The CDCP covers a wide range of services to prevent and treat oral health issues, but it's important to know what is included, what's excluded, and what requires pre-approval. This section breaks down the key categories of care.
✔️ Covered Services
- Preventive Services: Cleanings, scaling, polishing, fluoride, and sealants.
- Diagnostic Services: Exams and x-rays to identify issues.
- Restorative Services: Fillings and crowns to repair teeth.
- Endodontic Services: Root canal treatments to save infected teeth.
- Prosthodontic Services: Removable dentures to replace missing teeth.
- Oral Surgery: Extractions and other surgical procedures.
❌ Key Exclusions
- Cosmetic Procedures: Teeth whitening and veneers.
- Dental Implants: Implants and all related procedures are not covered.
- Fixed Bridges: Permanent bridges to replace teeth are excluded.
- Specialty Appliances: Night guards, bruxism appliances, and TMJ therapy.
- Extensive Rehabilitation: Full mouth reconstruction procedures.
- Certain Crowns & Inlays: ¾ crowns, inlays, and onlays are not covered.
📋 Services Requiring Preauthorization
For some major treatments, your dentist must get approval from the CDCP before starting. This ensures the treatment is clinically necessary. These include major procedures like crowns, dentures, and general anaesthesia. The process for this began in November 2024. Always talk to your dentist first to see if preauthorization is needed for your treatment plan.
Applying for the CDCP is a multi-step process that was rolled out in phases. This guide outlines the key steps and dates to help you navigate your application, from initial eligibility checks to receiving your welcome package from Sun Life.
1
Check Eligibility & Prepare Documents
Ensure you meet all four criteria: no private insurance, income under $90k, Canadian resident, and filed last year's taxes. Gather your SIN and Notice of Assessment (NOA).
2
Apply Based on Your Group
Applications were opened in phases. Seniors began applying in late 2023, followed by those with a Disability Tax Credit and children in June 2024. All other eligible Canadians (ages 18-64) could begin applying in May 2025.
3
Submit Your Application
The primary method is online through your My Service Canada Account. Phone applications are also available. Processing typically takes 4-6 weeks.
4
Receive Welcome Package
Once approved, the plan administrator, Sun Life, will mail you a package. It includes your member card and your official coverage start date.
5
Annual Renewal
You must file your taxes annually to maintain coverage. Renewal is required by June 1 each year to avoid a lapse in benefits.
The CDCP is a landmark program with significant positive impacts, but it also faces challenges and criticisms from experts. This section provides a balanced overview of the plan's performance and the key debates surrounding its design and future.
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Key Challenges & Expert Criticisms
A major criticism is that the CDCP excludes anyone with *access* to private insurance, even if they don't enroll. Unlike other health programs that top-up private plans, the CDCP replaces them. Experts warn this could cause employers to cancel their dental benefits, potentially leaving some employees with worse coverage than before.
The CDCP's reimbursement fees are often lower than a dentist's standard fees. This means even if you have 100% coverage, you may have to pay the difference out-of-pocket. This is called "balance billing," and it's a common source of confusion and unexpected costs for patients who believe their care is "free."
The plan's value drops sharply for incomes over $70,000. With co-payments of 40% or 60% on top of potential balance billing, the financial benefit is significantly reduced. Critics argue this penalizes many working-class families and may create disincentives for earning more income.