The Canadian Dental Care Plan (CDCP)

Essential Information Clarifying Five Common Misconceptions Regarding Coverage and Eligibility

The Canadian Dental Care Plan (CDCP), introduced by the federal government in 2023 and currently being implemented in phases, is designed to provide dental coverage to Canadian residents whose adjusted family income is below $90,000 and who lack access to dental insurance. The plan aims to offer all eligible Canadians the opportunity to apply by 2025.

While the prospect of universal dental and health coverage is appealing to many, certain aspects of the CDCP remain unclear. The following outlines and clarifies five commonly held misconceptions regarding the plan.

1.Misconception: All Canadians Are Eligible for the CDCP

Clarification: Presently, eligibility is restricted to specific groups, including seniors aged 65 and older, children under the age of 18, and adults possessing a valid Disability Tax Credit certificate for the year 2023. Beginning in 2025, the program is expected to expand to include a broader segment of the population, contingent upon fulfillment of specific criteria.

To qualify, an individual’s adjusted family net income must be below $90,000 for the year 2024. This figure includes the combined income of both the individual and their spouse, excluding amounts from the Universal Child Care Benefit (UCCB) and the Registered Disability Savings Plan (RDSP), while including any repaid amounts. For instance, an individual earning $80,000 annually and whose spouse earns $10,100 from part-time employment would not qualify.

Additional criteria include:

  • Canadian residency and submission of a prior year’s income tax return;
  • No access to dental insurance through an employer, a spouse’s employer, or a pension benefit (voluntarily opting out of such coverage does not confer eligibility);
  • No existing private dental insurance coverage.

2. Misconception: All Dental Care Providers Participate in the CDCP Clarification: Participation in the CDCP by dental professionals is entirely voluntary. Providers may choose to formally enroll in the plan or submit claims on a per-service basis. Individuals who are eligible for the CDCP should confirm a provider’s participation before receiving treatment, as services performed by non-participating professionals may not be reimbursed.

3. Misconception: All Dental Procedures Are Covered by the CDCP Clarification: While the CDCP encompasses a broad range of essential dental services, it does not cover all procedures. Certain treatments require prior authorization from the government, and many services are subject to limitations regarding frequency. In every case, the service must be deemed necessary by a dental professional who is enrolled in the program.

The following services are excluded from coverage:

  • Composite resin or porcelain veneers
  • Three-quarter dental crowns
  • Inlays and onlays made of any material
  • Temporomandibular joint (TMJ) therapy and appliances
  • Fixed dental bridges
  • Teeth whitening procedures
  • Mouthguards and appliances for bruxism
  • Crown lengthening procedures
  • Dental implants and related procedures
  • Bone grafting
  • Precision attachments for partial dentures
  • Extensive restorative rehabilitation


For comprehensive details on excluded services, refer to the CDCP Dental Benefits Guide.

4. Misconception: Enrollment in the CDCP is Automatic Clarification: Enrollment in the CDCP is not automatic. Individuals must apply annually and meet the eligibility criteria each year. The approval process may take up to three months, making it essential to apply in advance. Applications can be submitted online or via telephone.

Applicants will be required to provide the following information:

  • Social Insurance Number (SIN)
  • Full legal name, date of birth, and residential/mailing address
  • Information concerning any existing dental coverage through government-sponsored social assistance programs

5. Misconception: The CDCP Covers 100% of Dental Expenses Clarification: The CDCP does not necessarily cover the entirety of dental treatment costs. Out-of-pocket payments may be required in several circumstances, including:

  • When the service provider’s fees exceed the maximum allowable rates under the CDCP. For example, if a provider charges $150 for a filling and the CDCP reimburses only $130, the patient is responsible for the $20 difference.
  • If the patient accepts services outside the CDCP’s coverage.
  • When the adjusted family net income exceeds $70,000, a co-payment is required. The breakdown is as follows:

Adjusted Family Net Income (After Tax) CDCP Coverage Percentage

Less than $70,000100%
$70,000 – $79,99960%
$80,000 – $89,99940%

Oral health is a vital component of overall well-being. The Canadian Dental Care Plan represents a significant step toward equitable access to dental services across the country. However, due to its eligibility restrictions and coverage limitations, the CDCP may not meet the needs of every individual. Those needing more extensive coverage should explore additional insurance options that may offer broader and more affordable benefits.
For the latest and most detailed information, please visit Canada.ca.

References

  • Government of Canada. Canadian Dental Care Plan. August 21, 2024.
  • Canadian Dental Association. Canadian Dental Care Plan (CDCP). May 30, 2024.