Canada Dental Care Plan 2024 Changes, More Coverage and Additional Services

Canadian Dental Care Plan (CDCP) is set to expand its coverage to provide better and more comprehensive oral health services for Canadians. With this expansion, more treatments will be included, helping millions of uninsured Canadians get the necessary dental care they need.

The CDCP, initially launched in 2023, targets Canadians who lack access to dental insurance, focusing on families earning less than $90,000 annually. The Government of Canada expects this initiative to improve oral health for up to 09 million uninsured residents.

Expanded CDCP Coverage Started in November 2024

From November 2024 onwards, the CDCP will include more advanced treatments that were previously either partially covered or unavailable. Below are the main additions to the dental care services that will require preauthorization for coverage:

• Complete Specialist Examinations: Thorough specialist dental examinations will now be included under the CDCP.
• Crowns: Crowns, which are used to restore damaged teeth, will require preauthorization.
• Root Canal Re-Treatments: Additional root canal treatments for previously treated teeth will be included.
• Dentures: This includes removable partial dentures, overdentures, and immediate dentures.
• Major Surgical Procedures: Complex surgeries, including procedures on gums, jaws, and other oral tissues.
• Sedation and Anesthesia: Moderate sedation, deep sedation, and general anaesthesia for dental procedures are covered upon approval.

Services Currently Covered by the CDCP

The Canadian Dental Care Plan covers a wide range of oral health services to ensure dental needs are met affordably. Some of the services already covered under the CDCP include diagnostic and preventive services, basic dental work, and minor surgeries.

Diagnostic and Preventive Services

• Dental Exams: Complete, routine, specific, and emergency dental exams.
• X-rays: To help diagnose oral health problems.
• Cleanings and Fluoride Treatments: Routine cleanings (scaling) and fluoride applications to prevent tooth decay.
• Sealants: To protect teeth from decay.

Basic Services

• Restorative Services: Includes permanent and temporary fillings, as well as pain management for diseased teeth.
• Endodontic Services: Root canal treatments, pulpectomies, and procedures to alleviate pain and infection are covered.
• Periodontal Services: Treatment of gums, cleaning under the gumline, abscess treatment, and non-surgical gum disease management.

Major Dental Services

• Crowns and Major Restorations: Crowns for restoring significantly damaged teeth.
• Removable Prosthodontic Services: Complete and partial dentures, including immediate dentures.
• Oral Surgery: Removal of teeth, tumours, cysts, and surgical procedures to treat oral issues.
• Anesthesia and Sedation: For procedures requiring pain management beyond local anaesthetics.

Future Services

• Orthodontic Services: Starting in 2025, orthodontic services will also be covered, but only in cases where there is a medical need.

Who Qualifies for the Dental Care Plan?

To qualify for the CDCP, individuals must meet the following criteria:

• Canadian Resident: Applicants must reside in Canada.
• No Dental Insurance: Applicants must not have access to dental insurance through employment or other sources, including personal dental insurance.
• Income Requirements: The annual family income must be less than $90,000. Individuals with an income below $70,000 do not have co-pays, whereas those between $70,000 and $90,000 will have varying co-pay responsibilities.
• Eligibility Groups:
  • Children under 18 years old.
  • Adults with a valid Disability Tax Credit certificate.
  • Adults aged 65 and above.

Additional categories of residents will be eligible to apply once the program’s next phase launches in 2025, expanding coverage to more groups across the country.

How Much Is Covered by CDCP?

The Canadian Dental Care Plan reimburses a portion of the cost for eligible dental services. The percentage of coverage is determined by adjusted family net income, as summarized below:

Co-Payment Examples

Here are some examples of how co-payments and additional costs apply for different family income levels:

• No Co-Payment: Jane, aged 86, with an adjusted family net income of $32,000, pays no co-payment. If her dentist charges $145 for teeth cleaning, and the CDCP established fee is $134, Jane pays $11, while the CDCP covers $134.
• 40% Co-Payment: Sam and Anne, with an adjusted net income of $76,000, must pay a 40% co-payment. If the total cost is $134, CDCP pays $80.40, while Sam pays $53.60 as a co-payment, plus any difference between the charged and established fees.
• 60% Co-Payment: Kate, aged 67, has an adjusted net income of $82,000 and must pay a 60% co-payment. If the cleaning costs $145 and the established fee is $134, Kate pays $91.40, while the CDCP covers $53.60.

What’s Next for the CDCP?

The CDCP is still evolving, with significant expansions expected in 2025. The government aims to ensure that comprehensive dental care is accessible to all Canadians, reducing financial barriers and ensuring quality oral health for everyone. Services such as orthodontics, previously not covered, will also be included based on strict medical criteria.

While the Canadian Dental Care Plan covers a wide range of dental services, it is important to understand that coverage limitations exist. Applicants should discuss costs and coverage with their dental providers before undergoing any treatments to avoid unexpected expenses.

• Preauthorization Requirements: Advanced treatments will require approval from the CDCP before they can be covered. Patients should work with their dental providers to get the required authorization.
• Co-Payments: Depending on the family income, applicants may need to cover a portion of the treatment costs.

This service is an ambitious step towards universal dental care in Canada, addressing long-standing issues of accessibility and affordability. As the plan continues to expand, more Canadians will gain access to essential dental services, significantly improving the country’s overall health outcomes.