The Government of Canada has introduced the Canadian Dental Care Plan (CDCP), as part of its objective to make dental care more accessible and affordable for those who might not otherwise be able to afford the care needed to maintain good oral health.
Scheduled to begin covering treatment in May 2024, the CDCP is a publicly funded dental benefit for those with an annual household income under $90,000 and no private dental insurance.
The plan covers a portion of the cost of an enrolled patient's oral health treatments to prevent and treat oral disease which, in turn, can protect against serious health problems.
Application periods are staggered between December 2023 and 2025. See FAQs below for details. As of May 2024, seniors 65+ can apply online or over the phone.
Anyone wishing to participate in this plan must meet the eligibility requirements outlined below.
Applications for the CDCP are phased, beginning with seniors. Children under age 18 and those with disabilities are eligible starting June 2024. All other Canadian residents can apply starting in 2025.
| Eligible Age Groups | Date Applications Open |
|---|---|
| Seniors 87+ | December 2023 |
| Seniors between 77 - 86 | January 2024 |
| Seniors between 72 - 76 | February 2024 |
| Seniors between 70 - 71 | March 2024 |
| Seniors between 65 - 69 | May 2024 |
| People holding a valid Disability Tax Credit Certificate | June 2024 |
| Children under 18 | June 2024 |
| All other eligible Canadian citizens and residents | 2025 |
The CDCP has developed their own fee guide, which determines the fees the CDCP will pay for services covered under the plan. These fees can differ from provincial or territorial fee guides. Not all patients will receive complete financial assistance through the CDCP due to required co-payments, so it is important to ask about costs not covered by the plan. These co-payments are the portion of treatment costs you would be expected to cover out of pocket, and the percentage is determined by your family's net annual income shown on the previous year's tax return. Co-payment or fees not covered are paid directly to the dental office.
Please note the percentages covered are for the CDCP fee guide, which is sometimes lower than the provincial guides.
| Net Family Income | Covered by CDCP | Covered by Patient |
|---|---|---|
| Below $70,000 | 100% | 0% |
| $70,000 - $79,999 | 60% | 40% |
| $80,000 - $89,999 | 40% | 60% |
Additionally, when a dentist follows their established fee structure, it may be higher than the CDCP’s fees, in which case there is a gap in payments. The gap can be filled by balanced billing, where the patient is billed for the difference between the CDCP fees and the fee their dentist would charge a patient who does not qualify for coverage under the plan.
For example, if a dentist follows the provincial fee guide and charges $100 for a recall dental exam but the CDCP fee structure only covers $90 the patient is responsible for the $10 difference. In the same example, for a patient with a net family income of $85,000, the plan would cover $36 (40% of the CDCP established fee) and the patient would be responsible for $54 (the remaining 60% of the CDCP established fee) plus the additional $10. Please note these figures are for illustration only.
If you are a senior (age 65 or older), there is no need to do anything, as you will receive a letter with instructions on applying and an application code. You can then apply over the phone by following the instructions included in the letter.
If you are eligible but haven't received a letter, check the mailing address used for your 2022 tax filing is current. If your address is out of date, you will need to contact the Canada Revenue Agency (CRA) to update it.
From May 2024, people can apply online. At the time of writing, no information is available on applying online.
Once you have applied, Health Canada will confirm your eligibility and share your information with Sun Life to enroll you in the plan. You will receive a welcome package from Sun Life within three months of your application, which will include:
Once enrolled, you must meet the eligibility requirements each subsequent year with an annual reassessment. Details about the reassessment process have yet to be released.
The CDCP covers oral health services designed to prevent and treat oral disease and to maintain healthy teeth and gums. Services that are covered when recommended by a dental professional can include the following listed below.
Coverage under the CDCP is limited to basic services that protect and preserve natural teeth so people can benefit from teeth that function properly. Many people have missing teeth or teeth that are failing and need removing. When this is the case, the CDCP includes the provision of removable dentures, allowing people to eat and talk effectively.
The plan is not designed to improve the overall appearance of teeth or provide purely aesthetic benefits. It also excludes more complex treatments. Treatments not considered for coverage under the CDCP include those listed below.
Certain services, such as deep sedation, are not covered in all cases. If a provider believes the treatment is medically necessary, they can submit a preauthorization request on behalf of the patient. Approval of the preauthorization request is based on the recommendations of the dental care professional and considers the patient's dental and medical history.
Services that need preauthorization, including coverage beyond the established frequency limitations, will not be covered under the plan until November 2024. If a service is given without preauthorization, for example, if urgent dental care is required, it may be submitted for post-determination beginning November 2024, with no guarantee that the service will be covered.
Treatments requiring preauthorization are listed below.
For further information on services covered, please visit the Government of Canada website.
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