Canadian Dental Care Plan FAQ

 
 

The Canadian Dental Care Plan (CDCP) is a federal government program that is intended to provide coverage for Canadian residents who do not have dental benefits and have a household income of less than $90,000 a year. You need to know that this is a government dental benefit; it is not a free dental program.

The CDCP is for Canadians who do not have dental benefits. It is not intended to replace benefits that people already have through work, school or private plans.

The CDCP is managed by Health Canada and administered by Sun Life. Dentists are not involved in deciding who is eligible or what services are covered.

The federal government is currently contacting the first groups of eligible citizens to inform them of the process. If you have not received a letter before May, you may not be eligible, or at least not yet./p>

Check your eligibility on the government website: https://www.canada.ca/en/services/benefits/dental/dental-care-plan/qualify.html

No. The CDCP does not provide free dental care. It is a government dental benefit that covers a part of the cost of your care. You may have to pay the portion of costs that are not covered.

Patients may be required to make a co-payment (that is, pay for a portion of their dental care under the CDCP) depending on their adjusted family net income, as follows:

  • No co-payment of the CDCP benefit for those with an adjusted annual family net income under $70,000.
  • A 40 per cent co-payment of the CDCP benefit for those with an adjusted annual family net income between $70,000 and $79,999.
  • A 60 per cent co-payment of the CDCP benefit for those with an adjusted annual family net income between $80,000 and $89,999.

Dentists have the choice to bill their usual and standard fees. In addition to the potential co-payment, you may have to pay the portion of a dentist’s usual and standard fees that aren’t covered by the CDCP.

When booking your dental appointment, talk to your dentist about the costs of your treatment and any costs that won’t be covered by the CDCP.

The ODA does not have further information about the additional fees that dental offices may individually choose to bill patients enrolled in the CDCP and cannot enter into a discussion about fees on your behalf.

The federal government is currently contacting the first groups of eligible citizens. Seniors who are eligible will receive letters from Service Canada inviting them to apply, with instructions on how to validate their eligibility and apply by telephone. Dental care under the CDCP is expected to start in May 2024.

Your coverage start date is based when on when you apply and when you’ll be enrolled in the CDCP. It will be different for each person.

In May 2024, an online application portal will be open for seniors 65 and older. If you have a valid Disability Tax Credit certificate or have a child under the age of 18, you will be able to apply online as of June 2024. All remaining eligible Canadians will be able to apply online in 2025.

The ODA or any other dental association do not run nor manage the CDCP, it is Government of Canada program. We cannot help you apply or answer questions about your eligibility for the CDCP. For more information on eligibility, visit canada.ca/dental.

Examples of services that could be covered under the CDCP when recommended by your dentist include:

  • Scaling (cleaning), polishing, sealants, and fluoride
  • Examinations and X-rays
  • Fillings and root canal treatments
  • Complete and partial removable dentures
  • Oral surgery services, including extractions

Some services will require preauthorization, which means prior approval is needed. This will be based on a dentist’s recommendations. Before the treatment begins, your dentist will check to see if it will be covered under the CDCP. Services requiring preauthorization will become available in November 2024.

For full information on all services covered, go to the CDCP Dental Benefits Guide.

No. The CDCP is designed for Canadian residents who do not have dental benefits. To qualify for the CDCP, you must not have access to any type of dental insurance or coverage through:

  • Your employer or a family member’s employer benefits, including health and wellness accounts.
  • A professional or student organization;
  • Your pension benefits (previous employer) or a family member’s pension benefits.
    • Exception: You may be eligible for the CDCP if you’re retired and you opted out of pension benefits before December 11, 2023, and you can’t opt back in under the pension rules.
  • Coverage purchased by yourself or by a family member or through a group plan from an insurance or benefits company.

Did you know? If you’re eligible for dental coverage through your employment benefits or a professional or student organization, you are not eligible for CDCP. This is true even if you decide not to take it or use it.

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.

The ODA does not recommend cancelling your existing dental coverage thinking that the CDCP will replace those benefits. Please take a careful look at your current coverage and how it compares to the CDCP. It may be that getting dental care with CDCP coverage is more costly than your private insurance. Make sure you understand all the details and costs of your coverage so that you can make the best decision for you and/or your family.

More details on whether you are eligible for the CDCP are on canada.ca/dental.

We don’t know and this should concern us all. Two-thirds of Canadians have dental benefits provided by their work, school, or other group plans. These plans give them the choice of which dentist they would like to see, and the right to choose what dental care they get.

Dentists believe that the CDCP should improve access to care for people who don’t have benefits. The CDCP should not take away dental benefits that people already have.

A recent study showed that a third of Canadians would not support a dental care plan which would cause them to lose their employer-provided dental coverage. This is why we need the federal government to tell us what they are planning to do to protect your existing dental benefits.

