The Canadian Dental Care Plan (CDCP) is expanding its coverage to offer more comprehensive dental care services to Canadians. This expansion aims to help those who do not have dental insurance, enabling them to access essential treatments. Initially launched in 2023, the CDCP targets individuals and families earning less than $90,000 annually, with a goal to provide oral health services to up to 9 million uninsured Canadians.
CDCP Expanded Coverage (November 2024)
Starting in November 2024, the CDCP will offer coverage for a broader range of advanced dental treatments that were either partially covered or previously excluded. Key additions to the coverage include:
- Specialist Examinations: Comprehensive dental specialist exams are now included.
- Crowns: Crowns to restore damaged teeth will now require preauthorization for coverage.
- Root Canal Re-Treatments: Additional root canal procedures for previously treated teeth are now covered.
- Dentures: Includes partial dentures, overdentures, and immediate dentures.
- Major Surgical Procedures: Complex surgeries related to gums, jaws, and oral tissues are now included.
- Sedation and Anesthesia: Moderate sedation, deep sedation, and general anesthesia for dental procedures are covered with prior approval.
Services Covered by the CDCP
The CDCP already covers a wide variety of dental services, ensuring that necessary dental care is accessible at an affordable cost. The current coverage includes:
Diagnostic and Preventive Services:
- Dental exams (routine, specific, emergency)
- X-rays to diagnose oral health issues
- Cleanings, fluoride treatments, and sealants for tooth protection
Basic Services:
- Restorative services like fillings and pain management for diseased teeth
- Endodontic treatments, including root canals and procedures for pain relief
- Periodontal care, including gum disease management and treatments under the gumline
Major Dental Services:
- Crowns and restorations for heavily damaged teeth
- Removable prosthetics, such as dentures (full and partial)
- Oral surgeries, including extractions and treatments for tumors or cysts
- Anesthesia and sedation for more invasive dental work
Future Services:
- Orthodontics: Starting in 2025, orthodontic treatments will be covered under specific medical conditions.
Eligibility for the Dental Care Plan
To be eligible for the CDCP, applicants must meet the following criteria:
- Residency: Must be a resident of Canada.
- No Dental Insurance: Applicants must not have access to dental insurance from their employer or any other source.
- Income Requirements: Families with a net income under $90,000 are eligible. Those earning less than $70,000 are exempt from co-payments, while those earning between $70,000 and $90,000 will have co-payments based on their income.
Eligibility Groups:
- Children under 18 years of age
- Adults with a Disability Tax Credit certificate
- Seniors aged 65 and above
The program is set to expand in 2025, extending coverage to more groups across Canada.
Coverage and Co-Payment Details
The CDCP covers a percentage of dental treatment costs based on the family’s adjusted net income. The percentage of coverage is structured as follows:
- Under $70,000: 100% coverage, no co-payment required
- Between $70,000 and $79,999: 60% coverage, 40% co-payment
- Between $80,000 and $89,999: 40% coverage, 60% co-payment
Co-Payment Examples:
- No Co-Payment: Jane, 86 years old, with an adjusted income of $32,000, pays no co-payment. For a cleaning costing $145 (with an established fee of $134), Jane pays $11, and the CDCP covers $134.
- 40% Co-Payment: Sam and Anne, with an income of $76,000, pay 40%. If the cost is $134, the CDCP pays $80.40, and they cover $53.60.
- 60% Co-Payment: Kate, 67 years old, with an income of $82,000, pays 60%. If cleaning costs $145, the CDCP covers $53.60, and Kate pays $91.40.
What’s Next for the CDCP?
The CDCP is continuously evolving, with substantial expansions planned for 2025. The government aims to make dental care more accessible for all Canadians, removing financial barriers and promoting better oral health across the population. Among the upcoming changes, orthodontic services will be added, though they will be subject to strict medical criteria.
As the program grows, more individuals will benefit from increased access to essential dental care. However, it’s important to note that preauthorization will be required for advanced treatments. Applicants should communicate with their dental providers to ensure necessary approvals are obtained before proceeding with treatments.
The CDCP is a significant step towards improving oral health accessibility in Canada, ensuring that financial constraints no longer prevent people from receiving the dental care they need. With continued expansion, the program is set to play a pivotal role in enhancing the overall health and well-being of Canadians.
