Canadian Dental Care Plan (CDCP)
What is the CDCP?
Eligibility & Requirements
Individuals must satisfy many essential criteria to qualify for the Canadian Dental Care Plan (CDCP). They must be Canadian residents for tax purposes and possess an adjusted family net income below $90,000. Applicants must not own any other dental insurance coverage, whether obtained through employment, a pension plan, a family member, or voluntary insurance. The “no access” policy is stringent; even the refusal of a proposed dental plan is considered as having access and results in the disqualification of eligibility. Furthermore, candidates are required to have submitted a tax return for the preceding year to verify their income level. The CDCP was initially implemented for seniors, children, and individuals with disabilities, but by 2025, it will encompass all income-eligible adults who satisfy these criteria. The initiative seeks to guarantee accessible dental treatment for Canadians lacking private or employer-sponsored dental insurance.
What Dental Services Are Covered
CDCP encompasses a wide range of oral health services, categorized accordingly. Many services necessitate preauthorization if they surpass conventional limits or include greater complexity.
The primary categories are as follows:
Diagnostic and Preventive
- Dental examinations (regular, emergency)
- X-rays
- Cleanings / Scaling
- Fluoride Treatments
- Sealants
Restorative / Basic
- Fillings (Permanent and Temporary)
- Pain control for decayed teeth
Endodontics (root canal / related)
Root canal treatment, pulpectomy, retreatments (with preauthorization)
Periodontal (gums and supporting structures)
- Subgingival cleaning, abscess treatment, non-invasive periodontal therapy.
- Attachment of movable teeth, post-operative assessments (some necessitate preauthorization.)
Prosthodontics (removable dentures, etc.)
- Full dentures, partial dentures, denture repairs, relining, rebasing.
- Certain prosthodontic services necessitate preauthorization for eligibility.
Oral Surgery
- Extraction of teeth and excision of roots.
- Surgical excision of neoplasms and cysts; treatment of mandibular fractures.
Sedation / Anesthesia
- Minimal sedation is covered.
- Moderate, deep sedation, general anesthesia are possible but require preauthorization.
Orthodontics (coming in 2025)
- Orthodontic services are not yet broadly covered; starting in 2025, limited coverage will be available for cases of medical necessity, under strict criteria.
Cost Sharing / Co-Payments & Fees
Because CDCP is not free care, cost sharing is structured based on adjusted family net income. The proportion covered by the CDCP (versus what the patient must pay) is roughly:
| Income bracket | CDCP pays | Patient co-payment (of CDCP “established fees”) |
| Below $70,000 | 100 % | 0 % |
| $70,000 – $79,999 | 60 % | 40 % |
| $80,000 – $89,999 | 40 % | 60 % |
A few notes:
- “Established fees” means there is a fee schedule defined by CDCP for specific dental procedure codes. These may be lower than what dentists customarily charge. If a dentist charges more than the CDCP fee, the patient might have to pay the difference (if the dentist agrees to do so).
- For services beyond the frequency limits, or services that require preauthorization, the CDCP may grant exceptions, but the dental provider and the patient need to follow submission and approval rules.
- Some services are explicitly excluded (see section below).
Exclusions & Limitations (What CDCP Does Not Cover)
CDCP does not cover certain types of dental services. Some typical exclusions are:
- Cosmetic procedures (e.g. tooth whitening, veneers)
- Implants (dental implants) are not covered under CDCP.
- Fixed prosthodontics (permanently affixed bridges, etc.), bone grafting, and certain specialized adjunctive procedures.
- Services already declined by the CDCP through preauthorization or not eligible under its policies.
- Some minor services or adjustments have changes in coverage over time (for example, a few services removed in the 2025 update).
Also, not all dentists necessarily participate in CDCP (i.e. agree to bill CDCP under its reimbursement rules). Patients need to check whether their dental provider participates.
Application, Enrolment & Implementation
- The government began a staggered rollout from late 2023 into 2025, starting with elderly populations and children, then expanding to all eligible income-qualified persons.
- Eligible individuals will receive a letter inviting them to apply.
- Once enrolled, individuals get a CDCP card, coverage details, and a start date for coverage. Only services rendered after the coverage start date are covered.
- Providers must confirm client’s coverage before providing treatment (via an Electronic Data Interchange estimate or via contact).
- For services needing preauthorization or exceeding certain frequency limits, providers submit documentation ahead of time; some services might also use post-determination in emergencies.
- The CDCP Dental Benefit Grids (procedure codes with allowable amounts) are published (e.g. 2025 grids).