The Canadian Dental Care Plan / Canada Dental Benefit

In 2022, the federal government announced plans to create the Canadian Dental Care Plan (CDCP), providing dental care coverage for uninsured Canadians with a household income of less than $90,000 a year. The program is administered by Health Canada with support from Sun Life.

Program administrator Sun Life has a Provider Search portal on its website.

Find it here: https://www.sunlife.ca/sl/cdcp/en/member/provider-search

Individuals must meet all of the following criteria in order to be eligible for CDCP coverage:

• No access to dental insurance, meaning:
  • no coverage through employer or a family member’s employer benefits; including health and wellness accounts;
  • no coverage through pension (previous employer) or a family member’s pension benefits; or
  • no coverage through a purchased plan by yourself or by a family member or through a group plan from an insurance or benefits company.
• an adjusted family net income of less than $90,000;
• be a Canadian resident for tax purposes; and
• have filed their tax return in the previous year.

Canadian residents who have access to dental benefits through a social program offered by their province or territory and/or by the federal government will be eligible for the CDCP if they meet all the eligibility criteria.

Patients who decide to opt out of available benefits to them will be considered as having access to dental insurance for the purposes of determining qualification criteria.

For more on qualifying for the CDCP, visit canada.ca/dental.

CDCP patients may have to pay a co-payment out of pocket based on their adjusted family net income. A co-payment is the percentage of the CDCP fees that is not covered by the CDCP and that a patient will have to pay directly to the oral health provider.

The co-payment is based on a patient’s adjusted family net income:

• 60% required co-payment for patients with an adjusted annual family net income between $80,000 and $89,999. Patients may face additional charges as described below.
• 40% required co-payment for patients with an adjusted annual family net income between $70,000 and $79,999. Patients may face additional charges as described below.
• No required co-payment for patients with an adjusted annual family net income under $70,000. Patients may face additional charges as described below.

Additional charges

In addition to co-payments, patients may be required to pay additional charges. These additional charges are to cover a portion of the cost of their care when the CDCP rate is lower than the dentist’s usual and customary fee or if the patient chooses to proceed with care that is not covered by CDCP.

The CDCP pays only for services covered within the plan at the established CDCP rates. These rates are not the same as provincial and territorial fee guides that dentists usually utilize as reference to establish their usual and customary fee.

For an overview of which dental services may be covered under the CDCP, visit canada.ca/dental

Once you’ve applied through Health Canada and it is confirm that you qualify, your information will be shared with Sun Life, which will enroll you in the CDCP. Sun Life will then send you your coverage start date and member card.

The start date to access oral health care will vary based on when each group can apply, when the application is received, and when enrolment is completed. We recommend you contact the Government with any specific questions regarding your qualifications.

Application schedule:

The government has said that the CDCP is not intended to replace existing workplace or private dental benefits. It is meant for Canadians who do not have dental benefits.

If you have existing insurance, you should not cancel your insurance as not all details of the CDCP are public knowledge at this point.

You’re still considered to have access to dental insurance if you choose to opt out of available benefits like these.

Patients who have dental coverage through a provincial, territorial, or federal government social program qualify for the Canadian Dental Care Plan (CDCP). If patients meet all the eligibility criteria, their coverage will be coordinated between the plans.

Please don’t delay treatments or your dental appointments! It’s better to keep getting regular dental check-ups now to catch problems before they become painful and expensive to treat.

We understand you may be thinking of delaying dental care or rethinking your benefit coverage hoping the costs will be covered by the CDCP, but it remains unknown what services or treatments will be covered, or when that coverage will even start.

The Canada Dental Benefit (CDB) provides direct, up-front, tax-free payments to help cover out-of-pocket dental care expenses for children under 12 years of age who do not have access to private dental insurance and whose family income is less than $90,000 a year. The CDB provides payments of up to $650 for each eligible under 12 years of age, each year for two years.

Payments are administered by the Canada Revenue Agency (CRA). The CRA uses adjusted income to determine eligibility and the amount of benefit you will receive. You need to have filed the previous year’s taxes to be eligible.

The benefit provides:

• $650 for each eligible child per year if the family’s adjusted income is under $70,000.
• $390 for each eligible child per year if the family’s adjusted income is between $70,000 and $79,999.
• $260 for each eligible child per year if the family’s adjusted income is between $80,000 and $89,999.

The CDB is only available for two periods. The first benefit period, which is now closed, covered dental care your eligible child received between Oct. 1, 2022, and June 30, 2023.

The second benefit period runs from July 1, 2023 to June 30, 2024.

To access the second (i.e. current) benefit period, you must meet the following criteria:

• You have a child or children under 12 as of July 1, 2023, and are currently receiving the Canada Child Benefit (CCB) for that child;
• You have an adjusted family net income of less than $90,000;
• Your child does not have access to private dental care coverage;
• You have filed your 2022 tax return; and
• You have out-of-pocket expenses for your child’s dental care services incurred in Canada between July 1, 2023, and June 30, 2024, for which the costs have not been fully covered under another federal, provincial or territorial government program.

The CRA My Account is the quickest, easiest, and most secure way to apply for the CDB. Visit Canada.ca/dental for more information. If you are unable to apply online, call the CRA at 1-800-715-8836.

You can apply to get the benefit ahead of your child’s dental appointment.

When you apply, you will need to confirm that:

• Your child does not have access to private dental care coverage.
• You will have out-of-pocket dental care expenses and will use the CDB to pay for those expenses.
• You understand that you may have to provide receipts to prove the CDB was used to pay for out-of-pocket dental care expenses.

When applying, you should have the following information close by as you will be required to provide:

• The name, address, and telephone number of your child’s dental care professional.
• The date (or expected date) of your child’s or children’s dental appointment.
• The name, address, and telephone number of your employer and your spouse’s or common-law partner’s employer, if applicable.

If you apply online and are signed up for direct deposit, you could receive your payment within five business days. If you are unable to apply online, you can call a new dedicated phone line at 1-800-715-8836 to complete your application with an agent.

Once you receive the benefit, you must use it to pay for dental services. If the services in that year cost less than the total benefit amount, the CRA expects you to spend it on the child’s oral health needs in lieu of returning any unused money.

Health Canada has a factsheet (PDF, English) that you can download and print. It explains the main points of the CDB in an easy-to-understand graphic. It is also available in other languages on the Health Canada website.

You can also learn how to apply for the CDB by watching this video.

It’s very important to have an open dialogue with your dentist, as they might be able to set up treatment and payment options that work with your financial situation. Talk to them to see what can be done to help.

Please log in to your NSDA member account and visit 'Canadian Dental Care Plan' under the Member Resources drop-down menu.