What is the Canadian Dental Care Plan (CDCP)

The CDCP is a federally funded dental care program, designed to reduce financial barriers to oral healthcare for Canadian residents who lack dental benefits with an annual net income of less than $90,000.

The program provides coverage for various dental services, including preventive, diagnostic, restorative, endodontic, prosthodontic, periodontal, and oral surgery services.

Who is eligible for the CDCP?

Individuals must meet the following criteria, established by the Government of Canada to qualify as an eligible CDCP member:

  • Does not have access to dental insurance.
  • Has a family net income of less than $90,000.
  • Be a Canadian resident and has filed a tax return in the previous year.
  • To retain eligibility, CDCP members are required to re-enrol for the program annually.
  • Learn more about the CDCP

The CDCP offers three levels of coverage – these are based on adjusted family net income.

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Tier 1

  • 100% CDCP fee guide coverage
  • Adjusted family net income under $70k

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Tier 2

  • 60% CDCP fee guide coverage
  • Adjusted family net income between $70k and $80k

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Tier 3

  • 40% CDCP fee guide coverage
  • Adjusted family net income between $80k and $90k

What is Covered by the CDCP?

  • Basic oral health services will be covered starting in May
  • Services requiring pre-authorization (more complicated treatments or those exceeding frequency limitations) will be available in November 2024
  • Co-payments will be required for those with an adjusted family net income between $70,000 and $89,999
  • Providers may charge higher fees than the established CDCP fees; patients are responsible for paying the difference

Services Not Requiring Pre-authorization

General services include:

  • Diagnostic services
  • Examinations, radiographs, laboratory tests
  • Preventive services
  • Polishing, scaling, topical fluoride
  • treatments, sealants etc.
    • Restorative services
    • Restorations on primary and permanent
  • teeth, caries etc.
    • Endodontic services
    • Standard root canal treatment etc.
    • Prosthodontic services
    • Standard complete dentures etc.
    • Sedation and General Anesthesia
    • Minimal sedation procedures

Services Requiring Pre-authorization

Services requiring pre-authorization will not be offered until November 2024.

Services requiring pre-authorization include:

  • Specialist examinations
  • Interproximal disking of teeth
  • Cores and posts
  • Crowns
  • Root canal re-treatment, apicoectomy, retrofilling, root canal treatment on third molars
  • Initial placements of partial cast dentures and partial acrylic dentures
  • Major surgical procedures
  • Orthodontic services (available in 2025)
  • Moderate sedation, deep sedation, general anesthesia and sessions of sedation above the frequency limit

Exclusions to
CDCP

Select procedures will not be covered by the CDCP.

Services excluded from CDCP coverage include, but are not limited to:

  • Veneers in composite or ceramic
  • All ¾ crowns
  • Teeth whitening
  • Inlays/onlays in composite, precious metal or ceramic
  • Temporomandibular joint therapy and appliances
  • Fixed prosthodontics (bridges)
  • Mouthguards
  • Crown lengthening
  • Root re-sectioning
  • Implants and any associated procedures
  • Bone grafts
  • Ridge augmentation

Timelines for Eligible Groups

Eligibility groups will be invited to apply on an ongoing basis:

Date Group

May 2024

Seniors age 65+

June 2024

Children under 18

June 2024

Adults with Disability
Tax Credit

2025

Adults aged 18-64

How does the Patient Get Coverage?

The CDCP covers a range of dental procedures, focused on preventing and treating oral health disease and the impacts of oral disease. The rollout timelines for CDCP services vary, based on pre-authorization requirements.

Currently, invitations to apply are being sent in the mail; patients can follow the instructions in the letter to apply over the phone.

Starting in May, eligible patients may apply through an online portal.  Once approved, Patients will receive a welcome package from Sun Life within three months of applying, which includes:

  • Information on the CDCP
  • A member card
  • Their individual coverage start date

Patients can also be directed to Health Canada’s CDCP website for more information on eligibility, covered services and more.

FAQ

Important Facts For Patients

  • The CDCP is a subsidy, not full coverage.
  • CDCP coverage is only available to patients after their individual coverage start date is effective.
  • Delaying appointments to wait for CDCP coverage could result in worsening oral health issues.
  • Patients currently using a government social program will still be eligible for the CDCP; coordination of benefits is still being determined.
  • We follow the Ontario Dental Association’s Suggested Fee Guide however thanks to the CDCP program, patients will receive the coverage that they are entitled to under the level of coverage that they are approved for. The coverage received will be applied to your total balance from your treatment.  We are so grateful to be able to offer this to our patients as a support to their overall oral health needs.

Will the entire cost of my dental treatment be covered under the new plan?

As the CDCP is not a fully subsidized program, we want to be transparent that there may be some out-of-pocket costs when you receive treatment. These additional costs stem from three factors:

  1. The fees covered by the CDCP are generally lower than the recommended fees for dental

care in [province/territory].

  1. Those with an adjusted family net income between $70,000 and $89,999 will have a

co-payment, meaning only a set percentage of fees will be covered.

  1. Not all dental services will be covered by the CDCP.

We will be sure to make any anticipated out-of-pocket costs clear to you before you receive treatment. Although messaging around the coverage included in this program has been unclear, we still believe the subsidization that patients will receive as part of the CDCP will help remove significant financial barriers to accessing dental care.

What dental services will be covered under the new plan?

The CDCP will cover basic dental care, including a range of essential services that prevent and treat oral disease or its consequences. Coverage for certain treatments or higher frequencies of treatment requiring preauthorization will start in November 2024.

Some examples of services that could be covered under the CDCP include the following:

  1. preventive services, including scaling (cleaning), polishing, sealants, and fluoride
  2. diagnostic services, including examinations and x-rays
  3. restorative services, including fillings
  4. endodontic services, including root canal treatments
  5. prosthodontic services, including complete and partial removable dentures
  6. periodontal services, including deep scaling
  7. oral surgery services, including extractions

How long will I be covered by the CDCP?

In order to continue qualifying for the CDCP, you will need to meet the eligibility requirements each year. Eligibility will be reassessed on an annual basis, although the process for reassessment has not yet been communicated by the government. We will be sure to let you know if any actions are required on your end to continue receiving care under the CDCP in the coming years.

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