Apply for coverage from the Yukon Dental Program

Use this service to apply for dental coverage or benefits if you aren't currently covered by any other dental plan. If you are partially covered by the Pharmacare and Extended Health Care Benefits program, you can apply for additional coverage. This form must be completed annually.

Before you start

If you are a substitute decision maker applying on behalf of someone else, you cannot use this online form. Download the PDF instead.

You will need:

• your Yukon Health Care Insurance Plan (YHCIP) number (see example);
• the YHCIP numbers of any children or dependents;
• one of the following proofs of income:
  • a copy of your Notice of Assessment from the Canada Revenue Agency; or
  • a letter confirming you are the recipient of social assistance;
• an email address or phone number in case we need to contact you.

Other ways to apply

You can download a printable PDF version of this form.

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A note about privacy

Information contained in this form is collected, used and disclosed in accordance with Yukon’s Health Information Privacy and Management Act and other applicable laws. A written statement of Health and Social Services information practices can be viewed at https://yukon.ca/healthprivacy or by contacting the department’s privacy officer at [email protected]