The government has stated that the CDCP is not intended to replace existing workplace or private dental benefits. The ODA strongly encourages employers and other groups to keep the dental benefits for their employees and members, so they don’t lose access to dental care.

Please don’t delay treatments or your dental appointments! It’s better to keep getting regular dental checkups now to catch problems before they become painful and expensive to treat. It isn’t clear when coverage under the CDCP will start for everyone.

For more information on preventing dental problems, visit our Care and Disease Prevention page.

Your dentist can continue to provide you with the same level of care and treatment, but the costs won’t be covered by the CDCP.

It’s very important to speak openly with your dentist. They might be able to set up treatment and payment options that work with your financial situation. Give them a call to see what can be done to help.

Some Ontario municipalities have dental programs or financial support specifically for people on low incomes. Try contacting your local public health unit; they may be able to help you find resources in your community. The ODA does not have a list of these programs and can’t assist you in finding one.

If you are covered under other government dental programs (such as Healthy Smiles Ontario, the Ontario Disability Support Program, or the Ontario Seniors Dental Care Program) and are eligible for the CDCP, you will be able to apply. Benefits will be coordinated between the programs, which means that your coverage will not be duplicated.

The federal government is now working with the provinces and territories to figure out how this will work.

The Canada Dental Benefit (CDB) is an interim benefit that provides direct, up-front, tax-free payments to help cover out-of-pocket dental care expenses for children under 12 years of age who do not have access to private dental benefits and whose family income is less than $90,000 a year. The CDB provides payments of up to $650 for each eligible child under 12 years of age, each year for two years.

Applications are open until June 30, 2024, for:

  • dental care received between July 1, 2023, and June 30, 2024
  • one additional payment if you meet the criteria

More information is available on the Canada.ca website.

The CRA My Account is the quickest, easiest and most secure way to apply for the CDB. Go to Canada.ca/dental for more information. If you’re unable to apply online, call the CRA at 1-800-715-8836.

Currently, you can apply to get the Canada benefit ahead of your child’s dental appointment.

For more information on how to apply, Health Canada has a factsheet (PDF, English) that you can download and print. It explains the main points of the CDB in an easy-to-understand graphic. It is also available in other languages on the Health Canada website.

The CDB will expire in June 2024. Eligible children under 18 years can be enrolled in the CDCP to continue to receive dental coverage. For more information on eligibility, visit canada.ca/dental.

You aren’t automatically ineligible for the CDB just because you are covered under another government program, like Healthy Smiles Ontario. The CDB is designed to cover any out-of-pocket dental care expenses for each eligible child that have not been fully reimbursed under another federal or provincial government dental program.

In Ontario, once a dental service has been provided and paid for under a provincial program like Healthy Smiles Ontario, there can be no further billing for the same service. However, if you are willing to pay out of pocket for a service, your dentist may bill you directly for that service and, provided you are eligible for the CDB, you would be able to use the CDB to pay for the service.

The federal government has said you can apply for CDCP if you are eligible, even if you are covered under another government program and that they will ensure there is no duplication of coverage. Beyond this, they have not shared any details.

The CDCP is intended to help millions of people without dental benefits access essential oral health care. Although this is an historic investment, the CDCP has been developed under tight timelines and with limited involvement of practising dentists. It is critical that the government has a full understanding of the impact it will have on patients trying to access the program.

Now that more details of the CDCP have been released, it’s time for the federal government to answer the big questions Canadians have:

  • Am I getting free dental care? No – patients may pay out-of-pocket for services and fees that aren’t covered under the federal government’s new dental benefits plan, including 40 to 60 per cent co-payments for families who earn more than $70,000 per year. Where government reimbursement does not cover the full cost of care, some patients may be required to pay the balance.
  • Can I choose my own dentist? Maybe not – patients will have to search for dentists who agree to participate, despite the unclear terms and conditions set by the government. The ODA does not have a list of participating dentists.
  • Will it be easy to get the care I need? Maybe not – dentists expect there will be a lot of red tape that may delay care and not make this a smooth process. Unlike other dental benefits programs, the CDCP has inserted processes that get in the way of how patients can access essential oral health care, and the relationship they have with their dentist.

The federal government has not answered other critical questions: How will they protect existing work, school and/or group dental benefits? How will the CDCP work with other publicly funded dental programs, including provincial programs? Without addressing these legitimate concerns, how do they expect people to know what this will mean for their dental coverage and what they should do next?

As experts in oral health care, the provincial and territorial dental associations, representing over 25,000 dentists across the country, have pointed out that the CDCP does not meet most of the principles of our proposed framework. This is an historic investment, so it is critical that the federal government truly gets it right.

To learn more, read our latest media release.