Canadian Dental Care Plan: Who’s eligible and what’s covered?


Here’s what you need to know about the Canada Dental Care Plan launching on May 1

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More than 1 million Canadian seniors without dental insurance can now receive free or subsidized care under the new federal Canada Dental Care Plan launching on May 1.

The initial rollout covers Canadians aged 65 and older, with the goal of eventually providing dental care to uninsured Canadians with annual household incomes below $90,000.

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Here's what you should know about the Canadian Dental Care Plan, including whether you qualify, how to apply, and where to find a dentist.


What is the Canadian Dental Care Plan?

The Canada Dental Care Plan (CDCP) is designed to provide dental coverage to low- and moderate-income Canadian residents who do not have access to dental benefits.

It's part of the Liberals' 2022 supply and confidence agreement with the NDP, which is expected to cost $13 billion over five years and $4.4 billion the year after that.

The program will be administered by Health Canada and managed by Sun Life Financial.

Health Minister Mark Holland said the national dental care plan will improve the health of Canadians and build equity by expanding access to oral care for all Canadians, calling Wednesday's launch date “a critical moment in our country's history.” ”.

Who is eligible for the Canadian Dental Care Plan?

Canadian residents with an annual adjusted net household income of less than $90,000 do not have dental insurance. You will also need to file your tax return from the previous year.

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If you are eligible for dental coverage through your workplace, professional, or student organization but choose not to receive it or use it, you are not eligible for CDCP.

The program is expected to cover up to 9 million Canadians, although the initial rollout will only cover about 1 million seniors who have applied for the program and will have access to dental care starting May 1.

What dental benefits are covered?

Dental services covered by CDCP include: exams, cleanings, polishes, fillings, root canals, crowns, dentures, tooth extractions, and X-rays.

Some services require prior approval and are based on the dentist's recommendation. Services requiring pre-authorization will not be available until November 2024.

For a complete list of covered services, see here.

How much is covered?

CDCP covers some or all of the cost of services based on your income and what your oral health provider charges.

If your household income is less than $70,000, the plan will cover 100% of eligible services at CDCP-mandated fees (these fees may differ from those charged by your provider).

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Households making more than $70,000 will be required to pay a co-pay.

Households with incomes between $70,000 and $79,000 will have 60 per cent of services covered, while households with incomes between $80,000 and $89,999 will have 40 per cent of services covered.

How do I apply for the Canadian Dental Care Plan?

Health Canada is accepting applications in phases.

Seniors aged 65 and above are eligible to apply. If you have a valid disability tax credit certificate or have children aged 18 and under, you can apply from June 2024.

Starting in 2025, all other eligible Canadians can apply.

In the application, you will need to submit information including: name, home and mailing address, Social Security number, and date of birth. The form will also ask you to list any dental insurance you may have through government social programs.

You can apply here.

When can I start receiving dental care under CDCP?

Once Health Canada approves your application, Sun Life Financial will enroll you in the program and send you a welcome package that includes information about CPCP, your membership card and your coverage start date.

Where can I go to receive dental care?

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Health Canada says more than 6,500 oral health providers have been contracted to provide care under CDCP.

You can use Sun Life's CDCP Provider Search Tool to search for a participating dentist, dental hygienist, denturist or dental specialist. If you can't find it online, call Sun Life at 1-888-888-8110.

Beginning July 8, care providers do not have to register with CDCP but can bill Sun Life directly for services on a claim basis.

To ensure your care is reimbursed under the CDCP, Health Canada recommends people check with their healthcare provider to make sure they are enrolled in the program.

chchan@postmedia.com

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