The Canadian Dental Care Plan (CDCP) is undergoing significant improvements to offer better and broader oral health services to millions of Canadians. These enhancements aim to include more treatments, ensuring uninsured individuals receive the dental care they need.
Introduction to the Canadian Dental Care Plan
Launched in 2023, the CDCP was created to provide essential dental coverage for Canadians without dental insurance. It primarily targets families with annual incomes below $90,000, addressing oral health disparities for approximately 9 million uninsured residents.
Key Highlights of the Expanded Coverage Starting November 2024
From November 2024, the CDCP will include advanced dental procedures previously excluded or partially covered. Here are the newly added treatments that require preauthorization:
| Service | Description |
|---|---|
| Specialist Examinations | Comprehensive dental assessments conducted by specialists. |
| Crowns | Restorations for damaged teeth. Preauthorization is required. |
| Root Canal Re-Treatments | Coverage for additional treatment on previously treated teeth. |
| Dentures | Includes removable partial dentures, overdentures, and immediate dentures. |
| Major Surgical Procedures | Complex surgeries involving gums, jaws, and other oral tissues. |
| Sedation and Anesthesia | Moderate and deep sedation or general anesthesia upon approval. |
Services Currently Covered by CDCP
The CDCP already supports various oral health services to make dental care affordable and accessible.
Diagnostic and Preventive Services
- Dental Exams: Coverage includes routine, specific, emergency, and comprehensive dental examinations.
- X-rays: Diagnostic imaging to identify oral health issues.
- Cleanings and Fluoride Treatments: Routine scaling and fluoride applications to prevent tooth decay.
- Sealants: Protective coatings to shield teeth from cavities.
Basic Services
- Restorative Treatments: Includes fillings (temporary and permanent) and pain management for tooth decay.
- Endodontic Treatments: Root canals, pulpectomies, and infection control procedures.
- Periodontal Care: Treatments for gum disease, abscesses, and cleaning below the gumline.
Major Dental Services
- Crowns and Restorations: Repairs for significantly damaged teeth.
- Removable Prosthodontics: Full and partial dentures, including immediate dentures.
- Oral Surgery: Removal of teeth, cysts, and tumors.
- Sedation and Anesthesia: Pain management options for complex procedures.
Eligibility for the Canadian Dental Care Plan
To qualify for the CDCP, applicants must meet specific criteria:
General Requirements
- Residency: Must reside in Canada.
- No Dental Insurance: Should not have dental insurance from employment, private plans, or other sources.
- Income Limits:
- Families earning less than $90,000 annually qualify.
- No co-pay for incomes under $70,000.
- Sliding scale co-payments for incomes between $70,000 and $90,000.
Eligible Groups
- Children under 18 years.
- Seniors aged 65 and above.
- Adults with a Disability Tax Credit certificate.
In 2025, additional eligibility categories will expand access to even more Canadians.
Coverage and Co-Payments: Understanding Your Contribution
The amount covered by the CDCP depends on the adjusted family net income, as summarized below:
| Income Range | CDCP Coverage (%) | Applicant Contribution (%) |
|---|---|---|
| Less than $70,000 | 100% | 0% |
| $70,000 to $79,999 | 60% | 40% |
| $80,000 to $89,999 | 40% | 60% |
Co-Payment Examples
| Example | Income | CDCP Coverage | Patient Contribution |
|---|---|---|---|
| Jane (86 years) | $32,000 | $134 (100%) | $11 for uncovered costs |
| Sam & Anne (Couple) | $76,000 | $80.40 (60%) | $53.60 + additional fees |
| Kate (67 years) | $82,000 | $53.60 (40%) | $91.40 |
Future Additions to CDCP Coverage
From 2025, orthodontic services will be introduced, with coverage restricted to cases demonstrating medical necessity. This inclusion highlights the government’s commitment to expanding dental care for all Canadians.
Important Considerations
- Preauthorization: Approval is required for advanced procedures.
- Co-Payment Obligations: Based on income, applicants may need to pay a portion of treatment costs.
FAQs
What treatments will the CDCP cover starting November 2024?
The plan will expand to include specialist examinations, crowns, root canal re-treatments, dentures, major surgeries, and sedation upon preauthorization.
Who qualifies for no co-payment?
Families with adjusted net incomes below $70,000 are eligible for 100% coverage with no co-payment.
Will orthodontics be covered under the CDCP?
Yes, starting in 2025, medically necessary orthodontic treatments will be covered.
