Canadian Dental
Care Plan (CDCP)
Overview of the Canadian Dental Care Plan (CDCP)
The Canadian Dental Care Plan (CDCP) was created to make dental care more affordable for Canadians who don’t have access to dental insurance.
This program helps Canadians who would otherwise struggle to pay for dental treatments, ensuring that more people can maintain good oral health without worrying about high costs. Administered by Sun Life, the CDCP provides access to a variety of dental services for Canadians from different income levels.
Eligibility Criteria
To qualify for the CDCP, there are specific requirements based on your residency, income, and whether you already have dental coverage. Here’s a breakdown of who can apply.
Canadian Residents
You must be a Canadian resident for tax purposes to apply. This means you need to live in Canada and file taxes here.
Adjusted Family Net Income
Income plays a big role in determining your eligibility. If your household’s adjusted family net income is less than $90,000, you may qualify. The amount of coverage depends on where your income falls:
- If your income is below $70,000, you get 100% coverage for dental services.
- Families with incomes between $70,000 and $79,999 will have 60% of their dental costs covered, with a 40% co-payment.
- Those earning between $80,000 and $89,999 will get 40% coverage, with 60% paid out-of-pocket.
Disability Tax Credit Certificate Holders
Adults who have a valid federal Disability Tax Credit certificate for 2023 are also eligible for the CDCP. This is important for individuals with disabilities who often have higher healthcare costs, including dental care.
Coverage Details
1. Scope of Dental Coverage
The CDCP covers a wide range of dental services, from routine check-ups to more advanced treatments. This includes diagnostic services like x-rays, preventive care like cleanings, and major procedures like crowns and dentures.
2. Start Date and Duration of Coverage
Your coverage under the CDCP begins on the date listed in your welcome letter from Sun Life. Make sure to wait until this date before scheduling any dental appointments to ensure your services are covered. Each year, your eligibility will be reassessed to confirm that you still qualify for the plan.
3. Co-Payments and Deductibles
Your level of coverage is based on your household income, meaning some families will need to make co-payments of 40% to 60%. It’s a good idea to confirm any additional charges with your dentist before receiving treatment to avoid surprises.
Dental Services Included
1. Preventive Services
The CDCP covers preventive services like regular check-ups, cleanings, and fluoride treatments. These are crucial for maintaining good oral health and catching problems early before they get worse.
2. Restorative Services
Restorative services, such as fillings, are also covered. These treatments restore the function and appearance of your teeth after they’ve been damaged by decay or trauma.
3. Major Dental Procedures
The plan covers major procedures, including root canals, crowns, and dentures. Starting in 2025, orthodontic services will also be included, but only for cases with a medical need.
Service Providers and Accessibility
List of Participating Oral Health Providers
The CDCP allows various oral health professionals to participate, including dentists, dental hygienists, and dental specialists. These providers must agree to bill Sun Life directly to limit out-of-pocket costs for patients.
Nationwide Accessibility
The CDCP is accessible across Canada, and you can find participating oral health providers using Sun Life’s Provider Search tool. It’s important to confirm with your provider that they accept CDCP clients before making an appointment.
Registration and Claims
1. Enrolling in CDCP
Eligible individuals can apply online for the CDCP. Right now, applications are open for seniors aged 65 and older, children under 18, and adults with a valid Disability Tax Credit certificate. Others will be able to apply starting in 2025. When applying, you’ll need documents like your Social Insurance Number and proof of income.
2. Submitting Claims
After receiving care, your dentist will submit claims to Sun Life on your behalf. This makes it easy for you, as payments go directly to the provider. You’ll only need to pay for any costs that aren’t covered by the CDCP.
3. Preauthorization Process
Starting in November 2024, certain treatments will need preauthorization before they can be covered by the CDCP. This ensures that high-cost treatments are reviewed in advance to confirm that they qualify for coverage.
When can you visit an oral health provider
Costs and Financial Considerations
The CDCP covers a large portion of dental services, depending on your income. Families earning less than $70,000 receive 100% coverage, while those with incomes between $70,000 and $89,999 will need to make co-payments of 40% to 60%.
Be aware that additional fees might apply if your dentist’s rates are higher than the CDCP’s established fees or if you request services that aren’t covered by the plan. Always check with your dentist about costs before your treatment to avoid unexpected bills.
Frequently Ask Questions
CDCP-participating dentists, denturists, and other oral health professionals must sign up with Sun Life or submit claims directly. You can use Sun Life’s Provider Search tool to find local participants.