Canadian Dental Care Plan (CDCP)
The Canadian Dental Care Plan (CDCP) is a new program from the federal government intended to help Canadians who experience financial barriers to adequate oral health care—specifically, households with an annual income of below $90,000 who have no existing dental coverage.
The CDCP began its invitations for applications in phases. Beginning in December 2023, seniors (65+) were the first group invited to apply for the CDCP.
As of June 27th 2024, children under the age of 18, as well as adults between the ages of 18 and 65 who have a valid Disability Tax Credit (DTC) certificate are now able to apply online and over the phone. DABC offers resources and services to help residents of BC apply for the DTC. Please call 604-872-1278 or email rdsp@dabc.ca for more information.
To be eligible to receive coverage from the CDCP, you must:
- Have an adjusted family net income of less than $90,000
- Be a Canadian Resident
- Have filed your tax return for the previous year and received your Notice of Assessment
- Have no access to dental coverage* (see below for specifics)
*Access to Dental Coverage includes:
- From an employer, or a family member’s employer (including health and wellness accounts) *
- From a professional or student organization*
*** This applies even if you:- Decide not to take it
- Have to pay a premium for it
- Do not use it
- From a pension or a family member’s pension (including all government employer pension plans)
- You may still be eligible if you’re retired and opted out of pension benefits before December 11th, 2023
- From a purchased plan or group plan through a private insurance company
This does not include dental coverage from existing provincial, territorial or federal social programs, including PWD. You can still apply for the CDCP. This existing coverage will work alongside the CDCP to ensure there are no gaps in coverage. In British Columbia, these social programs include the Healthy Kids Program and BC Employment and Assistance (BCEA) Program. You can find out how these plans will be coordinated with the CDCP here: https://www.canada.ca/en/services/benefits/dental/dental-care-plan/providers/fact-sheet-bc.html
If SDPR clients have CDCP coverage:
- They will need to provide their CDCP card to the dental provider to determine how much will be covered by the CDCP program as the first payer.
- If there is an amount left over, the dental provider will connect with PBC to determine how much will be covered as the second payer.
- In some cases, the combination of CDCP and PBC will cover the full amount of the dental service.
- If there is an outstanding amount remaining the dental provider will let the client know how much they would need to pay.
It is beneficial for clients to apply for CDCP as they may cover a portion of the dental expenses not covered by PBC. If SDPR clients do not have CDCP coverage, there is no change, and dental providers will follow the current process with PBC.
How to Apply
Applications will be accepted through the Government of Canada’s online portal here: https://www.canada.ca/en/services/benefits/dental/dental-care-plan/apply.html
To apply, you must be able to provide your (and, if applicable, your spouse’s or common-law partner’s):
- Full Name
- Date of Birth
- Social Insurance Number (SIN)
- Home and Mailing Address
- Your Notice of Assessment from your 2023 tax return
- List of existing coverage you have through government social programs
If you are applying on behalf of someone else, you cannot apply online. If you are not able to apply online, you can apply through phone by calling 1-833-537-4342.
You can ask a trusted individual to help you apply over the phone. You must be able to provide clear consent that you agree to let them help you on the phone call.
Once you submit your application online, you will receive an Application Code on the application confirmation page. You can use this code to check the status of your application online here:
https://mydentalapplication-mademandedentaire.canada.ca/en/status-etat/
How It Works
The CDCP is administrated by Health Canada and coverage will be managed through Sun Life. If your application is approved, you will receive a package from Sun Life in the mail within three months of applying. This package will include a membership card, a coverage start date, and a summary of CDCP covered services. Services received before this start date will not be eligible for reimbursement from the CDCP.
To receive CDCP coverage, you can book an appointment on or after the coverage start date with a participating oral health care provider. These providers must have voluntarily signed up to participate in the CDCP. Please ask the provider before booking the appointment if they are participating in the CDCP or alternatively, you can check Sun Life’s list of participating providers here: https://www.sunlife.ca/sl/cdcp/en/member/provider-search/
These participating providers will directly bill CDCP for reimbursement.
