Blog
All of us are aware that oral health is an important part of our overall well-being. Regular dental check-ups significantly help reduce the risk of dental decay, gum disease, and other oral health issues. Ignoring oral health can ultimately lead to diseases like cardiovascular disease, stroke, etc.
Despite the important role of orthodontic treatment and oral health in our overall well-being, one-third of Canadians don’t have dental insurance. Sadly, one in four Canadians avoid visiting a dental professional due to the high costs.
However, we have good news for you. The Canadian Dental Care Plan (CDCP) aims to ease financial barriers to accessing dental healthcare for uninsured Canadian residents with an annual net income below $90,000.
In this article, we’ll delve into CDCP orthodontics and explain its details for you.
Read More: CDCP Braces
Who Qualifies for the Canadian Dental Care Plan (CDCP Insurance)?
To qualify for the CDCP Insurance, you must meet the following criteria:
- Not having the opportunity to access dental or orthodontics insurance
- Be a resident of Canada and have filed a tax return in the previous year
- Have an annual net income of less than $90,000
- You and your spouse/common-law partner must file Canadian tax returns to assess your family income for the previous year
You must be a Canadian resident for tax purposes.
What does not having access to dental insurance mean?
It simply means you do not have access to any type of dental insurance or coverage through:
- A professional or student organization
- Your employment benefits or a family member’s employment benefits, including health and wellness accounts
- Your pension benefits or a family member’s pension benefits (including federal, provincial, and territorial government employer pension plans)
- Coverage purchased by you or a family member or through a group plan from an insurance or benefits company
- If you’re eligible for dental coverage through employment benefits or professional/student organization, you’re not eligible for a Canadian Dental Care Plan (CDCP), even if:
- You don’t use it
- You have to pay a premium for it
- You decide not to take it
- If you take advantage of pension benefits or a family member’s pension benefits, you’re not eligible for CDCP, unless you’re retired and:
- You opted out of pension benefits before December 11, 2023
- You can’t opt back in under the pension rules
- If you purchased private dental insurance (not as part of the coverage described above), you’re not eligible for the CDCP while that coverage is in effect.
- If you have orthodontics coverage through a provincial, territorial, or federal government social program, you may still qualify for the Canadian Dental Care Plan (CDCP). Your coverage will be coordinated between plans to ensure no duplication or gaps.
When to Apply for the CDCP?
The CDCP is being implemented in phases over several months, with seniors as the initial beneficiaries.
|
Group |
Applications open |
|---|---|
|
Seniors aged 87 and above |
Starting December 2023 |
|
Seniors aged 77 to 86 |
Starting January 2024 |
| Seniors aged 72 to76 |
Starting February 2024 |
| Seniors aged 70 to 71 | Starting March 2024 |
| Seniors aged 65 to 69 | Starting May 2024 |
| Persons with a valid Disability Tax Credit certificate | Starting June 2024 |
| Children under 18 years old | Starting June 2024 |
| All remaining eligible Canadian residents | Starting 2025 |
How to Apply for the Canadian Dental Care Plan (CDCP)?
Eligible individuals can apply through “srv024.service.canada.ca.” To qualify, applicants must fall under one of the following four categories:
Group | When you can apply |
Aged 65 or older | Now |
Children under the age of 18 | Now |
Adults with a valid Disability Tax Credit certificate for 2023 | Now |
All remaining eligible residents (not in one of the above groups) | In 2025 |
To Apply online, please consider these notes:
- Do not submit more than one application.
- When applying for children (under 18), submit only 1 applications by one of their parapets or guardian.
- If you already enrolled in the CDCP, please avoid reapplying or contact Service Canada unless your access the dental/orthodontics insurance has changes. Your current coverage level will remain unchanged until June 30, 2025
Information Required to Complete Your Online Application
To complete your application, you will need to provide the following details for each applicant, as well as for your spouse or common-law partner (if applicable):
- Social Insurance Number (SIN) (if available for children):
- Date of birth
- Full name
- Home and mailing address
- List of dental coverage through government social programs (if applicable)
- You and your spouse or common-law partner (if applicable) must have filed your tax return for 2023 and have received your Notice of Assessment.
f you need more information, please visit Canada.ca.
What Is Covered By the Canadian Dental Care (CDCP)?
Based on Canada.ca/dental, the CDCP will cover a wide range of oral health, including:
- Oral Surgery services, including extraction
- Restorative services, including fillings
- Diagnostic services, including examinations and x-rays
- Preventive services, including scaling (cleaning), sealants, and fluoride
- Endodontic services, including root canal treatments
- Periodontal services, including deep scaling
- Prosthodontic services, including complete and partial removable dentures
Health Canada is working with provincial and territorial governments to coordinate the Canadian Dental Care Plan (CDCP) with existing publicly-funded oral health programs. This collaboration ensures seamless integration of benefits and avoids duplication of coverage.
To maintain the CDCP’s effectiveness and relevance, the program will undergo regular reviews based on data and evidence. These reviews will help identify opportunities for improvement and ensure the CDCP continues to meet the oral health needs of Canadians.
How Much the CDCP Program Is Covered?
Under the Canadian Dental Care Plan (CDCP), participating dental providers receive payments directly from Sun Life for covered services. CDCP fees may differ from fees suggested by provincial or territorial oral health associations.
CDCP patients may need to pay additional charges if:
- Their adjusted family net income is between $70,000 and $89,999, requiring a co-payment
- Their dental provider charges more than CDCP fees
- They agree to services not covered by the CDCP
Co-payments are determined by adjusted family net income:
- No co-payments for incomes below $70,000
- 40% co-payment for incomes between $70,000 and $79,999
- 60% co-payment for incomes between $80,000 and $89,999
CDCP patients should confirm any uncovered costs before receiving oral health care. Patients are responsible for paying the full cost of services not covered by the CDCP.
