On Monday, the federal government announced the specifics of its long-awaited Canadian Dental Care Plan, which would help poor and middle-income individuals who do not have private insurance.
The plan, known as the CDCP, arose from the Liberals’ supply-and-confidence agreement with the NDP in 2022, and it provides direct dental care payments to Canadian residents who are uninsured and have a household income of less than $90,000.
It is part of a policy included in the federal government’s spring 2023 budget, which allotted $13 billion over five years, from 2023 to 2024, and $4.4 billion on an ongoing basis.
Health Minister Mark Holland called the CDCP “transformative for our country.”
“It will significantly improve health outcomes, reduce a burden on our health care system, and build a foundation of equity by expanding access to oral health care for the millions of Canadians that currently do not have access to this critical care,” he said in the release.
Here are the key takeaways from the dental plan.
Who qualifies for the dental program?
To qualify for the CDCP, Canadians must meet the following criteria:
- they do not have access to dental insurance
- they have an annual adjusted family net income under $90,000
- they must be a Canadian resident for tax purposes
- a tax return from the previous year must have been filed
According to the media release, Canadians who already have access to dental coverage through provincial, territorial, and federal social programs and meet these criteria will be able to apply for the dental program.
When will the dental program start?
Starting in December 2023, applications for the dental plan will be open to seniors aged 87 and up, before gradually expanding by age group. According to the federal government’s announcement, those in this age range who may be eligible will get a letter encouraging them to apply.
Seniors aged 77 to 86 can apply beginning in January 2024. Seniors aged 72 to 76 can then apply in February 2024. Seniors aged 70 to 71 can apply starting in March 2024.
Then, in May 2024, seniors aged 65 to 69 will be able to apply.
Starting in June 2024, Canadians with a valid disability tax credit certificate and children under the age of 18 will be able to apply online.
Starting in 2025, all remaining eligible Canadian residents will be able to apply online.
Sun Life will send Canadian individuals who qualify a welcome package containing a member card and a start date for when their oral health care services will be covered.
Those who are covered will be able to see oral health-care experts as early as May 2024, with seniors being the first to benefit.
Any oral health-care service performed prior to the person’s start date will not be reimbursed by the dental care plan.
What dental services are covered?
The following services are covered by the federal dental care plan (with some being available only in the fall of 2024).
- preventive services, including scaling (cleaning), polishing, sealants and fluoride
- diagnostic services, including examinations and X-rays
- restorative services, including fillings
- endodontic services, including root canal treatments
- prosthodontic services, including complete and partial removable dentures
- periodontal services, including deep scaling
- oral surgery services, including extractions
How much is covered?
To reduce out-of-pocket expenses for plan participants, oral health-care providers must submit claims directly to Sun Life for payment, removing the need for consumers to seek reimbursement from the insurance company.
The dental program will reimburse a percentage of dental procedures, however some plan members may be required to pay a co-payment. This is the portion of the dental plan that is not covered by the federal government and must be paid for by the patient.
Family net incomes between $70,000 and $79,000 will be subject to a 40% co-payment. Those earning between $80,000 and $89,000 will have a 60% co-payment plan.