Canadian Dental Care Plan (CDCP)
– The Canadian Dental Care Plan (CDCP) is a federal initiative aimed at reducing dental care costs for Canadians without dental insurance. It subsidizes a portion of approved dental services but is not a free program.
– The CDCP is being rolled out in phases and aims to include all eligible Canadians with adjusted family net incomes below $90,000 annually by 2025, provided they meet the income and insurance criteria.
– Sun Life, a contracted private insurer, administers the plan, including claims, enrollment, and benefit management.
Eligibility & Requirements
To be eligible for the Canadian Dental Care Plan (CDCP), individuals must meet a number of criteria. They must be Canadian taxpayers with an adjusted family net income of less than $90,000. Applicants cannot have access to any other dental insurance coverage, whether through work, a pension plan, a family member, or voluntary insurance. This “no access” criteria is severe; even declining an offered dental plan constitutes having access and disqualifies eligibility. Furthermore, candidates must have submitted a tax return for the previous year to prove their income level. The CDCP was initially available to seniors, children, and people with disabilities, but by 2025, it will encompass all income-qualified adults who fit these criteria. The program attempts to provide inexpensive dental care to Canadians who do not have private or employment dental coverage.
What Dental Services Are Covered
CDCP includes a wide range of oral health services organized by category. However, many services require preauthorization (prior clearance) if they exceed normal limitations or are more sophisticated.
Here are the major categories:
Diagnostic & Preventive
- Conduct routine and emergency dental exams
- X-rays
- Cleaning and scaling
- Fluoride applications
- Sealants
Restorative / Basic
- Permanent and temporary fillings
- Pain relief for decaying teeth
Endodontics (root canal / related)
Root canal treatment, pulpectomy, retreatments (with preauthorization)
Periodontal (gum and supporting structures)
- Cleaning under the gumline, treating abscesses, and non-surgical gum disease treatments.
- Bonding of movable teeth and post-surgical assessments may require preauthorization.
Prosthodontics (e.g., detachable dentures)
- We offer whole and partial dentures, as well as repairs, relines, and rebases.
- Certain prosthodontic services necessitate preauthorization for eligibility.
Oral Surgery
- Tooth extraction and root removal.
- Surgical procedures for tumour and cyst excision, as well as managing jaw fractures.
Sedation and Anesthesia
- Minimal sedation is covered.
- Preauthorization is required for moderate, profound sedation, and general anesthesia.
Cost Sharing / Co-Payments & Fees
Because CDCP does not provide free care, cost sharing is based on adjusted family net income. The CDCP covers roughly the following proportion (compared to what the patient must pay):
| Income bracket | CDCP pays | Patient co-payment (of CDCP “established fees”) |
| Below $70,000 | 100 % | 0 % |
| $70,000 – $79,999 | 60 % | 40 % |
| $80,000 – $89,999 | 40 % | 60 % |
A few notes:
- “Established fees” refers to a fee schedule set by CDCP for specific dental operation codes. These may be lower than what dentists usually charge. If a dentist charges more than the CDCP fee, the patient may have to pay the difference (assuming the dentist agrees).
- The CDCP may approve exceptions for services that require preauthorization or exceed the frequency restrictions, but both the dental provider and the patient must adhere to submission and approval guidelines.
- Certain services are explicitly excluded (see section below).
Exclusions and Limitations: (What CDCP Does Not Cover)
CDCP does not cover some types of dental services. Common exclusions include:
- Cosmetic procedures such as teeth whitening and veneers.
- Dental implants are not covered by CDCP.
- Prosthodontic procedures include fixed bridges, bone grafts, and specific treatments.
- Services refused by CDCP due to preauthorization or ineligibility under their policies.
- Certain minor services or tweaks may alter in coverage over time, such as those deleted in the 2025 update.
Furthermore, not all dentists must engage in CDCP (i.e. agree to charge CDCP under its reimbursement standards). Patients should check to see if their dental provider participates.
Application, Enrollment and Implementation
- The government began a staged rollout from late 2023 to 2025, beginning with the elderly and children and gradually expanding to all eligible income-qualified individuals.
- Eligible applicants will receive a mail asking them to apply.
- After enrollment, consumers receive a CDCP card, coverage details, and a start date for coverage. Only services provided after the coverage start date are covered.
- Before providing therapy, providers must validate the client’s coverage through an Electronic Data Interchange estimate or direct contact.
- Providers must submit paperwork in advance for services that require preauthorization or exceed frequency limits. In emergency situations, post-determination may also be used.
- The CDCP Dental Benefit Grids (procedure codes with permissible amounts) are released, including the 2025 grids.