Am I eligible for the Canadian Dental Care Plan?

The federal government has a new Canadian Dental Care Plan (CDCP), which will help some Canadians pay for certain dental costs.   

There are rules about who's eligible, what's covered, and when the coverage starts. 

Who can apply

To qualify for the CDCP, you must:  

• not have other dental insurance, for example, from a pension, group, employer, or personal plan,  
• have a family net income of less than $90,000, 
• be a Canadian resident for tax purposes, and 
• have filed a tax return in the past year. 
  

If you have a spouse or common-law partner, they must have also filed their tax return.   

If you have dental coverage through a provincial social program, such as Healthy Smiles Ontario (HSO), the Ontario Disability Support Program (ODSP), or the Ontario Seniors Dental Care Plan (OSDCP), you can still qualify for the CDCP.  

If you have the OSDCP you can choose which plan to use. Talk to your dental professional about what's best for you.  

ODSP and HSO benefits are coordinated with the CDCP. This means if your dental service costs more than what the CDCP covers, your other benefit can help pay the difference. 

You must qualify for the CDCP each year. The government will say later how you can re-apply.  

When to apply

When you can start applying for the CDCP is based on your age and whether you have a Disability Tax Credit certificate:   

How to apply  

You can apply online or you can call 1-833-537-4342 and apply by phone.  A friend or relative can help you.  

You need to give some personal information, including your: 

• full legal name 
• mailing address 
• date of birth 
• social Insurance number
  

You also have to say whether you have any dental coverage through provincial programs, like the ODSP. 

You and your spouse or common-law partner, if you have one, must have also filed your tax return for the previous year and got your Notice of assessment.  

If you have not filed your taxes and need help, you might be able to get a help from a  free tax clinic.  

After you apply

The Government of Canada has chosen Sun Life to manage the plan for them. If you qualify, the government shares your information with them.  

Within 3 months of being approved you will get a welcome package from Sun Life that has: 

• information on the CDCP 
• your member card 
• the date your benefits start
  

You can check the status of your application online.  

What’s covered

The CDCP only covers dental services that are:   

• included in the plan, and  
• provided by dental professionals who are part of the plan. 
  

Dental professionals can be dentists, denturists, dental hygienists, and dental specialists.  The government calls these dental professionals “oral health providers”.  You can search for a CDCP dental professional near you on Sun Life's website. 

The government has a list of all the services the plan covers, and how often people can get them. Some examples are:  

• cleaning, polishing, sealants, and fluoride treatments 
• x-rays 
• fillings 
• root canal treatments 
• complete and partial removable dentures  
• removing teeth
  

Some more complicated dental services such as getting a crown, need preauthorization. Preauthorization means you need to ask permission to get the service covered before getting the work done. Your dental professional will have to explain why you need the service. 

Services that need preauthorization will be available starting November 2024. 

When coverage starts

 When your coverage starts depends on:  

• your age,  
• when you applied, and   
• when your application was accepted  

Check your Sun Life package to see the exact date your coverage starts.   

How much is covered

The CDCP covers a maximum amount for each included service.  

If a dental professional charges more than the CDCP maximum and you do not have dental benefits through ODSP or Health Smiles Ontario, you have to pay the difference.  For example, if your dentist charges $150 for a general oral examination, the CDCP will cover $133.59. You have to pay the balance of $16.41 

Based on your income you may also have to pay a co-payment. This means you're covered for only a percentage of the CDCP maximum, and you pay rest.  

You must also pay for any service that's not covered by the CDCP.   

 Before making your appointment with a dental professional, you should ask:  

• if they're part of the CDCP  
• if your service is covered by the CDCP, and 
• how much the service costs 
  

You do not have to pay for the portion of dental services that's covered by the CDCP. Your dental professional sends that part of the claim directly to Sun Life Insurance.  

If you’re covered by Ontario’s dental programs

If you have dental benefits through ODSP or HSO you can still qualify for the CDCP. Your coverage is coordinated between the 2 plans. This means that if the CDCP cannot cover the full cost of the service, your other benefit will cover the difference, up to a certain amount.  

If both dental benefits combined cannot cover the cost, you do not have to pay the rest.  

For example, if your dental professional charges $35.00 for 0.5 units of polishing: 

• CDCP covers: $8.75  
• ODSP or HSO covers: $12.67 
• Total covered: $21.42
  

Your dental professional cannot charge you the remaining $13.58.