Cost of the Canadian Dental Care Plan (CDCP)

• Adjusted Family Net Income Lower than $70,000: The CDCP covers 100% of eligible oral health care service costs at the CDCP established fees. You may face additional charges if the service costs exceed the CDCP fees.
   
• Adjusted Family Net Income Between $70,000 and $79,999: The CDCP covers 60% of eligible oral health care service costs at the CDCP established fees. You will be responsible for 40% of the CDCP fees, plus any additional charges if the service costs exceed these fees.
   
• Adjusted Family Net Income Between $80,000 and $89,999: The CDCP covers 40% of eligible oral health care service costs at the CDCP established fees. You will be responsible for 60% of the CDCP fees, plus any additional charges if the service costs exceed these fees.

While the CDCP covers a significant portion of dental care costs, there may be additional charges you need to consider:

Cost of Services Exceeding CDCP Fees

• The CDCP will only pay for services covered within the plan at the established CDCP fees. If your oral health care provider charges more than the CDCP fees, you will be responsible for paying the difference.

Services Not Covered by CDCP

• Some dental services, such as cosmetic procedures or treatments outside the plan’s scope, are not covered by the CDCP. You will need to pay for these services out of pocket.

Preauthorization Requirements

Certain dental services under the CDCP require preauthorization. Preauthorization is a process where prior approval is required based on the recommendation of your oral health provider before the treatment is provided. This ensures that the treatment will be covered under the plan. Services requiring preauthorization will be available starting in November 2024.

Understanding Co-payments

A co-payment is the portion of the dental care cost that you must pay out of pocket. Your co-payment percentage depends on your adjusted family net income and is calculated based on the CDCP established fees.

Co-payment Structure

• Income Lower than $70,000: 0% co-payment.
• Income Between $70,000 and $79,999: 40% co-payment.
• Income Between $80,000 and $89,999: 60% co-payment.

To effectively manage your dental care costs under the CDCP, consider the following tips:

1. Discuss Costs with Your Provider

• Before receiving treatment, discuss the costs with your oral health provider. Ensure you understand which services are covered and any potential additional charges.

2. Check Preauthorization Requirements

• For services requiring preauthorization, ensure that your provider submits the necessary documentation and receives approval before proceeding with treatment.

3. Budget for Co-payments

• Plan and budget for your co-payments and any additional charges not covered by the CDCP. This will help you avoid unexpected expenses.