Canadian Dental Care Plan

The Canadian Dental Care Plan (CDCP) aims to help reduce financial barriers to oral health care by covering eligible services for eligible Canadian residents without existing dental coverage.

Coverage Overview

The CDCP covers only specific dental services at pre-determined CDCP rates, which differ from standard fees at dental and denturist clinics. The CDCP is not an entirely free plan. As outlined in your welcome package, Individuals covered under the CDCP may have to pay any additional costs directly to the oral health provider. To minimize out-of-pocket expenses for individuals covered under the plan, the program will pay oral health providers who participate in the CDCP directly for eligible services at the CDCP-set fees.

Additional charges may apply if:

A co-payment is required based on your income tier *
Your oral health provider fees exceed the CDCP-approved rates.
You agree to receive services not covered by the CDCP (you will be responsible for the full cost of these services).

* A co-payment is the percentage of the CDCP fee not covered by the plan and must be paid directly to your provider. This percentage is based on your adjusted family net income.

Before receiving care, always confirm which services or costs are not covered by the CDCP. Services not covered by the CDCP will need to be paid in full by the client.

The information provided is intended only as an overview of the program and does not replace the detailed information from the federal government regarding all aspects of the program. A link to the dental plan is available throughout this page and can be referred to at any time.

As an independent provider, we do not control program changes or administrative processes. We do our best to provide you with the most up-to-date information as it becomes available; however, changes may be implemented suddenly, during your coverage period or treatment plan.

As a program participant, it is always best to refer to the program resources (on the dental plan website) periodically to ensure you have the most up-to-date information on the program and whether any changes have been made to treatment frequencies or coverage.

📌Learn more or apply at canada.ca/dental or call Service Canada at 1-833-537-4342.

Eligibility

You may qualify if all the following apply:

You do not have or have not previously had access to dental insurance (through work, school, pension, or privately).
Your household income is under $90,000/year.
You filed a tax return last year.
You are a Canadian resident for tax purposes.

A detailed outline is available on the dental plan website.

📌 Learn more or apply at canada.ca/dental or call Service Canada at 1-833-537-4342.

Renewal

Eligibility is reassessed annually by the appropriate government authority.

You must renew your CDCP coverage annually to maintain uninterrupted access to benefits. It is the participant’s responsibility to renew their coverage each year; it does not renew automatically.
If your coverage percentage changes once your renewal has been assessed, the co-pay or balance billing might change for services.

You will be responsible for any fees incurred for services received outside your coverage validity; any oral health care services received outside of coverage will NOT be covered, and no retroactive reimbursement will be provided by the program.

Please note that there are certain factors beyond the provider’s control, including but not limited to an increased booking time due to the launch of the CDCP (as many participants did not have prior access to dental care until now), delays in predetermination processing, or external lab turnaround times for certain denture services. All these factors influence when the denture service will be concluded.

We strive to accommodate all patients, but we cannot guarantee that the service will be completed before your coverage renews.

What denture services are eligible

Most, not all, denture services are eligible through the CDCP program; however, all services are subject to CDCP frequency limits and, where applicable, preauthorization requirements. All eligible services can be found on the dental plan website. The program does not cover any services received outside the frequency limit or the coverage validity period.

It is always important to confirm which services or costs are not covered by the CDCP. Services not covered by the CDCP will need to be paid in full by the client.

Being a participant also does not guarantee that a service will be approved. It is at the discretion of the plan administrator, per the program’s guidelines.

Regrettably, any dentures implant-related is not eligible for coverage by the CDCP.

📌 Learn more about eligible services and all exclusions.

Planning for Your Visit

Bring your CDCP Card, CDCP renewal letter, and government-issued ID (health card or driver’s license). Your renewal letter will serve as verification of coverage – a new card will not be provided.

When making an appointment, please have your member ID information ready to provide to the office before your visit. Receiving this information before your visit helps confirm your coverage.

All claims, plan verification, and correspondence will be submitted or communicated to the plan administrator by your service provider.

If a service requires preapproval, we’ll submit a predetermination and notify you of the outcome.

Predetermination and Prior Approvals

Services such as partial dentures, immediate dentures, dentures with soft-liners, and complex repairs require approval before treatment can proceed. Approval times vary depending on processing volume.

Before we can send a predetermination, we will schedule a consultation with the denturist. Where possible, impressions will be taken at the time of consultation, as these are required for the predetermination process.

Please ensure that all outstanding dental work (restorations/fillings, etc.) has been completed before your appointment with the denturist, as this is a program requirement for certain services.

If you have multiple teeth to be extracted and are considering an immediate denture, it is also essential to consult with a dentist to develop a personalized treatment plan. If this is the treatment plan you hope to proceed with, it is essential to understand all aspects of the process before having all your teeth extracted.

As with denture services, most dental services have been made more accessible through the plan, making it easier to maintain and prioritize your dental health.

We will notify you of the predetermination outcome. The co-pay and balance billing rate provided is based on the coverage % at the time of the predetermination. This could change if your coverage or the program has changed.

Claims will be paid based on the active coverage on the date the service is completed — NOT the coverage % on preauthorization or estimates approved before your coverage was renewed.

This could mean that the co-pay or balance billing might change. The patient must be eligible on the date of service for the plan to cover the claim.