Canada's new dental care plan could impact nearly 9 million Canadians — are you one of them?
In its current form, plan is expected to cost the federal treasury about $4.4B a year
The federal government unveiled details about its highly anticipated Canadian Dental Care Plan (CDCP) earlier on Monday.
The CDCP is a $13-billion insurance program that will start covering most basic dentistry costs next year for uninsured Canadians with a household income under $90,000.
That's about nine million Canadians, according to the federal government. In its current form, the plan is expected to cost the federal treasury about $4.4 billion per year.
Applications will first open to eligible seniors aged 87 and older. Applications for other age groups will then be phased in with a staggered approach, with the process opening up to all eligible applicants aged 18 and above sometime in 2025.
According to NDP Leader Jagmeet Singh, his party "forced" Ottawa to enact the program as a condition of the confidence-and-supply agreement that could keep the Liberals in power until 2025.
"People are living with pain, people are worried about the cost if they do have to go to the dentist," he told a news conference in Toronto on Monday.
CBC News has been fielding questions about the CDCP since the announcement. Here are some of those questions answered.
Who pays for what under the CDCP?
The CDCP will help cover the cost of various oral health-care services, with the focus on "those deemed medically necessary by an oral health-care professional," an information officer with the general information line for the government of Canada told CBC News.
Services covered under the Canadian Dental Care Plan include:
- Preventive services, including scaling (cleaning), polishing, sealants and fluoride.
- Diagnostic services, including examinations and X-rays.
- Restorative services, including fillings, crowns and dentures.
- Endodontic services, including root canal treatments.
- Prosthodontic services, including complete and partial removable dentures.
- Periodontal services, including deep scaling.
- Oral surgery services, including extractions.
Some of these services will be available in the fall of 2024. Other services such as teeth whitening, implants and mouth guards will not be covered under the plan.
Applicants with household incomes below $70,000 will not have to pay participating dentists, hygienists or denturists — Ottawa will pick up the tab for covered services.
Families with incomes between $70,000 and $79,999 will see 60 per cent of service fees covered by the government. The other 40 per cent they will have to cover out of pocket in what's known as a co-pay.
For those in the $80,000 to $89,999 income bracket, the co-pay jumps to 60 per cent, with the federal plan covering the rest of the costs.
Who is eligible?
To qualify for the CDCP, applicants must have an annual adjusted family net income under $90,000 and cannot have access to other dental insurance. All eligible applicants will receive a letter inviting them to apply, according to the government's announcement.
Applicants must be a Canadian resident for tax purposes, and an income tax return from the previous year must have been filed prior to applying for the CDCP.
The information officer said applicants will be reassessed every year to confirm they still meet eligibility requirements, but those reassessment details will be provided at a later date.
Applicants who have access to dental benefits through a program offered by a province, territory or the federal government can still apply for the CDCP if they meet all eligibility criteria, they said.
Is the cut-off income before or after taxes?
Applicants must have an adjusted family net income of $90,000 or less to qualify for the CDCP. This is not the family net income, which is the sum of line 23600 on your tax return, line 23600 on your partner's tax return and any world income not reported in a tax return to the Canada Revenue Agency.
To find your adjusted family net income, the government of Canada's website says to subtract any income from universal child care benefits (UCCB) and registered disability savings plans (RDSP) from your family's net income. These amounts can be found on lines 11700 and 12500 on your and your partner's tax returns.
Next, add any repaid UCCB and RDSP amounts to that total — these are found on lines 21300 and 23200 on your and your partner's tax returns.
This final amount is your adjusted family net income. This total will determine whether you meet the $90,000 threshold and how much co-pay you will have to cover if you qualify.
Can I use CDCP with my employer's plan?
Canadians who have access to dental insurance are not eligible to apply for the CDCP. According to the government of Canada's website, this includes individuals who:
- Have dental insurance through their employer or a family member's employer benefits, including health and wellness accounts.
- Have dental insurance through their pension from a previous employer or a family member's pension benefits.
- Have dental insurance purchased by themselves, by a family member or through a group plan from an insurance or benefits company.
In early 2024, oral health providers, including dentists, denturists and dental hygienists, will be able to enrol on a voluntary basis as a participating CDCP provider directly with insurance company Sun Life, which is administering the program.
Can I use my current dentist, denturist or dental hygienist?
If enrolled, oral health providers will directly submit claims to Sun Life for reimbursement; and if there's a co-pay, those using CDCP will pay the cost out of pocket to the provider.
In his Monday announcement, Singh said they worked hard to ensure the CDCP would be supported by all oral health professionals and opened up applications to all providers.
"So people should be able to use this to go to their local dentist, the one they've been going to before," he said.
But federal Health Minister Mark Holland acknowledged the government "still has work to do" to guarantee the country's dentists will provide services to publicly insured clients.
"The core success of this plan is making sure oral health professionals are signing up," he said. "I'm extraordinarily optimistic there is going to be very strong uptake."
If I'm eligible, when can I apply?
Applications for the CDCP will be opened in December, initially over the phone. Only eligible seniors aged 87 and older can apply at first. Applications for other age groups will be phased in with a staggered approach.
Starting in January 2024, seniors aged 77 to 86 can apply, followed by seniors aged 72 to 76 in February, and seniors aged 70 to 71 in March.
Seniors aged 65 to 69 can start applying in May 2024 — the same month the application process switches from telephone to online.
People with valid disability tax credit certificates and children under 18 will be able to apply starting in June 2024. Eligible low- and middle-income Canadians between the ages of 18 and 65 can start applying in 2025.
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With files from John Paul Tasker
