Canada’s healthcare system has long been admired for its accessibility; however, dental care has traditionally been excluded from public coverage.
Recognizing the essential role of oral health, the Canadian government introduced the Canada Dental Care Plan (CDCP) to support families without private insurance. Recent modifications to the CDCP aim to make dental care more accessible to Canadians.
Expanded Coverage
As of June 27, 2024, the CDCP has broadened its scope to include children up to 18 years old who meet specific conditions. This expansion is part of a phased approach to eventually cover all eligible Canadians by 2025.
Eligibility Criteria
To qualify for the CDCP, individuals must:
- Lack private dental insurance.
- Have a family net income below $90,000.
- Be Canadian residents for tax purposes with an eligible residency code on their Notice of Assessment from the Canada Revenue Agency (CRA).
Phased Rollout
The CDCP is being implemented in stages:
- December 2023: Seniors over 65 became eligible.
- June 2024: Eligibility extended to children under 18 and adults with disabilities.
- 2025: Planned extension to all remaining eligible Canadians.
Income-Based Coverage and Co-Payments
The level of coverage under the CDCP is determined by household income:
- Families earning less than $70,000: Receive full coverage for most services.
- Incomes between $70,000 and $89,999: Required to pay a portion of the cost for services.
- Earning above $90,000: Currently not eligible for the CDCP.
How the CDCP Works
Upon enrollment, participants receive a member card, coverage start date, and information about the CDCP. Starting July 8, 2024, dental care providers participating in the CDCP can bill Sun Life Financial directly for services provided to eligible patients, eliminating the need for patients to pay out-of-pocket and wait for reimbursements.
| Procedure | Average Cost (CAD) | Coverage for Income < $70,000 | Coverage for Income $70,000-$89,999 | Not Covered |
|---|---|---|---|---|
| Routine Cleaning | $100 – $200 | Fully Covered | Partial Co-Payment Required | Yes |
| Filling | $150 – $300 | Fully Covered | Partial Co-Payment Required | Yes |
| Root Canal | $500 – $1000 | Fully Covered | Partial Co-Payment Required | Yes |
| Dental Crown (Cap) | $800 – $2000 | Fully Covered | Partial Co-Payment Required | Yes |
This table provides an overview of average dental procedure costs and their coverage under the CDCP based on income levels.
In conclusion, the recent modifications to the Canada Dental Care Plan represent a significant step toward making dental care more accessible and affordable for Canadians, particularly those without private insurance.
By expanding coverage, adjusting eligibility criteria, and implementing a phased rollout, the CDCP aims to ensure that essential dental services are within reach for all eligible citizens by 2025.
FAQs
What dental services are covered under the CDCP?
The CDCP covers essential services, including preventive care, diagnostics, restorative treatments, endodontic services, prosthodontic services, periodontal services, and oral surgery. Cosmetic procedures like teeth whitening and elective surgeries are not covered.
How do I apply for the CDCP?
Eligible individuals will receive a letter inviting them to apply. Once enrolled, eligibility is verified annually. Applications opened in December 2023 for certain age groups, with a staggered rollout for others throughout 2024 and 2025.
Are newcomers to Canada eligible for the CDCP?
Temporary residents, such as those on work or study permits, may be eligible if they meet the residency requirements and have an eligible residency code.
What if I have partial private dental insurance?
Applicants must not have coverage through an employer or any other private dental insurance plan to qualify for the CDCP. Those with partial coverage may not be eligible.
When will the CDCP be fully implemented?
The plan aims to extend coverage to all remaining eligible Canadians by 2025.
