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Canadian Dental Care Plan 2023 (CDCP) for Adults & Seniors, Benefits & Who Qualifies

In a commendable move to break down financial barriers to oral health, the Canadian Dental Care Plan (CDCP) promises relief for eligible Canadian residents facing the daunting hurdle of an annual adjusted family net income below $90,000 without dental insurance coverage. If you’re a parent or guardian of a child under 12 and lack dental insurance, you might already be eligible for the Canada Dental Benefit, a limited-time opportunity lasting until June 30, 2024.

Who qualifies for the new Canadian dental plan?

To avail the CDCP benefits, meeting specific eligibility criteria is imperative. Not having access to dental insurance is defined as the absence of coverage through employers, pensions, or personal plans. Additionally, eligibility hinges on being a Canadian resident for tax purposes and filing the previous year’s tax return. For couples, both partners need to meet the eligibility criteria, and children under 18 are assessed based on their parents’ or guardians’ eligibility.

Canadian Dental Care Plan 2023 (CDCP) for Adults & Seniors, Benefits & Who Qualifies

Deciphering Adjusted Family Net Income

Understanding the concept of adjusted family net income is crucial. It is derived by subtracting any Universal Child Care Benefit (UCCB) and Registered Disability Savings Plan (RDSP) income from your family net income, providing a clear picture of your financial standing.

Inclusion of Social Program Coverage

Even if you have dental coverage through government social programs, you can still qualify for the CDCP by meeting all eligibility criteria. The coverage coordination ensures no duplication, preventing gaps in oral health care.

Application Schedule for Canada Dental Care Plan by Different Age Groups

The application process is streamlined by age groups, starting with seniors aged 87 and above in December 2023. The timeline progresses through various age brackets, concluding with all remaining eligible Canadian residents in 2025. If you receive an invitation letter, follow the provided instructions to apply by phone. Ensure your address is up-to-date to receive notifications.

  • Seniors aged 87 and above: Applications open in December 2023.
  • Seniors aged 77 to 86: Applications open in January 2024.
  • Seniors aged 72 to 76: Applications open in February 2024.
  • Seniors aged 70 to 71: Applications open in March 2024.
  • Seniors aged 65 to 69: Applications open in May 2024.
  • Adults with a valid Disability Tax Credit certificate: Applications open in June 2024.
  • Children under the age of 18: Applications open in June 2024.
  • All remaining eligible Canadian residents: Applications open in 2025.

Partnership with Sun Life

Sun Life, the contracted service provider, manages the CDCP on behalf of the Government of Canada. Once approved, you will receive a welcome package containing essential information, your member card, and the coverage start date.

Accessing Oral Health Providers

Enrollment confirmation kicks off the process, allowing Canadian residents enrolled in the CDCP to start seeing oral health providers as early as May 2024. Appointments should align with the coverage start date mentioned in the welcome package.

Benefits, Covered Services and Reimbursement Structure

The CDCP comprehensively covers various oral health services, including preventive, diagnostic, restorative, endodontic, prosthodontic, periodontal, and oral surgery services. The reimbursement structure involves a percentage coverage of eligible expenses, with co-payments based on adjusted family net income.

Co-payment Breakdown

  • Adjusted Family Net Income Below $70,000:
    • CDCP covers 100%, patient covers 0%
  • Between $70,000 and $79,999:
    • CDCP covers 60%, patient covers 40%
  • Between $80,000 and $89,999:
    • CDCP covers 40%, patient covers 60%

Enrolment for Oral Health Providers

In a bid to expand access to quality care, oral health professionals, including dentists, denturists, dental hygienists, and specialists, can voluntarily enroll as participating CDCP providers with Sun Life, beginning in early 2024.

The Canadian Dental Care Plan is not just a financial support mechanism; it’s a commitment to fostering a nation with healthier smiles. As the CDCP unfolds, more details on annual reassessment processes and additional covered services will be communicated, ensuring a brighter and healthier future for all Canadians.