exceptions:
- Services provided by a specialized children’s hospital that has a cleft palate clinic, such as the Isaac Walton Killam Hospital in Halifax
- Services provided by a specialist not available in New Brunswick, such as prosthodontists
Payments are made directly to the provider, except for :
- Emergency services you have to pay out-of-pocket
- Treatment costs incurred during an appeal process if the decision is favourable
- Service providers who do not accept payments from the Cleft Palate Program.
The New Brunswick Cleft Palate Program is administered by Medavie Blue Cross.
To be eligible for the New Brunswick Cleft Palate Program, your child must:
- Be aged 18 or under.
Note: Eligibility ends on their 19th birthday unless the approved dental treatment began before that. The program will cover the cost to complete the planned treatment in this situation.
- Be a resident of New Brunswick.
- Have an N.B. Medicare card.
- Be born with a cleft of the hard palate or have a condition that is consistent with it, and one of the following applies:
- The development of their jaw will be hindered to the point of requiring surgical intervention if appropriate treatment for skeletal and dental problems is not received.
- The condition presents with or may lead to serious functional and/or systemic problems, such as malocclusion, trouble swallowing, chewing, breathing, speaking, salivating, pain, etc.
- Have family net income level not exceeding the following amounts based on the previous year’s New Brunswick Income Tax return(s) or Notice of Assessment(s):
- 2 people: $26,928
- 3 people: $32,980
- 4 people: $38,082
- 5 people: $42,577
- 6 people: $46,641
- 7 people: $50,378
- 8 people: $53,856
Eligibility will not be considered when:
- You have access to similar services through private insurance
- The procedure is recommended for cosmetic purposes only
- Coordination of benefits is being requested
Please note: If you receive benefits under the Healthy Smiles, Clear Vision plan, you are automatically eligible for the Cleft Palate Program.
You must complete the application form for each phase of treatment. Since each phase involves a different type of treatment that may take years, each phase is processed separately. Your service provider must also complete a pre-authorization form describing the required treatment for each phase.
Fill out the New Brunswick Cleft Palate Program application form. You can download the form by clicking this link.
You will need to provide the following documents with your application form:
- Child’s N.B Medicare number
- Copy of New Brunswick Income Tax return(s) or Notice of Assessment(s) for parent/guardian and spouse or common-law partner (if applicable).
Have your service provider fill out the Pre-Authorization Form, which provides the classification of cleft, duration of treatment, projected cost, and treatment plan.
Please mail your completed application to:
NB Cleft Palate Program
P.O. Box 690
Moncton, N.B.
E1C 8M7
After the application and supporting information is reviewed and assessed, you and your service provider will be notified in writing of the decision. If your child is eligible for the program, you will receive an identification card for them.
Your child’s N.B Medicare number.
Copy of New Brunswick Income Tax return(s) or Notice of Assessment(s) for parent/guardian and spouse or common-law partner (if applicable).