The Canadian Dental Care Plan(CCDP) is a federal government program to provide coverage for Canadian residents who do not have dental benefits. This program is in addition to the already run programs by any government and the benefits of those do not lapse. Benefits will be coordinated between the programs and no benefits will be duplicated.
Eligibility
- You must be a tax resident of Canada- meaning students, work permit holders holding temporary visa are covered under this.
- Must have filed income for the last year.
- If you are 70 years or more of age Initially, then this will be applicable instantly, to the rest eligibility is in the phased manner. Like from 2024 it is open to ager 65 above and for the adult people below 65 who have Disability certificate and children under 18 years.
- Your adjusted family net income is less than $90K.
- There shall be no dental insurance either directly or through the employer or through the employer of family member. E.g.(coverage given to the spouse of employee) or no insurance through your pension benefits or through pension benefits of your spouse.
Exceptions to the insurance- if you got any insurance coverage through any of the other program run by province, you are still eligible for the Canadian Dental Care Plan.
- CRA is collecting data from the employers through T4/T4A whether their employees and families have access to dental insurance coverage and wellness accounts.
The eligibility will be assessed on a yearly basis.
Who are Oral Service Providers?
In this plan the service is to be provided by oral health care clinics and they include the following
- Dentists
- Denturists
- Dental Hygienists
- Dental Specialists
When to Launch/Start?
Applications to start from Dec 2023 in phased manner.
Application schedule by age group
Group Applications open Seniors aged 87 and above Starting December 2023 Seniors aged 77 to 86 Starting February 2024 Seniors aged 72 to 76 Starting February 2024 Seniors aged 70 to 71 Starting March 2024 Seniors aged 65 to 69 Starting May 2024 Adults with a valid Disability Starting June 2024 Tax Credit certificate Children under the age of 18 Starting June 2024 All remaining eligible Canadian Residents Starting 2025 CRA will send you a letter which will have a personalized application code and instructions on how to apply.
Enrolment procedure
You will receive email/letter from CRA, and you need to fill out the form. After that the CRA will check your credentials and will then confirm your qualification to the program. From CRA side, Sun Life Insurance is the partner and CRA will send your information to Sun Life. Then Sun Life will send you a welcome package which will have your member ID, coverage start date and detailed information on the program.
Important- Package form Sun Life will have the start date of coverage and if any person gets treatment before the start date, there will be no reimbursement under this CDCP.
When booking appointments with an oral health provided, please ensure that service provider has enrolled under CDCP tominimize out of pocket cost.
What is Covered in Dental Care plan?
CDCP will cover the various health services related to oral health care that keeps teeth and gums healthy. This will cover precautionary, preventive, diagnostic and restoration services.
examples are given as:
preventive such as scaling, polishing and fluoride etc.
Diagnostic services includex-rays and examinations.
Restoration services including fillings.
Endodontic services including RCT (root canal treatment).
Prosthodontic services include complete and partial removable dentures.
Periodontal Services including deep Scaling.
Oral surgery Services including extractions.
The rates for the services covered are established and the plan will compensate as per the rates established. For the extra payments will be paid by the person availing facility/service.
To whatextent amounts will be covered?
Service rates are established under the territorial and provincial fee guides and service providers are encouraged to follow those. The clinic enrolled under CDCP will submit the claims to Sun Life and payment will be collected from Insurance company. In the event the payment is more than the covered amount that needs to be paid directly to the clinic by the person from own pocket.
So, it is advised to check before initiating the treatment what costs are covered by the plan to know what amounts they need to have in hand before receiving care.
Coverage to the person is based on the income and the details are given below.
| Adjusted family net Income | Extent of Coverage under CDCP | Balance from personal pocket. |
| less than $70K | 100% of the total eligible expense | 0% |
| Less than$80K | 60% of the total eligible expense | 40% |
| Less than$90K | 40% of the total eligible expense | 60% |
IF you need any help with the matter, Team Aaras is always there for you for case specific solutions.
Note: The information is not intended to constitute professional advice and may not be appropriate for a specific individual or fact situation. It is written by the author solely in their personal capacity and cannot be attributed to the accounting firm with which they are affiliated. It is not intended to constitute professional advice, and neither the author nor the firm with which the author is associated shall accept any liability in respect of any reliance on the information contained herein. Readers should always consult with their professional advisors in respect of their situations.
-Raman Nagpal
B Com, CA, CMA, DISA
Source: CRA and other legal material