Beginning July 8th 2024, it will be possible for oral health care providers who have not voluntarily signed up to participate in the CDCP, by direct billing Sun Life on a claim-by-claim basis. This means if you have a preferred provider who has not signed up for CDCP, the provider can agree to direct bill Sun Life for services that are covered by CDCP.
Before you receive care from any provider, you should also:
- Ask if there are any costs you will be responsible for, beyond co-payment (see below for co-payment details).
- Never pay fully for the services in advance with the expectation that Sun Life will reimburse you. Sun Life will not reimburse a CDCP patient, only providers.
CDCP Coverage of Services
The CDCP will cover the cost of oral health care services based on an established list of CDCP “fees”. This means that for any CDCP approved oral health care service, there is a set amount or “fee” the CDCP will cover for that service. This amount may not be covered completely. This is based on your income, which may result in co-payment.
Co-Payment Levels
Depending on your adjusted family net income below $90,000, CDCP will only cover a portion of CDCP established fees.
- Lower than $70,000: CDCP will cover 100% of CDCP established fees
- From $70,000 to $79,999: CDCP will cover 60% of CDCP fees
- From $80,000 to $89,000: CDCP will cover 40% of CDCP fees
Scope of Services and CDCP Fees
Please refer to the Canada Dental Care Benefits Guide for the list of approved services covered, as well as the frequency limits of those services. There are also different requirements for different services. This can include the type of the tooth, the age of the patient, health conditions and more. The general list of services includes:
- preventive services, including scaling (cleaning), sealants and fluoride
- diagnostic services, including examinations and x-rays
- restorative services, including fillings
- endodontic services, including root canal treatments
- prosthodontic services, including:
- complete dentures, and
- partial removable dentures
- periodontal services, including deep scaling
- oral surgery services, including extractions
Many services require preauthorization from the CDCP. This means that the service must be approved by the CDCP prior to being performed, using the recommendation of the health care service provider. These preauthorization services will not be available for coverage until November 2024. Orthodontic services will require preauthorization and will not be available for coverage until 2025.
Preauthorization for services will take disability status into account. This means that for individuals with a higher need for care in different service areas, the CDCP may approve coverage beyond the established service and frequency guidelines.
CDCP fees are established by the Canadian government and are not based on provincial and territorial health care providers’ associations fee guides. You can find the established fees on Sun Life’s Dental Benefit Grids here: https://www.sunlife.ca/sl/cdcp/en/provider/dental-benefit-grids/
This means that the service provider fee may be more than the established CDCP fee and will require the patient to pay for a portion of the service themselves. This is why it is important to clarify CDCP coverage before receiving any service.
Coverage Period and Re-Enrollment
The CDCP coverage period will extend for 1 calendar year from July 1st to June 30th. Individuals will have to re-enroll every year by July 1st to ensure they continue to meet all eligibility criteria. The details for this process have not been announced.
How we can help
For more information on the Disability Tax Credit (DTC) please click here.
The Access RDSP Program can help you apply for the Disability Tax Credit (DTC). Please email rdsp@dabc.ca or call 604-923-8136 for more information.
The Tax AID Partnership can help file your 2023 taxes. Find local support near you:
METRO VANCOUVER AND FRASER VALLEY (and all of BC)
Disability Alliance BC
1450-605 Robson Street, Vancouver, BC, V6B 5J3
Tel: 236-477-1717 Toll Free 1-877-940-7797
taxaid@dabc.ca
BC INTERIOR
Ki-Low-Na Friendship Society
442 Leon Ave, Kelowna, BC V1Y 6J3
Tel: 250-763-4905
taxdisability@kfs.bc.ca
VANCOUVER ISLAND
Together Against Poverty Society
828 View Street, Victoria, BC, V8W 1K2
Tel: 250-361-3521
tax@tapsbc.ca
NORTHERN BC
Active Support Against Poverty Society
1188 6 Ave, Prince George, BC V2L 3M6
Tel: 250-563-6112 Toll-free: 1-877-563-6112
taxaid@asaphs.com