Canadian Dental Care Plan
What is the Canadian Dental Care Plan?
The Government of Canada has introduced the Canadian Dental Care Plan (CDCP), as part of its objective to make dental care more accessible and affordable for those who might not otherwise be able to afford the care needed to maintain good oral health.
How Does it Work?
Scheduled to begin covering treatment in May 2024, the CDCP is a publicly funded dental benefit for those with an annual household income under $90,000 and no private dental insurance.
The plan covers a portion of the cost of an enrolled patient’s oral health treatments to prevent and treat oral disease which, in turn, can protect against serious health problems.
What is the Canadian Dental Care Plan?
The Government of Canada has introduced the Canadian Dental Care Plan (CDCP), as part of its objective to make dental care more accessible and affordable for those who might not otherwise be able to afford the care needed to maintain good oral health.
How Does it Work?
Scheduled to begin covering treatment in May 2024, the CDCP is a publicly funded dental benefit for those with an annual household income under $90,000 and no private dental insurance.
The plan covers a portion of the cost of an enrolled patient’s oral health treatments to prevent and treat oral disease which, in turn, can protect against serious health problems.
How Can I apply for the CDCP?
Application periods are staggered between December 2023 and 2025. See FAQs below for details. As of May 2024, seniors 65+ can apply online or over the phone.
Who qualifies for the CDCP?
Anyone wishing to participate in this plan must meet the eligibility requirements outlined below.
• Be a Canadian resident for tax purposes.
• Filed an income tax return for the previous year.
• Do not have dental insurance through a private or pension plan or with an employer.
• Have a net (after tax) family income of less than $90,000 annually.
Applications for the CDCP are phased, beginning with seniors. Children under age 18 and those with disabilities are eligible starting June 2024. All other Canadian residents can apply starting in 2025.
How Much will the CDCP Cover?
The CDCP has developed their own fee guide, which determines the fees the CDCP will pay for services covered under the plan. These fees can differ from provincial or territorial fee guides. Not all patients will receive complete financial assistance through the CDCP due to required co-payments, so it is important to ask about costs not covered by the plan. These co-payments are the portion of treatment costs you would be expected to cover out of pocket, and the percentage is determined by your family’s net annual income shown on the previous year’s tax return. Co-payment or fees not covered are paid directly to the dental office (please see table below for examples).
TABLE ON CO-PAYMENTS
Based on Adjusted Family Net Income
| Net Family Income | Covered by CDCP | Covered by Patient |
|---|---|---|
| Below $70,000 | 100% | 0% |
| $70,000 – $79,999 | 60% | 40% |
| $80,000 – $89,999 | 40% | 60% |
Please note the percentages covered are for the CDCP fee guide, which is sometimes lower than the provincial guides.
Fee Structure
Additionally, when a dentist follows their established fee structure, it may be higher than the CDCP’s fees, in which case there is a gap in payments. The gap can be filled by balanced billing, where the patient is billed for the difference between the CDCP fees and the fee their dentist would charge a patient who does not qualify for coverage under the plan.
For example, if a dentist follows the provincial fee guide and charges $100 for a recall dental exam but the CDCP fee structure only covers $90 the patient is responsible for the $10 difference. In the same example, for a patient with a net family income of $85,000, the plan would cover $36 (40% of the CDCP established fee) and the patient would be responsible for $54 (the remaining 60% of the CDCP established fee) plus the additional $10. Please note these figures are for illustration only.
Fee Structure
Additionally, when a dentist follows their established fee structure, it may be higher than the CDCP’s fees, in which case there is a gap in payments. The gap can be filled by balanced billing, where the patient is billed for the difference between the CDCP fees and the fee their dentist would charge a patient who does not qualify for coverage under the plan.
For example, if a dentist follows the provincial fee guide and charges $100 for a recall dental exam but the CDCP fee structure only covers $90 the patient is responsible for the $10 difference. In the same example, for a patient with a net family income of $85,000, the plan would cover $36 (40% of the CDCP established fee) and the patient would be responsible for $54 (the remaining 60% of the CDCP established fee) plus the additional $10. Please note these figures are for illustration only.
Which Dental Services are Covered?
The CDCP covers oral health services designed to prevent and treat oral disease and to maintain healthy teeth and gums.
Services that are covered when recommended by a dental professional can include the following listed below.
- Diagnostic services
- Dental X-rays
- Preventive services
- Periodontal services
- Restorative services
- Endodontic services
- Prosthodontic services
- Sedation dentistry
- Oral surgery services
Which Dental Services are Not Covered?
Coverage under the CDCP is limited to basic services that protect and preserve natural teeth so people can benefit from teeth that function properly. Many people have missing teeth or teeth that are failing and need removing. When this is the case, the CDCP includes the provision of removable dentures, allowing people to eat and talk effectively.
The plan is not designed to improve the overall appearance of teeth or provide purely aesthetic benefits. It also excludes more complex treatments. Treatments not considered for coverage under the CDCP include those listed below.
- Composite resin or porcelain veneers
- Three-quarter crowns
- Inlays and onlays made from any dental materials
- Temporomandibular appliances and therapy
- Fixed dental bridges
- Teeth whitening
- Mouthguards and bruxism appliances
- Crown lengthening
- Dental implants and any associated treatments
- Bone grafting
- Precision attachments for partial dentures
- Extensive rehabilitation
