Key Takeaways
- The Canadian Dental Care Plan, also called the CDCP, is meant for people without access to private dental insurance.
- Access to employer, pension, group, or privately purchased dental coverage generally makes you ineligible, even if you opted out.
- Provincial and territorial social programs can coordinate with the CDCP without overlap.
- The CDCP covers many preventive and restorative services, although some require preauthorization and others are excluded.
- Your income bracket affects how much the plan pays and what co-payment you might owe.
You may be wondering whether the CDCP can supplement a workplace dental plan. In most cases, having access to private dental coverage means you are not eligible for the CDCP. The team at Fairlawn Dental Centre can help you understand your coverage before you begin care.
The CDCP is designed for Canadian residents who do not have access to private dental insurance and whose adjusted family net income is below $90,000.
How Private Dental Insurance Affects CDCP Eligibility
The CDCP is meant to fill gaps for people without access to private dental coverage. If an eligible private plan is available to you, you generally cannot use the CDCP as secondary coverage or stack the two plans.
Private coverage can include dental benefits through an employer, pension, professional or student organization, a plan purchased privately, or coverage available through a family member.
Who Qualifies for the CDCP
The plan looks at a few things before you can sign up. Your household needs an adjusted net income under $90,000 a year.
You also need to be without access to private dental insurance. On top of that, you must be a Canadian resident for tax purposes and have filed your tax return for the previous year.
Who May Not Qualify
Access to dental benefits through an employer, pension, professional group, or private plan generally places you outside the CDCP. This usually applies even if you opted out, do not use the coverage, or must pay a premium.
A narrow exception may apply to certain retired people who opted out of pension dental coverage before December 11, 2023 and cannot opt back in. Service Canada determines eligibility, so check the current rules if this situation applies to you.
Government Social Programs Exception
Provincial and territorial dental programs work a little differently. If you already receive dental care through a government social program, the CDCP can coordinate with it.
That coordination is meant to prevent gaps and avoid paying twice for the same service. Your existing coverage and the CDCP sort out who pays for what.
What the CDCP Covers
The CDCP can help pay for a range of preventive, diagnostic, restorative, periodontal, endodontic, denture, oral surgery, and sedation services. Some services have frequency limits or require preauthorization.
Covered services include the following.
- Exams, x-rays, cleanings, fluoride treatments, and sealants.
- Fillings, root canals, and gum care.
- Crowns, dentures, and certain oral surgery services, sometimes with preauthorization.
Services Beyond CDCP Coverage
Not every treatment is covered, and orthodontic care is not yet available through the CDCP. If you are considering a service outside the plan, ask our team about expected costs and payment options.
- Braces and Invisalign treatment are not yet available through the CDCP.
- Dental implants, implant-related procedures, and veneers are not covered.
How Much CDCP Pays for Care
How much the CDCP pays depends on your adjusted family net income. At the CDCP’s established fees, eligible clients below $70,000 have no co-payment, those from $70,000 to $79,999 have a 40% co-payment, and those from $80,000 to $89,999 have a 60% co-payment.
A co-payment is the percentage of the CDCP-established fee that you pay. You may still have additional charges if the dental office’s fee is higher than the amount the CDCP reimburses or if you choose a service the plan does not cover.
Some care can also carry charges the plan does not handle at all. The team can walk you through any extra costs before treatment starts, so the numbers are clear ahead of time.
How to Use Your CDCP Coverage
Once you’re approved, putting your coverage to work takes only a few steps. A little prep can keep your visit smooth.
- Confirm the provider accepts CDCP clients and will bill Sun Life directly before you book.
- Bring your CDCP member card, information letter with start and end dates clearly noted, and a piece of identification to your appointment.
- Ask about costs upfront, including any co-payment or charges outside the plan.
Fairlawn Dental Centre accepts CDCP clients and can help you understand estimated coverage, co-payments, and possible additional charges before treatment. Book an appointment with our Ottawa dental team to discuss your oral health needs and make an informed care plan.
