What you need to know about the new Canadian Dental Care Plan

March 19, 2024

For business owners, plan sponsors and administrators

In December 2023, the Federal government announced its dental care plan for Canadians who don’t already have dental coverage. The government has now launched a slow roll out of the plan, starting with seniors and children in 2024, and then all eligible Canadians by 2025.

We want to save you some time searching for the answers to common questions, so we’re providing the government’s answers on how the program works. For the most current information, visit Canada.ca.

Does the CDCP replace employer offered benefits?

No. The CDCP does not replace existing benefits. The CDCP offers dental coverage to Canadians who do not have access to dental insurance.

Are all oral health professionals automatically a CDCP provider?

No. Oral health providers will be able to enroll, on a voluntary basis, as a participating CDCP provider.  Oral health providers include:

• dentists
• denturists
• dental hygienists, and
• dental specialists

CDCP members need to confirm with their oral health provider prior to booking an appointment if they have enrolled in the CDCP to limit unexpected out of pocket payments.

What services are covered?

Services covered under the CDCP, as recommended by an oral health provider, include the following:

• 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
• oral surgery services, including extractions

Who qualifies?

In order to qualify for CDCP, the applicant must satisfy all the following requirements:¹

• dental specialistsNo insurance through their or their family member’s employer, including health care spending and wellness accounts
  • No insurance coverage through their or their family member’s pension benefit, or
  • No dental insurance purchased by themselves or their family member through a plan from an insurance or benefits company
• Have an adjusted family income of less than $90,000¹
• Be a Canadian resident for tax purposes
• Have filed an income tax return in the previous year

You’re still considered to have access to dental insurance if you choose to opt out of available benefits like these.

When can people apply?

Does someone need to apply every year?

Eligibility requirements must be met each year to qualify for the CDCP. The government still needs to share its reassessment process.

Does the CDCP pay according to current Provincial and Territorial fee guides?

No. Eligible oral health care service costs will be covered at the CDCP established fees.

Are expenses covered in full?

Not always. For the most current information, please visit Canada.ca. The amount of coverage depends on the annual adjusted family net income. Co-payments are introduced for those households making a combined family income of more than $70,000.

Can the co-pay amount be submitted for reimbursement from another plan?

No. Not having any dental coverage is a qualifying factor in determining eligibility for the CDCP. Since the patient would not have any other dental coverage than the CDCP, there would be no other plan to coordinate the out-of-pocket amount with.

References:

^{1 Definition of Adjusted Family Income: Do you qualify - Canada.ca}