Understanding the Canadian Dental Care Plan (CDCP): Affordable Oral Health for Eligible Canadian Residents
Access to quality dental care is critical for maintaining overall health and wellness. However, many Canadians face financial barriers that make dental treatments out of reach. To address this problem, the Canadian government has introduced the Canadian Dental Care Plan (CDCP), designed to make oral health care services more affordable for those who qualify. This guide will take you through the eligibility criteria, what services are covered, and how to apply for these essential dental benefits.
What is the Canadian Dental Care Plan (CDCP)?
The Canadian Dental Care Plan (CDCP) is a government initiative aimed at helping eligible Canadian residents afford the oral health care services they need. This plan is being rolled out in phases, with different groups of Canadians eligible to apply at various times. Currently, seniors aged 65 and over, adults with a valid Disability Tax Credit certificate, and children under 18 can apply. The program will be extended to all remaining eligible Canadians by 2025.
Who is Eligible for the CDCP?
To benefit from the CDCP, applicants must meet all of the following eligibility criteria:
You don’t have access to dental insurance: This means that you and your family members do not have any existing dental insurance coverage through an employer or government program.
Your adjusted family net income is less than $90,000: If your household income falls between $70,000 and $89,999, you may still qualify for partial coverage, which we’ll discuss in more detail below.
You are a Canadian resident for tax purposes: You and your family members must be recognized as Canadian residents for tax purposes to apply for these dental benefits.
You filed your tax return for the previous year: This requirement applies to both you and your spouse or common-law partner.
Income Brackets and Coverage
The amount the CDCP will cover depends on your adjusted family net income. Here’s a breakdown of how income affects the portion of costs the plan will cover:
Lower than $70,000: If your household income is below this threshold, the CDCP will cover 100% of eligible oral health care services. You and your family members will not need to pay any co-payment, though additional charges may apply if the services go beyond what the CDCP covers.
Between $70,000 and $79,999: In this income bracket, the CDCP covers 60% of the eligible service costs. You will need to only pay the remaining 40% directly to your dental care provider.
Between $80,000 and $89,999: If your adjusted family net income falls between $80,000 and $89,999, the CDCP will cover 40% of the service costs. You will be responsible for the remaining 60%.
What Services Are Covered by the CDCP?
The CDCP covers a broad range of oral health care services, from preventive to major restorative treatments. Here’s a list of the types of services that may be included:
Diagnostic and Preventive Services: This includes dental exams (routine, specific, and emergency), x-rays, teeth cleanings, and fluoride applications. These services aim to keep your teeth and gums healthy and to prevent major issues from developing.
Basic Services: For those who need restorative treatments, the plan covers permanent and temporary fillings, pain control for diseased teeth, and other treatments for cavities.
Endodontic Services: More complex procedures, such as root canal treatments, pulpectomies, and procedures to relieve infections or pain, are also covered under the plan.
Periodontal Services: The CDCP offers coverage for treatments involving gums and bone, including cleaning under the gumline, managing abscesses, and non-surgical gum disease management.
Major Restorative Services: This includes more intensive treatments, such as repairs to crowns and dentures. Some procedures, like crowns and posts, require pre-approval by the CDCP before you can receive the treatment.
Oral Surgery: Surgical extractions, removal of cysts, and treatment for broken jawbones are part of the coverage as well.
Anesthesia and Sedation: For certain procedures, the plan covers anesthesia or sedation, with pre-approval required for more extensive sedation like general anesthesia.
How to Apply for the CDCP
If you meet the eligibility criteria and are ready to apply, you can do so easily online through the official CDCP portal. The application process is straightforward, but you’ll need the following information:
- Social Insurance Number (SIN) (if available for children)
- Date of birth for each applicant and your spouse or common-law partner
- Home and mailing address
- Information on existing dental coverage through government social programs (if applicable)
- You and your spouse or common-law partner must have filed your tax return for 2023 and received your Notice of Assessment
When applying for children, submit one application for all kids under 18. Only one parent or guardian should apply for them. This helps avoid delays in processing.
Important Considerations: Co-payments and Additional Charges
Even if you’re approved for the CDCP, there may still be additional charges depending on the type of service and your adjusted family net income. Before undergoing any treatment, it’s a good idea to ask your oral health provider for a breakdown of potential costs to ensure there are no surprises. Be aware of any co-payments you may be responsible for, based on your income bracket.
For those receiving member’s pension benefits or with a valid Disability Tax Credit certificate, coordinating with the CDCP can further help minimize out-of-pocket expenses. The plan is designed to work alongside other government social programs, so there should be no gaps in coverage.
FAQ
How is my co-payment determined?
Your co-payment is based on your adjusted family net income. Families earning less than $70,000 will not have a co-payment, while those earning between $70,000 and $89,999 will cover a percentage of the cost, with higher income brackets facing higher co-payments.
Will orthodontic services be covered?
Orthodontic services are not available under the CDCP until 2025. When introduced, they will be covered based on medical need and have a maximum spending limit.
What should I do if my dental provider charges more than the CDCP fees?
You may need to pay any additional charges directly to your dental provider if their fees exceed the CDCP reimbursement rates. Always check with your provider about any potential costs before receiving treatment.
In Summary
The Canadian Dental Care Plan is a significant step towards making oral health care services more affordable and accessible for eligible Canadian residents. By meeting the eligibility criteria and applying for coverage, you and your family members can benefit from reduced costs on essential dental benefits, ensuring that financial barriers are no longer a barrier to maintaining healthy smiles.
At Advanced Dental, we’re committed to providing top-quality care. Contact us today to learn how we can help you make the most of your dental benefits under the Canadian Dental Care Plan (CDCP).