Canada’s dental care plan begins today. Here’s what you need to know


The Canada Dental Care Plan (CDCP) starts covering 1.7 million seniors today, but many patients may have to wait a while before getting dental care coverage.

The massive public dental health insurance program will eventually cover a quarter of Canadians without private dental plans and will cost $13 billion over the next five years.Ottawa is gradually rolling out eligibility (new windows)starting with the elderly.

They were happy to get their teeth cleaned because it had been so many years, Independent dental hygienist Shannon Maitland runs a mobile clinic in Carleton Place outside Ottawa.

Maitland is one of 5,000 oral health providers who have joined CDCP to date. But she won't start seeing patients under the program for several weeks as she decides to wait and see how the initial rollout goes.

Dentists, denturists and hygienists generally support the country's publicly funded dental insurance program, arguing it would fill the gap for the nine million low- and moderate-income Canadians who must pay for oral health care out of pocket.

But while coverage for those 70 and older began on May 1, some patients are finding that their dentists aren't participating. Changes in Ottawa that would allow dentists to still process claims without registering won't come into effect until July. In addition to this, there is a six-month delay before certain dental services that require pre-approval are covered, such as crowns and partial dentures.

Since the program was announced in December, there has been confusion about who is eligible, how the program affects other insurance plans and whether enough dentists will sign up to meet demand.

Here are answers to some frequently asked questions about the program.

How do I find professionals who provide CDCP?

The federal government contracts with the insurance company Sun Life to administer the program. The company recently launched a searchable database of available CDCP providers. (new windows)

According to their association, approximately 30,500 oral health professionals can sign up to provide the program, including approximately 26,500 dentists, 1,700 independent hygienists and 2,400 denturists.

This means that only about 16% of oral health providers have signed up so far.

Why doesn't my dentist sign up?

Some dentists are unwilling to register (new windows) Because Ottawa wants them to sign a contract to provide care, and they believe the program requires a lot of paperwork.

The vast majority of dentists are still waiting for more information before agreeing to participate, said Dr. Joel Antle, a Winnipeg dentist and newly elected president of the Canadian Dental Association.

He said he has not signed up to provide CDCP at his clinic.

I have to admit there was a certain amount of disappointment, because I got involved very early in the process, and it looked really promising, He said.

Then at some point, things took a turn and became complicated and burdensome—and unnecessarily so.

Do I need to change dentists?

Dentists have the right to choose whether to accept patients through CDCP, just like they can choose under existing public plans.

If dentists aren't involved…they can't go to those dentists, PhD. Antle said. Therefore, they may have to change dentists with whom they have developed a long-term relationship.

Can I visit CDCP at an unregistered dentist?

Two weeks ago, Health Minister Mark Holland sought to address concerns when he announced (new windows) Oral health providers can bill the plan directly without a formal contract.

That option won't be available until July. This means that if your dentist is not a registered provider but still accepts you under CDCP, you will not be able to see them until the summer.

On Tuesday, Holland pushed back against ongoing criticism of the program from dental associations, saying Ottawa listened to their concerns and streamlined the CDCP.

That's crazy. To be fair…at some point, let's be honest. Are you crazy? he said outside a cabinet meeting in the House of Commons.

Holland said the federal government is making the system easier to use while still retaining necessary checks to prevent abuse, such as allowing Ottawa to review claims.

We created a normal… claims process that exists in all other insurance claims processes, and they wanted us to streamline it. we did it, Holland said.

We have now reduced it to a process that is as simple and basic as anything else, if not simpler.

WATCH: Health minister refutes claims from dental association:

Health minister calls dental association's claims about national plan 'crazy'

Federal Health Minister Mark Holland said the federal government has worked hard to make the insurance claims process “as simple and basic as any other process”. Some dental associations have expressed concerns about the administrative burden of the national dental care scheme, which is due to begin on Wednesday.

How does CDCP compare to other provincial programs?

If you can get dental care through an existing public program, you are still eligible to participate in CDCP. This can be a provincial program through social assistance, disability or national programs such as the Uninsured Health Benefit Program for First Nations and Inuit.

Nova Scotia dentist Dr. Brandon Doucet, who advocates for a national public dental insurance plan, said he understands the reluctance of many dentists, which is largely related to their current attempts to offer public plans. experience related.

Existing public dental plans are very, very meager, and many dentists are frustrated because they often pay less than half what private plans pay, Doucet said.

In comparison, CDCP covers more services at higher rates than existing public programs, Doucette said. In Nova Scotia, where he practices, Ottawa pays about 89 per cent of the guideline-recommended fees. These fee guidelines are set by provincial dental associations and are used by dentists when billing private insurance companies for services.

Doucette said he thinks more dentists will sign up once the program starts because they realize they could lose money by not accepting CDCP patients.

Many dentists just don't want and never wanted public dental care, just like doctors in the 1960s opposed universal health care, He said.

Doucette said public spending on dental care in Canada accounts for about 6% of total spending on all oral care services, which is far lower than the 10% public spending in the United States and the 57% in Germany. National plans would bring that number closer to around 25%.

Can I get free dental care?

As Doucette mentioned, the federal government sets its own fee schedule for how much it pays oral health providers per procedure, which is slightly lower than the guidelines published by provincial dental associations.

but this is not free Dental care.

Like private plans, CDCP only covers a certain amount of services, meaning dental care providers can still charge patients the difference. Patients with income (or total household income) below $90,000 should qualify, but if your income is between $70,000 and $90,000, coverage is only partial. More details can be found here. (new windows)

What is covered?

Most routine dental care will be covered by CDCP, including cleanings, x-rays, fillings, root canals, and dentures.

Some more complex dental services—such as partial dentures and crowns—will require federal preauthorization payments. Pre-authorized services will not be covered until November 2024.

We certainly hope that some things will be launched at the same time, Jaro Wojcicki is a denturist in Penetanguishene, Ontario, and president of the Canadian Association of Dentists.

The government did say it would be difficult to start all projects on May 1.

Oral health care providers need to educate patients about coordinating care during this time, he said.

You can find out more about what is covered and when on the government website here . (new windows)

When will I be eligible?

The federal government is gradually expanding eligibility for CDCP. As of May 1, Canadian residents aged 70 and older can obtain oral health care services covered by the plan, and seniors aged 65 to 69 can sign up.

In June, people with disabilities and children under 18 will be included. (This is also when temporary dental benefits are available (new windows) The program that has been covering children under 12 years of age since December 2022 will be replaced by CDCP.

According to the federal government, the program will be open to all eligible Canadian residents starting in 2025.

In order to qualify, patients cannot obtain any existing private dental insurance, no matter how comprehensive your existing private insurance is.Ottawa has clarified (new windows) If you buy private insurance on your own, you will be eligible for CDCP once the plan is no longer in effect.

The government passed legislation last summer requiring employers to declare to the Canada Revenue Agency whether they offer private dental plans to workers. This will allow Ottawa to review claims through the CDCP.

Marina von Stackelberg (new windows) · CBC News



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