The Canadian Dental Care Plan (CDCP), a significant initiative by the Government of Canada, is set to alleviate financial barriers to accessing dental care for eligible residents.
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The plan specifically targets Canadian residents with an annual adjusted family net income below $90,000 who lack dental insurance. The CDCP is a part of the government’s commitment, as outlined in Budget 2023, to invest $13 billion over five years and an ongoing allocation of $4.4 billion.
The CDCP aims to provide dental coverage for up to nine million uninsured Canadians. It is designed not to replace existing dental benefits from employer/pension-sponsored or private plans but to complement them and fill coverage gaps. The plan includes no co-pays for families earning less than $70,000 annually.
Who Qualifies for Canadian Dental Care Plan
To be eligible for the Canadian Dental Care Plan (CDCP), individuals must meet specific criteria:
- they should not have dental insurance, have an adjusted family net income of less than $90,000, be a Canadian resident for tax purposes;
- filed their tax return in the previous year.
- not having access to dental insurance is defined as lacking dental coverage through employer or family member’s employer benefits, pension benefits, or any insurance purchased individually or through a group plan from an insurance or benefits company.
- Canadian residents who are already receiving dental benefits through a social program offered by their province, territory, or the federal government are eligible for the CDCP, provided they fulfill all other eligibility criteria.
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When do applications open for the Canadian Dental Care Plan
The phased rollout of the CDCP begins in December 2023, initially focusing on seniors aged 87 and above. The plan will then gradually expand in subsequent months to include younger age groups, down to those aged 70-71 by March 2024.
Eligible individuals will receive invitations to apply, with the initial application process conducted via telephone. In May 2024, an online application portal will open for seniors aged 65 and above, followed by persons with a Disability Tax Credit certificate and children under 18 starting from June 2024. The plan will be available to all remaining eligible residents in 2025.
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How to apply for the Canadian Dental Care Plan
The initial application process commences in December 2023 and continues until the end of April 2024.
In mid-December 2023, the rollout of the Canadian Dental Care Plan (CDCP) will commence with letters being mailed to seniors, beginning with those aged 87 and above. This will be followed by mailings to seniors aged 77 to 86 in January 2024, 72 to 76 in February 2024, and finally 70 to 71 in March 2024. These letters will contain a personalized application code and instructions for applying by phone.
Recipients are advised to follow the letter’s instructions to apply and await a confirmation from Service Canada about their CDCP qualification. Successful applicants will then receive a welcome package from Sun Life, detailing the start date for covered dental care and further instructions.
For those who are eligible but have not received a letter by the end of March 2024, it’s important to note that these letters are sent to the address on the 2022 tax return and are based on having an adjusted family net income of less than $90,000. Individuals with outdated addresses or those who have not filed their 2022 taxes may not receive a letter and should update their information with the Canada Revenue Agency.
The application opportunity extends to seniors aged 65 to 69, who can apply online starting in May 2024. This is followed by persons with a valid Disability Tax Credit certificate and children under 18 in June 2024. Details for these phases will be shared later.
Enrolled Canadians can begin consulting oral health providers as early as May 2024, beginning with seniors.
The specific start date for accessing dental care services depends on the application and enrollment timeline for each group. It’s important to note that the CDCP coverage is effective from the start date mentioned in Sun Life’s welcome package and does not cover any oral health care services availed before this date.
What is covered in the Canadian Dental Care Plan
The plan covers a broad spectrum of services, including preventive services like scaling, polishing, sealants, and fluoride treatments; diagnostic services such as examinations and x-rays; restorative services including fillings; endodontic treatments like root canal procedures; prosthodontic options encompassing complete and partial removable dentures; periodontal services including deep scaling; and oral surgery services such as tooth extractions.
- Preventive Services: This category includes scaling (cleaning), polishing, sealants, and fluoride treatments, all of which are crucial for maintaining oral hygiene and preventing dental issues.
- Diagnostic Services: These services encompass examinations and x-rays, which are fundamental for identifying dental problems at their earliest stages.
- Restorative Services: This includes procedures like fillings, which are essential for repairing damage caused by cavities or trauma.
- Endodontic Services: Root canal treatments, a key component of endodontics, are vital for treating infected or decayed teeth.
- Prosthodontic Services: The plan covers complete and partial removable dentures, addressing the needs of individuals with missing teeth.
- Periodontal Services: This includes deep scaling, crucial for treating gum disease and maintaining gum health.
- Oral Surgery Services: Services like extractions, which are sometimes necessary to address severe dental issues, are also included.
Some of these services will be introduced in fall 2024. To ensure a comprehensive and effective implementation, Health Canada is actively collaborating with provincial and territorial authorities to align the CDCP with existing publicly-funded oral health programs.
Additionally, the CDCP will undergo regular reviews, informed by data and evidence, to continuously adapt and meet the evolving oral health needs of Canadians.
How much will be covered in the Canadian Dental Care Plan
The Canadian Dental Care Plan (CDCP) aims to reduce financial hurdles in accessing oral health care for Canadians without dental insurance.
Under the CDCP, enrolled oral health providers will bill the program directly for services rendered, streamlining the reimbursement process and sparing patients from seeking reimbursements from Sun Life.
The CDCP reimburses a portion of eligible expenses based on its fee rates, but patients covered under the CDCP are responsible for a co-payment, which varies with their adjusted family net income. Specifically, there is no co-payment for those with an annual family net income under $70,000, a 40% co-payment for incomes between $70,000 and $79,999, and a 60% co-payment for incomes between $80,000 and $89,999.
Per the news release, 0ral health providers are encouraged to adhere to the established CDCP fee rates, which differ from provincial and territorial fee guides, to prevent additional patient charges at the point of care.
Beginning in early 2024, oral health providers, including dentists, denturists, dental hygienists, and dental specialists, will have the opportunity to voluntarily enroll as participating providers in the Canadian Dental Care Plan (CDCP) through Sun Life. To be eligible for enrollment, providers must be licensed and in good standing to practice in their respective province or territory. A provider awareness campaign, supported by Sun Life, will be launched to encourage and guide providers through the enrollment process.
View Comments (2)
Where do professionals find the fee guide. Its 2024 and no fee guide has been created?
87 and older. Are you kidding me. It's highly unlikely that many will be around to take advantage of this. Our trusted politicians are covered until the end of time so they surely don't have to worry.