The following are some important considerations:

1. Is my oral health provider participating in the Canadian Dental Care Plan?

   Unlike traditional benefit plans, oral health providers must enroll in the Canadian Dental Care Plan to treat patients. You should check with your oral health provider or ensure there is one in your community who plans on enrolling, as participation in the Canadian Dental Care Plan is on a voluntary basis.

   What this means for you: You may have to find a new oral health provider.

2. Will I pay out of pocket when covered by the Canadian Dental Care Plan?

   There are three main areas that could result in you paying out of pocket are:

   1. Application of co-payments. The Canadian Dental Care Plan will cover a percentage of eligible expensesbased on adjusted net family income. Those with adjusted family incomes between $70,000 to $89,999 will have co-payments between 40 to 60 per cent. 
      
      
   2. Charges greater than stated in the Canadian Dental Care Plan. Oral health providers are “encouraged” to follow the Canadian Dental Care Plan’s Fee Schedule, but they also have to consider their needs to run their practice. Therefore, your oral health provider may charge a higher price for their services beyond what is covered by the Canadian Dental Care Plan, and you will have to pay the difference.
      
      
   3. You agree to receive care that the Canadian Dental Care Plan doesn’t cover. The Canadian Dental Care Plan will only pay for oral health care services covered within the plan at the established Canadian Dental Care Plan fees. If you and your oral health provider agree to services that the Canadian Dental Care Plan doesn’t cover, you’ll need to pay the full cost of these services out of pocket.

   What this means for you: You may have to pay out-of-pocket if:

   • Your adjusted net family income requires co-payments
   • Your oral health provider charges more than the Canadian Dental Care Plan
   • You agree to receive oral health care that the Canadian Dental Care Plan does not cover

   Before receiving oral health care, you should always ask your oral health provider about any costs that won’t be covered by the plan. Make sure you know what you’ll have to pay directly to your oral health provider ahead of receiving treatment. For more information, visit What services are covered.

3. What services are covered by the Canadian Dental Care Plan?

   The Canadian Dental Care Plan has a defined list of oral health care services that will be covered; some of these services will only become available in November, 2024 and will require preauthorization for coverage. 

   What this means for you: oral health care services you require may not be covered, limited and/or delayed for approval.

   Details on services covered can be found on the Canadian Dental Care Plan website. More specific information regarding the coverage amounts available for specific services can be found in the Dental Benefits Guide.

4. Am I eligible for the Canadian Dental Care Plan?

   Application for the Canadian Dental Care Plan for other eligible individuals opens in phases. Invitation letters will be sent out to those with an adjusted family net income of less than $90,000 in phases extending to 2025. It is important to review the eligibility criteria of the Canadian Dental Care Plan:

   • Have no access to dental insurance – meaning not available through your employer or that of your family members’ employer benefits, health and wellness accounts, your pension or a family member’s pension benefits or an individually purchased plan.
   • Have an adjusted family net income of less than $90,000.
   • Be a Canadian resident for tax purposes.
   • Have filed your tax return in the previous year.

   Please note: Starting in the 2023 tax year, employers must indicate on their employees' T4 or T4A forms if the employee or any of the employee’s family members were eligible for dental insurance as of December each year.

   What it means to you: the program has been created for a limited number of Canadians, in particular for vulnerable populations, so you should be aware of eligibility criteria and potential delays in coverage before cancelling your current dental insurance.

5. Are you eligible for the Canadian Dental Care Plan in the future?

   Each year, you will need to meet the eligibility requirements to qualify for the Canadian Dental Care Plan. Please be aware that more details regarding the annual reassessment process are yet to be released.

   What it means to you: Your eligibility in future years is not guaranteed.