The federal government unveiled rollout details of its long-awaited Canadian Dental Care Plan on Monday, giving a leg up for low and middle-income residents without private insurance.
The plan, known as the CDCP, was born out of the Liberals’ supply-and-confidence deal with the NDP in 2022, and it offers dental care benefits directly to Canadian residents who are uninsured with a household income under $90,000.
It’s part of a measure in the federal government’s spring 2023 budget, which allocated $13 billion over five years beginning in 2023 to 2024, and $4.4 billion ongoing.
“The CDCP aims to help ease financial barriers to accessing oral health care services and provides coverage to eligible Canadian residents, who currently do not have access to dental insurance,” according to a Monday media release.
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
Canadians who already have access to dental benefits through provincial, territorial, and federal social programs and who meet these criteria will still be able to apply for the dental program, according to the media release.
When will the dental program start?
Applications for the dental plan will first open for seniors aged 87 and up starting in December 2023, expanding in phases by age group. People in this age bracket who may be eligible will receive a letter inviting them to apply, according to the federal government’s announcement.
Starting in January 2024, seniors aged 77 to 86 can then apply. Then in February 2024, seniors aged 72 to 76 can apply. Starting in March 2024, seniors aged 70 to 71 can apply.
And then in May 2024, seniors aged 65 to 69 can start applying.
Canadians with a valid disability tax credit certificate and children under the age of 18 will be able to apply online starting in June 2024.
All remaining eligible Canadian residents will be able to apply online starting in 2025.
Once enrolled, Canadian residents who qualify will be sent a welcome package by Sun Life with a member card and a starting date for when their oral health care services will be covered.
Those who are covered will be able to start seeing oral health-care providers as early as May 2024, starting with seniors.
The dental care plan will not reimburse any oral health-care service done before the person’s start date.
What dental services are covered?
Services covered under the federal dental care plan include the following (with some services only becoming available in fall 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 minimize out-of-pocket expenses for individuals covered by the plan, oral health-care providers must submit claims directly to Sun Life for payment, eliminating the need for patients to seek reimbursement from the insurance company.
The dental program will reimburse a percentage of dental procedures, but some people covered under the plan may have a co-payment. This is the percentage of the dental plan that is not covered by the federal government, which people will have to pay out of pocket.
Family net incomes between $70,000 and $79,000 will have a 40 per cent co-payment. And those between $80,000 and $89,000 will have a 60 per cent co-payment plan.
— With files from the Canadian Press