The following information is retrieved from the Canadian Dental Care Plan official website.
Services covered
The Canadian Dental Care Plan (CDCP) will help cover a wide range of oral health care services that:
keep your teeth and gums healthy
prevent and treat oral health care issues and diseases
Examples of services that could be covered under the CDCP when recommended by an oral health provider, include:
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
Note: Some oral health care services will require preauthorization. Preauthorization is a process where prior approval is required, based on the recommendation of the oral health provider, before the treatment is provided, to confirm it will be covered under the plan. These treatments and/or services take into consideration an individual’s oral health history and medical conditions. Services requiring preauthorization will become available in November 2024.
The CDCP will only pay for oral health care services covered within the plan at the established CDCP fees. These fees are not the same as the provincial and territorial oral health associations suggested fee guides that providers often use to charge for oral health services. People covered under the CDCP may have to pay any additional charges directly to the oral health provider.
Diagnostic and preventive services
Basic services
Major services
Anesthesia/Sedation services
Orthodontic Services
For more information on services covered, consult the CDCP Dental Benefits Guide.
How much will be covered
The CDCP will reimburse a percentage of the cost, based on established CDCP fees and your adjusted family net income. You may have to pay additional charges directly to the oral health provider, if:
your adjusted family net income is between $70,000 and $89,999
the cost of your oral health care services are more than the established CDCP fees, or
you and your oral health care provider agree to services that the CDCP doesn’t cover
Co-payments
You may have a co-payment based on your adjusted family net income. A co-payment is the percentage of the CDCP fees that isn’t covered by the CDCP, and that you will have to pay directly to the oral health provider. Your co-payment is based on your adjusted family net income.
Co-payments based on adjusted family net income | ||
Adjusted family net income | How much will the CDCP cover | How much you will cover |
Lower than $70,000 | 100% of eligible oral health care service costs will be covered at the CDCP established fees. | 0% of the CDCP established fees. You may face additional charges as described below. |
Between $70,000 and $79,999 | 60% of eligible oral health care service costs will be covered at the CDCP established fees. | 40% of the CDCP established fees. You may face additional fees as described below. |
Between $80,000 and $89,999 | 40% of eligible oral health care service costs will be covered at the CDCP established fees. | 60% of the CDCP established fees. You may face additional fees as described below. |
Additional charges
The CDCP fees may not be the same as what providers charge. You may have to pay fees in addition to the potential co-payment if:
the cost of your oral health care services are more than what the CDCP will reimburse based on the established CDCP fees
you agree to receive care that the plan doesn’t cover
Before receiving oral health care, you should always ask your oral health provider about any costs that won’t be covered by the plan. Make sure you know what you’ll have to pay directly to your oral health provider ahead of receiving treatment.
Innisfil Dental Arts does not currently accept CDCP. The notes below provide clarification regarding our position on the plan:
Contrary to some representations, the CDCP is not equivalent to "free dental care." The benefit provided is based on a fee guide below the current ODA General Practitioner Fee Guide. Consequently, regardless of the coverage tier (100%, 70%, 40%), patients using the CDCP benefit will still have out-of-pocket expenses. Hence, it's vital to understand:
The program is NOT Free Dentistry as advertised; patients are responsible for discrepancies in the fee guide.
As a non-assignment office, we're unable to offer direct billing.
Our focus is on patient care rather than administrative tasks tied to insurance.
We maintain a policy of nondiscrimination and cannot selectively offer assignment/non-assignment programs or charge our patients differently.
The Government and Sun Life Insurance Company have the right to audit and request patient information at any time, compromising our policy of patient record confidentiality.
The contract is unilateral and lacks clarification on crucial aspects, causing confusion for our patients.
The plan's design prevents us from providing quality evidence-based care with inadequate coverage.
You can find dentists who accept CDCP from the link below.
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