Clinical content reviewed by Dr. Ash Kler, DDS ·
For most of the past decade, dental coverage in Canada worked on a simple and slightly unfair principle: if your job provided it, you had it, and if it did not, you paid for everything yourself. Roughly nine million people fell into the second group.
The Canadian Dental Care Plan changed that. It is now open to Canadian residents of any age who meet the criteria, and for a large number of households in Kamloops it is the first dental coverage they have ever had.
Here is what it actually means, in plain terms.
The most common misunderstanding is that the plan is some kind of reduced-fee scheme. It is not. It is federal dental coverage, administered by Sun Life, that pays participating dental offices directly for covered services. You do not pay up front and claim it back.
Four things have to be true at once:
You do not have access to private dental insurance, whether through your employer, your pension, a spouse's plan or a policy you bought yourself. This is the criterion people most often trip over, and it is worth being careful with: if you gain coverage partway through the year, you have to tell the plan.
Your adjusted family net income is under $90,000.
You have filed your most recent tax return, and so has your spouse or common-law partner if you have one.
You are a Canadian resident for tax purposes.
Eligibility is decided by the federal government rather than by any dental office. Applications go through canada.ca/dental.
Qualifying and paying nothing are not the same thing, and this is where people are most often caught out.
Income determines your co-payment tier. Under $70,000 in family income, there is no co-payment on covered services. Between $70,000 and $79,999 you pay a share. Between $80,000 and $89,999 you pay a larger share. Your determination letter tells you which applies.
Separately, the plan pays established rates. If a dental office's fee is higher than the plan's rate, the difference can be charged to you. That is not a hidden practice; it is how the plan is designed. What matters is that the office tells you the number before treatment rather than after.
Examinations, cleanings and preventive care. Fillings. Extractions. Root canal treatment. Dentures. A good deal of ordinary dentistry, in other words.
Larger work such as crowns, oral surgery and orthodontics generally needs preauthorisation, which the dental office submits before treatment starts. That takes time, which matters for the reason below.
Cosmetic treatment is excluded. Whitening and veneers are not covered, and no amount of paperwork changes that.
Coverage runs in benefit years ending 30 June, and it has to be renewed annually. Every year a number of people discover in July that their coverage lapsed because they missed the renewal window in the spring.
Two practical consequences. Renew when the window opens rather than when you remember. And if you expect to need major treatment, book earlier in your benefit year rather than later, because preauthorisation for a crown submitted in June may not come back before your coverage period ends.
This is worth saying directly, because it is the situation a great many new CDCP patients are in.
If cost is the reason you have avoided the dentist, you are in extremely common company, and you will not be judged for it at this practice. A first visit is an assessment and a conversation, not a lecture. You will find out what is going on, what the plan covers, what you would pay, and what can reasonably wait.
Very often the news is better than people expect. The things that grow into expensive problems start small, and finding them small is the whole point.
Blue Bird Dental is a participating provider for the Canadian Dental Care Plan. Call (250) 372-2326 or read more about coverage Canadian Dental Care Plan
Have questions about your own smile? Call (250) 372-2326 or request an appointment.