Canadian Dental Care Plan (CPCD)
The Canadian Dental Care Plan (CDCP) is a federal program that aims to make dental care cheaper for Canadians who don’t have insurance. It pays for some recognized dental services, but not all of them. Sun Life runs the program, which is growing in stages to cover families making less than $90,000 a year by 2025.
Eligibility & Requirements
To be eligible for the Canadian Dental Care Plan (CDCP), people must meet a number of important requirements. They must live in Canada for tax purposes and have a family net income of less than $90,000. People who want to apply for this must not have any other dental insurance, such as through work, a pension plan, a family member, or voluntary insurance. This “no access” requirement is very strict. Even saying no to a dental plan that is offered counts as having access and makes you ineligible. Also, candidates must have filed a tax return for the preceding year to prove how much money they make. At first, the CDCP was only for seniors, children, and people with disabilities. By 2025, it will be available to anybody who meets these qualifications and has a low enough income. The goal of the program is to make sure that Canadians who don’t have private or workplace dental insurance may get dental care at a price they can afford.
What Dental Services Are Covered
CDCP includes a wide range of oral health services organized by category. However, many services require preauthorization (prior clearance) if they exceed normal limitations or are more sophisticated.
Here are the major categories:
Diagnostic & Preventive
- Conduct routine and emergency dental exams.
- X-rays
- Cleaning and scaling
- Fluoride treatments
- Sealants
Restorative / Basic
- Permanent and temporary fillings.
- Pain relief for decaying teeth.
Endodontics (root canal and associated)
- Preauthorization required for root canal, pulpectomy, and retreatments.
Periodontal (gum, supporting structures)
- Cleaning under the gumline, treating abscesses, and non-surgical gum disease treatments.
- Bonding of movable teeth and post-surgical assessments may require preauthorization.
Prosthodontics (e.g., detachable dentures)
- We offer whole and partial dentures, as well as repairs, relines, and rebases.
- Certain prosthodontic services necessitate preauthorization for eligibility.
Oral Surgery
- Tooth extraction and root removal.
- Surgical removal of tumours, cysts; management of jaw fractures.
Sedation and Anesthesia
- Minimal sedation is covered.
- Preauthorization is required for moderate, profound sedation, and general anesthesia.
Orthodontics (Coming in 2025).
- Beginning in 2025, limited coverage for orthodontic services will be available based on medical need and rigorous requirements.
Cost Sharing / Co-Payments & Fees
Because CDCP does not provide free care, cost sharing is based on adjusted family net income. The CDCP covers roughly the following proportion (compared to what the patient must pay):
| Income bracket | CDCP pays | Patient co-payment (of CDCP “established fees”) |
| Below $70,000 | 100 % | 0 % |
| $70,000 – $79,999 | 60 % | 40 % |
| $80,000 – $89,999 | 40 % | 60 % |
A few notes:
- “Established fees” refers to a fee schedule set by CDCP for specific dental operation codes. These may be lower than what dentists usually charge. If a dentist charges more than the CDCP fee, the patient may have to pay the difference (assuming the dentist agrees).
- The CDCP may approve exceptions for services that require preauthorization or exceed the frequency restrictions, but both the dental provider and the patient must adhere to submission and approval guidelines.
- Certain services are explicitly excluded (see section below).
Exclusions & Limitations (What CDCP Does Not Cover)
CDCP does not cover some sorts of dental services. Common exclusions include:
- Cosmetic procedures such as teeth whitening and veneers.
- Dental implants are not covered by CDCP.
- Prosthodontic procedures include fixed bridges, bone grafts, and specific treatments.
- Services refused by CDCP due to preauthorization or ineligibility under their policies.
- Certain minor services or tweaks may alter in coverage over time, such as those deleted in the 2025 update.
Furthermore, not all dentists must engage in CDCP (i.e. agree to charge CDCP under its reimbursement standards). Patients should check to see if their dental provider participates.
Application, Enrolment & Implementation
- The government began a staged rollout from late 2023 to 2025, beginning with elderly and children and gradually expanding to all eligible income-qualified individuals.
- Eligible persons will receive a letter encouraging them to apply.
- After enrollment, individuals will receive a CDCP card, coverage details, and coverage start date. Only services provided after the coverage start date are covered.
- Before providing therapy, providers must validate the client’s coverage through an Electronic Data Interchange estimate or direct contact.
- Providers must submit paperwork ahead of time for services that require preauthorization or exceed frequency limits. In emergency situations, post-determination may also be used.
- The CDCP Dental Benefit Grids (procedure codes with permissible amounts) are released, including the 2025 grids.