CDCP does not cover appointment cancellation or no-show fees, so patients must pay these fees themselves.
Benefits of Canadian Dental Care Plan (CDCP) at a Glance
Statistics show that most adults in Canada, between 60 to 79 years old, experiencing cavity and gum disease. Sadly, 16% of those leave untreated tooth decay.
Generally, as we age, our oral health can be affected by various factors, including:
- Sensitive teeth: Teeth may become sensitive to hot, cold, or touch.
- Dry mouth: A lack of saliva increases the risk of tooth decay.
- Exposed roots: Gums can pull away from teeth, exposing roots to harmful bacteria.
- Tooth loss: Older adults are more likely to lose natural teeth.
How CDCP Helps Seniors
CDCP covers various oral health services to address seniors’ common issues:
- Tooth decay, gum disease, and sensitivity: CDCP covers fillings, root canals, examinations, X-rays, and preventive treatments.
- Tooth loss: CDCP covers complete and partial removable dentures (with preauthorization).
- Limited autonomy and dexterity: CDCP covers some oral hygiene care in institutional settings.
For more information on CDCP eligibility, application process, and coverage details, visit Canada.ca/dental.
Services Covered by the Canadian Dental Care Plan (CDCP)
Diagnostic and preventive services
- A range of dental exams, including complete, routine, specific and emergency exams
- X-rays
- Cleaning (scaling)
- Fluoride applications
- sealants
Basic Services
Restorative services
- Permanent fillings
- Temporary fillings
- Pain control for diseased teeth
- Other treatments for cavities
Endodontic services
- Root canal treatments
- Pulpectomies (first step of a root canal treatment)
- procedures to reduce infection and provide temporary pain relief
- Retreatment of previously completed root canal treatment (requires preauthorization)
Periodontal services
- Cleaning under the gumline
- Treatment of abscesses
- Bonding for mobile teeth (requires preauthorization)
- Post-surgical evaluations (requires preauthorization)
- Non-surgical gum disease management
Major Services
Restorative services
- Posts and post removal
- Repairs to crowns and rebonding of crowns and posts
- Crowns (requires preauthorization)
- Cores (to support crowns) (requires preauthorization)
- Posts for crown (requires preauthorization)
Removable prosthodontic services
- Complete dentures, including standard and temporary dentures
- Denture repairs, relines and rebases
- Placing lining in dentures to condition oral tissues (for comfort and healing)
- Complete immediate and overdentures (requires preauthorization)
- Initial placement of partial dentures (requires preauthorization)
- Replacement of partial dentures
Oral surgery
- Removal of teeth and roots
- surgical removal of tumours and cysts
- Surgical incisions, including draining
- Treatments for jaw bone fractures
Anesthesia/Sedation services
- Minimal sedation (conscious)
- Moderate sedation (requires preauthorization)
- Deep sedation (requires preauthorization)
- General anaesthesia (requires preauthorization)
Orthodontic Services
In 2025, orthodontic services will be added to the CDCP. Coverage will be limited to cases of medical necessity based on strict criteria, and there will be a maximum spending limit for these services.
Note: Stay tuned for further updates and detailed guidelines regarding the inclusion of orthodontic services.
How Easy Is It to Confirm Participation for the CDCP?
Digitally via Sun Life Direct (SLD)
Log in to SLD
Enter your unique identification number (UIN).
Via a paper form
Go to sunlife.ca/cdcp or call the CDCP call center.
Download and complete the PDF form.
FAQ
Some orthodontic services will be added to the CDCP starting in 2025. Orthodontic services will only be covered in cases of medical need based on stringent criteria and will include a maximum spending limit.
Starting in 2025, the Canadian Dental Care Plan (CDCP) will include coverage for some orthodontic services. Please note that orthodontic treatments like Invisalign, metal braces, or Invisaign retainers will only be covered by CDCP in cases of medical necessity, based on strict criteria.
Yes, many insurance plans cover various orthodontic treatments, including Invisalign. Here are some examples:
- Canada Life: If your policy includes orthodontic coverage, it would likely covers Invisalign treatment.
- Pacific Blue Cross: Through employer plans, they cover the cost of orthodontic treatments like Invisalign, up to 60%
- Manulife: Policies covering orthodontic treatment may include Invisalign coverage, up to 50%.
- Sunlife: Covers 90% of Invisalign costs. This insurance is typically provided by employer.
- Green Shield Canada: Covers 50% of orthodontics (including Invisalign) up to a lifetime maximum of $5,000.
- OTIP: Similar to Green Shield Canada, it provides with a life time maximum.
As of January 2025, Invisalign coverage in Canada primarily depends on your specific orthodontic insurance plan. The Canadian Dental Care Program (CDCP) is set to include orthodontic services, including Invisalign, but coverage will be limited to cases of medical necessity based on strict criteria and will have a maximum spending limit. Meanwhile, many private dental insurance providers offer varying levels of orthodontic insurance coverage for Invisalign, ranging from partial reimbursement for consultations and fittings to covering a percentage or even the full cost of treatment, depending on the plan. It's important to review your insurance policy details or contact your orthodontic insurance provider directly to understand the extent of Invisalign coverage available to you.
Bottom Line
At York Orthodontics, we believe it’s our responsibility to raise awareness in the community about the significant role oral health plays in overall well-being. We’re committed to sharing the latest news and information to help improve community health.