Government also expands access to Canadian Dental Care Plan

THE federal government announced on Monday that it is taking action to make it easier for oral health providers, including dentists, dental hygienists, denturists or dental specialists, to treat patients and submit Canadian Dental Care Plan (CDCP) claims.

To date, close to 12,000 providers have signed up to the CDCP and more continue to join every day. The government said it has heard that some providers prefer not to formally sign on to the program but would still like to see CDCP patients. Starting July 8, eligible providers in Canada can now provide services to CDCP clients on a claim-by-claim basis without formally signing up.

To limit out-of-pocket costs for CDCP patients, providers seeing a CDCP patient will need to agree to bill Sun Life directly and accept payment for services covered under the CDCP, regardless of how they choose to participate. Once a claim is approved, providers will receive reimbursement from Sun Life within 48 hours initially, and we will move towards a 24-hour turnaround time.

This means that Canadians covered by the CDCP will be able to see the provider of their choice, as long as their provider agrees to bill Sun Life directly. For those who don’t already have a provider, they can talk to a dentist, dental hygienist, denturist or dental specialist in their community or consult Sun Life’s CDCP Provider Search tool to find providers who have confirmed their participation in the CDCP.

CDCP patients may have to pay additional charges, in addition to their co-payment, if applicable, depending on the services received and the cost of the treatment. Before receiving any services, CDCP patients should always ask their provider about any additional costs that won’t be covered by the plan.

The government said that providers play a vital role in delivering oral health care, and the CDCP is allowing more Canadian residents to benefit from their care. It added that it is committed to working with partners to improve access and provide more affordable dental care to eligible Canadians across the country.

The CDCP is one of the largest social programs in Canadian history and, once fully implemented, will provide oral health care for up to 9 million eligible Canadians. As of today, more than 2.1 million Canadians have already been approved under the Plan and approximately 250,000 members have received care under the CDCP.

Health Minister Mark Holland said: “Allowing providers options for how they provide care to CDCP clients means that more people will be able to receive affordable dental care. We are dedicated to collaborating closely with oral health partners to make sure that all CDCP members enjoy equitable access to affordable care. This is something every Canadian deserves.”

Ginette Petitpas Taylor, Minister of Veterans Affairs and Associate Minister of National Defence, said: “Dental care is an integral part of our health and well-being. We’re making it easier for more Canadian families to access quality dental care. This change reduces out-of-pocket costs for families and speeds up reimbursements, making dental services more accessible and affordable across the country. It’s another concrete step towards fairness for every generation.”

(The federal government also announced that eligible children under the age of 18 and adults with a valid Disability Tax Credit certificate can apply for the Canadian Dental Care Plan (CDCP). With applications now open for two new groups of Canadians, another 1.2 million people will have access to improved dental care. This means approximately 938,000 children and close to 183,000 adults with a valid Disability Tax Credit certificate will have more affordable access to the oral health care that they need.)

Quick Facts

• The claim submission process is the same regardless of how the provider chooses to participate in the plan – they can submit claims directly to Sun Life and be reimbursed either by Electronic Funds Transfer (EFT) within 48 hours (moving toward a 24-hour turnaround time) if they have a Sun Life Direct account, or by receiving a cheque on a monthly basis.
• For providers who have formally signed up, there is no change or impact to their participation or how they file claims.
• CDCP provider participation is entirely voluntary. Oral health providers eligible to participate and who can bill for services include:
  • dentists
  • denturists
  • dental hygienists
  • dental specialists
• For more information on how providers can participate or see CDCP patients on a claim-by-claim basis, please visit Canada.ca/dental or Sun Life.
• Oral health providers can find information on how to submit claims as well as a side-by-side comparison of the two provider participation options here.
• To qualify for the CDCP, you must be a Canadian resident with an adjusted family net income of less than $90,000, not have access to employer/pension-sponsored or private dental insurance and have filed your 2023 tax return.
• The CDCP is now open to eligible seniors, adults with a valid Disability Tax Credit certificate, and children under 18. All remaining eligible Canadian residents between the ages of 18 and 64 will be able to apply online in 2025.
• Those who successfully apply to the CDCP will receive a welcome package within approximately three months of their application, which will include the coverage start date (benefit effective date). You can track the status of your application online.

Associated Links

Canadian Dental Care Plan – Apply
CDCP Provider Search Tool
OHAF Call for proposals