What to Know About the Canadian Dental Care Plan (CDCP) in 2024

Oral health plays a critical role in maintaining our overall well-being, yet dental care costs can be a financial burden for many Canadians. To address these concerns, the Canadian government introduced the Canadian Dental Care Plan (CDCP) to ensure that vulnerable populations, including low-income families, children, seniors, and individuals with disabilities, have access to essential dental services. The plan is set to roll out in phases, with full implementation expected by 2025.

In this blog, we’ll answer the top 10 questions Canadians are asking about the CDCP, shedding light on its eligibility requirements, coverage, and what you can expect if you’re considering applying.

1. Who Is Eligible for the CDCP?

Eligibility for the CDCP is based on three main factors: age, income, and disability status. The plan primarily targets vulnerable populations, including:

• Seniors aged 65 and over  
• Children under the age of 18
• Adults with a valid Disability Tax Credit (DTC)

To qualify, you must also have an adjusted family net income of less than $90,000 per year. It is NOT a free dental program. Depending on your adjusted family net income, patients may have to make a co-payment of up to 60%. They may also have to pay costs the CDCP does not cover. 

The CDCP does NOT cover all dental services. Before you start any treatment, you should understand your dental care costs. Please inform your dentist (the office)  if you plan to use the CDCP benefits.

It’s important to note that if you already have dental insurance, you may not be eligible for CDCP benefits unless you are part of a public dental program, such as one run by your province. This means that those who have access to private dental insurance through their employer or purchased independently may not qualify.

2. How Do I Apply for the CDCP?

The application process for the CDCP is conducted online through a government portal. Applicants will need to provide essential documentation, including:

• Social Insurance Number (SIN)  
• Proof of residency, such as a utility bill  
• Proof of income, usually from the Canada Revenue Agency (CRA)  
• Details of any existing dental coverage (if applicable)

The application process is straightforward, but assistance is available for those who may need help with documentation or completing the online form. Family members, trusted friends, or legal representatives can also assist applicants.

The timeline for when you can apply depends on your eligibility category. For example, seniors 65 and older could start applying in December 2023, while applications for children and adults with a Disability Tax Credit opened in June 2024.

3. What Services Are Covered Under the CDCP?

The CDCP provides comprehensive coverage for a wide range of dental services, including:

• Preventive care: cleanings, fluoride treatments, sealants, and regular check-ups  
• Diagnostic services: dental exams and X-rays  
• Restorative services: fillings and crowns  
• Prosthodontic treatments: complete and partial dentures  
• Endodontic services: root canals  
• Oral surgeries: tooth extractions  
• Periodontal treatments: deep scaling for gum disease

It is important to note there are many limitations in the coverage offered by CDCP. 

The goal is to provide a broad spectrum of dental services that address both preventive and urgent care needs. The plan also covers emergency dental treatments designed to alleviate pain and address pressing dental health issues.

4. How Much of My Dental Costs Will the CDCP Cover?

The amount of coverage you receive under the CDCP is tied to your adjusted family net income. There are three income brackets:

• 100% coverage of the CDCP Guide - Families earning less than $70,000 annually  
• 60% coverage of the CDCP Guide- Families with incomes between $70,000 and $79,999  
• 40% coverage of the CDCP Guide- Families earning between $80,000 and $89,999

However, the CDCP will only cover services based on a fee schedule established by the plan. If your dental provider charges the standard Ontario Dental Association Fee Guide, you will be responsible for the additional costs. To avoid unexpected expenses, it’s important to discuss the full cost of treatment with your dentist before receiving care.

5. What Services Require Pre-Authorization/Pre-Determination?

Some treatments under the CDCP require pre-authorization. This process ensures that specific treatments, especially major dental work, align with the plan’s guidelines and are covered under your benefits. For example, orthodontic treatments like braces, which are set to be covered starting in 2025, will require pre-approval from the CDCP.

Additionally, if your dentist recommends extra treatments that exceed the allowable limits, such as multiple cleanings due to specific oral health needs, you’ll need to get authorization for those services before proceeding.

6. How Are Dental Providers Paid Under the CDCP?

A unique feature of the CDCP is that dental providers are reimbursed directly for the services they provide. Once your treatment is complete, your dentist submits the claims directly to the government, and you only need to cover the portion of the bill that is not reimbursed. This eliminates the need for full upfront payment, easing financial burdens for families.

Providers who work with the CDCP are registered and can be found through a directory of participating dentists available on the government website. You are free to choose any provider in this network, and you can change dentists if necessary.

7. What If My Application Is Denied?

If your CDCP application is denied, there is an appeal process in place. Detailed instructions on how to appeal will be provided in the denial letter you receive from the CDCP. The government encourages applicants to reapply if they believe they meet the eligibility criteria but were denied based on incomplete or incorrect information.

8. What Costs Are Not Covered by the CDCP?

While the CDCP covers a wide range of services, there are additional costs that may not be covered, including:

• Treatments outside the established fee schedule
• Certain cosmetic procedures  
• Services provided outside the allowable frequency unless pre-authorized

It’s crucial to clarify these potential out-of-pocket expenses with your dental provider before undergoing treatment

9. How Can I Stay Updated on CDCP Changes?

The CDCP is a federally funded initiative, and as it rolls out, there may be updates to coverage, eligibility, or the application process. To stay informed, regularly check the government website or sign up for updates from participating dental organizations. It is stressed that you must stay informed of your policy and all updates or you will be subject to fees for any procedures completed.

The Canadian Dental Care Plan is a significant step toward making dental care more accessible and affordable for all Canadians. Whether you’re a senior, a parent, or someone with a disability, this program provides a pathway to better oral health without breaking the bank. If you think you’re eligible, don’t hesitate to apply or consult your dentist about how you can take advantage of the CDCP. 

By understanding the ins and outs of the plan, you can ensure that your dental care needs are met while minimizing financial stress.

Contact Whitby Dental Studio

If you’d like to take advantage of the new government-provided dental care plan, contact us to schedule an appointment. As a friendly reminder, please be sure to inform the office of your plan to use the CDCP benefits prior to your appointment.