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Canadian Dental Care Plan (CDCP)

What is the Canadian Dental Care Plan?

The Government of Canada has launched the Canadian Dental Care Plan (CDCP) to enhance the accessibility and affordability of dental care for those who might otherwise be unable to afford necessary oral health services.

How Does the Canadian Dental Care Plan Work?

Set to begin in May 2024, the CDCP is a publicly funded dental benefit aimed at individuals with an annual household income under $90,000 who do not have private dental insurance. This plan covers all or part of the costs associated with oral health treatments to prevent and treat oral diseases, thereby protecting against more serious health issues.

How Can I Apply for the CDCP?

Applications will be accepted in phases from December 2023 to 2025. Starting in May 2024, seniors aged 65 and older can apply either online or by phone.

Frequently Asked Questions

Who Can Apply for the Canadian Dental Care Plan (CDCP)?

To participate in the CDCP, applicants must meet the following eligibility requirements:

  1. Be a Canadian resident for tax purposes.
  2. Have filed an income tax return for the previous year.
  3. Do not have dental insurance through a private or pension plan, or with an employer.
  4. Have a net (after tax) family income of less than $90,000 annually.

 

Application Phases:

  • Seniors (65+): Eligible to apply starting in May 2024.
  • Children under 18 and individuals with disabilities: Eligible to apply starting in June 2024.
  • All other Canadian residents: Eligible to apply starting in 2025.
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The table below shows the application schedule.
Eligible Age GroupsDate Applications Open
Seniors 87+December 2023
Seniors between 77 – 86January 2024
Seniors between 72 – 76February 2024
Seniors between 70 – 71March 2024
Seniors between 65 – 69May 2024
People holding a valid Disability Tax Credit CertificateJune 2024
Children under 18June 2024
All other eligible Canadian citizens and residents2025

The CDCP uses its own fee guide to determine the payment amounts for covered services, which may differ from provincial or territorial fee guides. Not all patients will receive complete financial assistance through the CDCP due to required co-payments. Co-payments, which are the portion of treatment costs you need to cover out of pocket, are based on your family’s net annual income from the previous year’s tax return. These co-payments are paid directly to the dental office.

Co-Payment Structure:

The percentage of treatment costs covered by the CDCP is determined by your adjusted family net income:

Adjusted Family Net IncomeCDCP Coverage PercentagePatient Co-Payment Percentage
Less than $70,00090%10%
$70,000 – $79,99970%30%
$80,000 – $89,99940%60%

Note: These percentages are illustrative examples and might not reflect the actual percentages used by the CDCP.

When a dentist’s fee structure is higher than the CDCP’s fees, a gap in payments may occur. This difference can be addressed through balanced billing, where the patient is billed for the difference between the CDCP fees and the dentist’s regular fees.

Example:

  • A recall dental exam costs $100 according to the provincial fee guide.
  • The CDCP fee guide covers $90 for the same exam.
  • If your family’s net income is $85,000, the CDCP would cover 40% of $90 ($36), and you would be responsible for 60% of $90 ($54) plus the $10 difference between the CDCP and provincial fee guides, totaling $64 out of pocket.

This example illustrates how the co-payment works and highlights the importance of checking which costs are not covered by the plan.

For Seniors (Age 65 or Older):

  • You will receive a letter with instructions and an application code. Follow the instructions in the letter to apply over the phone.
  • If you haven’t received a letter but believe you are eligible, ensure that the mailing address used for your 2022 tax filing is current. If it is out of date, contact the Canada Revenue Agency (CRA) to update your address.

For Other Eligible Individuals:

  • Starting in May 2024, you can apply online.
  • As of now, detailed information on the online application process is unavailable.

Keep an eye on updates from the CDCP for more information on the online application process as it becomes available.

After you apply for the Canadian Dental Care Plan (CDCP), Health Canada will verify your eligibility and forward your information to Sun Life, which manages the plan’s enrollment process. Within three months of your application, you will receive a welcome package from Sun Life. This package will include:

  • The start date of your coverage
  • Your membership card
  • Information about the CDCP

Make sure to keep an eye out for this package to stay informed about your coverage details.

The Canadian Dental Care Plan (CDCP) covers a range of oral health services aimed at preventing and treating oral diseases and maintaining healthy teeth and gums. When recommended by a dental professional, the following services are covered:

  • Diagnostic Services: Examinations and assessments to identify dental issues.
  • Dental X-rays: Imaging to assist in diagnosing dental problems.
  • Preventive Services: Treatments to prevent dental issues, such as cleanings and fluoride applications.
  • Periodontal Services: Care for gum disease and other periodontal issues.
  • Restorative Services: Treatments to repair damaged teeth, such as fillings and crowns.
  • Endodontic Services: Root canal treatments and other procedures involving the tooth pulp.
  • Prosthodontic Services: Provision of dentures, bridges, and other prosthetics.
  • Sedation Dentistry: Use of sedatives to help patients relax during dental procedures.
  • Oral Surgery Services: Surgical procedures for various dental issues, including extractions and corrective surgeries.
 

The Canadian Dental Care Plan (CDCP) focuses on basic dental services that protect and preserve natural teeth, ensuring they function properly. It includes the provision of removable dentures for those with missing or failing teeth. However, the plan does not cover treatments aimed at improving the appearance of teeth or providing purely aesthetic benefits, nor does it cover more complex dental treatments. The following services are not covered by the CDCP:

  • Composite resin or porcelain veneers
  • Three-quarter crowns
  • Inlays and onlays made from any dental materials
  • Temporomandibular appliances and therapy
  • Fixed dental bridges
  • Teeth whitening
  • Mouthguards and bruxism appliances
  • Crown lengthening
  • Dental implants and any associated treatments
  • Bone grafting
  • Precision attachments for partial dentures
  • Extensive rehabilitation

These exclusions ensure the CDCP focuses on essential dental care necessary for oral health and functionality.

The types of treatment covered under the Canadian Dental Care Plan (CDCP) can vary. Certain services require preauthorization to ensure they are medically necessary. Providers can submit a preauthorization request on behalf of the patient, which will be evaluated based on the dental care professional’s recommendations and the patient’s dental and medical history.

Services needing preauthorization, including those that exceed established frequency limitations, will not be covered until November 2024. If a service is provided without preauthorization, such as in cases requiring urgent dental care, it can be submitted for post-determination starting in November 2024, but there is no guarantee that the service will be covered.

Treatments Requiring Preauthorization:

  • Specialist dental examination
  • Crowns
  • Posts and cores
  • Moderate sedation, deep sedation, and general anaesthesia
  • Major surgical procedures
  • Orthodontic services when clinically necessary (starting in 2025)

This ensures that only necessary treatments are covered and helps manage the plan’s resources effectively.

For further information on services covered, please visit the Government of Canada website.