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Understanding the Canadian Dental Care Plan: What You Need to Know

mother her children have-come consultation dentist

The Canadian Dental Care Plan (CDCP) is a new program initiated by the Government of Canada. The CDCP aims to ease the financial obstacles to oral health care for certain qualified Canadian residents. The application process will commence in stages, commencing with seniors.

Who Is Eligible?

To be eligible for enrollment in the Canadian Dental Care Plan (CDCP), you must satisfy all eligibility requirements.

Firstly, you must not have access to other forms of dental insurance, such as employer benefits, including health and wellness accounts, or pension benefits – either your own or a family member’s. It also includes coverage from professional or student organizations. This also includes personally purchased insurance or coverage through a group plan from an insurance or benefits company. If you choose to opt out of available benefits like these, you are still considered to have access to dental insurance.

Additionally, you must have an adjusted family net income of less than $90,000 and be a Canadian resident for tax purposes. Furthermore, you need to have filed a tax return in the previous year. 

If you currently have dental coverage through a provincial, territorial, or federal government social program, you can still qualify for the CDCP if you meet all of the above eligibility criteria. In this case, your coverage would be coordinated between the plans to ensure there are no duplications or gaps in coverage, ensuring comprehensive dental care access.

Eligibility will be reassessed annually, so you’ll need to meet the eligibility requirements each year to qualify. 

How Do You Apply?

Applications for different groups will open gradually. Currently, applications for seniors aged 70 and above are being accepted. Those aged 65 to 69 will be allowed to apply in May 2024, while adults with a Disability Tax Credit certificate may apply in June 2024. Children under 18 will become eligible in June 2024. Finally, all remaining eligible residents will be permitted to apply in 2025.

A trusted person, such as a friend or relative, or a delegate can help you with your application.

senior female receiving dental treatment from a medic

How Do You Enroll

Sun Life will oversee the administration of the Canadian Dental Care Plan (CDCP) on behalf of the Government of Canada. Upon confirmation of your eligibility by the government, they will share your details with Sun Life, who will then enroll you in the CDCP.

Next, Sun Life will send you a welcome package containing important information about the CDCP, your membership card, and the start date of your coverage. This package will also clarify when you can visit an oral health provider. Appointments for eligible oral health care services can only be scheduled from this specified date onward. The CDCP won’t cover any services that were completed before this date.

Your coverage start date depends on when your application was submitted and when you were fully enrolled. The first group eligible to visit oral health providers is expected to be eligible for coverage as of May 2024.

What Services Are Covered?

The CDCP will provide coverage for a diverse range of oral health care services, aimed at maintaining the health of your teeth and gums and addressing oral health issues and diseases. Services will be included under the recommendation of an oral health provider.

Examples that may be covered include:

  • Preventive services such as scaling (cleaning), polishing, sealants, and fluoride treatments.
  • Diagnostic services, including examinations and x-rays.
  • Restorative services like fillings.
  • Endodontic services, such as root canal treatments.
  • Prosthodontic services, encompassing complete and partial removable dentures.
  • Periodontal services, which may include deep scaling.
  • Oral surgery services, including extractions.

Certain oral healthcare services will require preauthorization; these will become available starting in November 2024.

jaw model dental tools flag canada white table

How Much Will Be Covered?

Services are covered at set fee rates, which differ from provincial and territorial fee guides. Additional charges may apply.

Reimbursement will be a percentage of the cost, based on the CDCP fee rates and your adjusted family net income. Your oral health provider’s charges may exceed the CDCP fees; you are responsible for any percentage not covered by the CDCP, as well as for any additional services not approved under the CDCP.

Your co-payment percentage is impacted by your adjusted family net income: 

  • For incomes under $70,000, 100% of eligible oral health care costs will be covered at the CDCP established fee rate.
  • For incomes between $70,000 and $79,999, 60% of eligible costs will be covered at the CDCP established fee rate.
  • For incomes between $80,000 and $89,999, 40% of eligible costs will be covered at the CDCP established fee rate.

Maple Ridge Smiles Dentaloffers friendly family dentistry, with a wide range of services under one roof, and also offers direct billing, to help coordinate your coverage and make the process easier for you. If you have any questions about this program, please continue to check our website for updates, as we will pass on any information as it comes available to us. 

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