Canada Dental Care Plan

Everything You Need to know......

General

The Canada Dental Care Plan (CDCP)covers a range of dental procedures that prevent and treat oral disease and/or the consequences of oral disease

It will provide coverage of the cost of dental care for Canadian residents who do not have dental benefits and have a household income of less than $90,000 a year.

The federal government has committed to rolling out the CDCP coverage in stages. Below is a table with the expected timelines for applications to the CDCP.

Coverage of dental services is determined on an individual basis taking into consideration criteria such as your oral health status

Benefit Period

Effective Date: May 2024 (when you can start to bill through an oral health care provider)

The CDCP coverage period extends for twelve months, from July 1 to June 30, annually. Re-enrolment will be required, and will take place by July 1 of each year for clients who continue to be eligible for coverage under the CDCP.

Group Applications open:

Seniors aged 87 and above: Starting December 2023

Seniors aged 77 to 86: Starting January 2024

Seniors aged 72 to 76: Starting February 2024

Seniors aged 70 to 71: Starting March 2024

Seniors aged 65 to 69: Starting May 2024

Persons with a valid Disability

Tax Credit certificate: Starting June 2024

Children under age 18: Starting June 2024

All remaining eligible Canadian residents: Starting 2025

How much does CDCP cover?

Some Canadian Dental Care Plan (CDCP) patients won’t receive full financial assistance with the cost of their care through CDCP due to co-payments. Government required co-payments are the percentage or portion of the CDCP rate that the patient is expected to pay out of pocket. The required co-payment is determined by patients’ annual family income: No required co-payment for patients with an adjusted annual family net income under $70,000. Patients may face additional charges as described below. 40% required co-payment for patients with an adjusted annual family net income between $70,000 and $79,999. Patients may face additional charges as described below. 60% required co-payment for patients with an adjusted annual family net income between $80,000 and $89,999. Patients may face additional charges as described below.

Additional charges?

In addition to co-payments, patients may be required to pay additional charges. These additional charges are to cover a portion of the cost of their care when the Canadian Dental Care Plan (CDCP) rate is lower than the oral health care provider's usual and customary fee or if the patient chooses to proceed with care that is not covered by CDCP. Health Canada asks patients to confirm their dental hygienists participation in the program and billing practices when booking an appointment. The CDCP pays only for services covered within the plan at the established CDCP rates. These rates are not the same as provincial and territorial fee guides that dental hygienists usually utilize as reference to establish their usual and customary fee. The CDCP is not intended to replace existing workplace or private dental benefits

Who qualifies for CDCP?

Individuals must meet all of the following criteria in order to be eligible for Canadian Dental Care Plan (CDCP) coverage. No access to dental insurance, meaning: no coverage through employer or a family member’s employer benefits; including health and wellness accounts; no coverage through pension (previous employer) or a family member’s pension benefits; or no coverage through a purchased plan by yourself or by a family member or through a group plan from an insurance or benefits company. an adjusted family net income of less than $90,000; be a Canadian resident for tax purposes; and have filed their tax return in the previous year. Canadian residents who have access to dental benefits through a social program offered by their province or territory and/or by the federal government will be eligible for the CDCP if they meet all the eligibility criteria. Patients who decide to opt out of available benefits to them will be considered as having access to dental insurance for the purposes of determining qualification criteria

Services covered by the CDCP?

Health Canada has stated that the following services will be covered under the Canadian Dental Care Plan (CDCP), with some services only becoming available in the fall of 2024: Preventive services, including scaling (cleaning), polishing, sealants, and fluoride; Diagnostic services, including examinations and X-rays; Restorative services, including fillings; Endodontic services, including root canal treatments; Prosthodontic services, including complete and partial removable dentures; Periodontal services, including deep scaling; and Oral surgery services, including extractions.

Is the CDCP intended to replace existing insurance coverage?

The Canadian Dental Care Plan (CDCP) is not intended to replace existing insurance coverage. It is important that Canadians do not drop their existing coverage, as they might not be eligible for the CDCP if they do. The CDCP is designed to provide coverage for Canadians who do not have any existing coverage. The Government of Canada is working to ensure employers and insurance carriers do not reduce or eliminate the coverage Canadians rely on. The Canada Revenue Agency now requires employers to report on their T4/T4A whether their employees and their families had access to dental insurance coverage, including spending and wellness accounts

Are individuals with existing coverage through government programs eligible?

If you have dental coverage through a provincial, territorial, or federal government social program, you can still qualify for the Canadian Dental Care Plan (CDCP). If you meet all the eligibility criteria, your coverage will be coordinated between the plans to ensure there are no duplications or gaps in coverage