Accessing affordable dental care is essential for maintaining your overall health and well-being. Navigating dental expenses without support from the Canada Dental Care Plan (CDCP) can feel overwhelming, but you’re far from alone. Whether your family income slightly exceeds the CDCP threshold, you’re self-employed, or your dental care needs simply fall outside the program’s criteria, there are multiple pathways to protect your smile without breaking the bank.
Let’s dive into practical solutions to keep your oral health on track.
Understanding Why You Don’t Qualify
Before exploring alternatives, it helps to confirm exactly why the CDCP isn’t accessible to you. The CDCP targets specific groups—low- and middle-income families, seniors, and persons with disabilities—under set income caps and residency requirements. If your household income, or employment status doesn’t align, you’ll need to look elsewhere for coverage.
Your income is above the CDCP threshold
Eligibility is limited to households earning under $90,000 annually, with full coverage only available to those earning under $70,000.
You are eligible workplace or other existing dental coverage
If you have access to dental coverage, you don’t qualify for CDCP but may face the problem of “under-insurance” — your dental plan doesn’t cover necessary dental work you need.
You (or your spouse) haven’t filed your individual tax return in Canada for the most recent tax year or are not a Canadian resident for tax purposes
CDCP coverage may not cover your needs
While the CDCP covers a wide range of essential dental treatments, it does not cover all treatments you or your family may need. The plan primarily focuses on preventive and basic dental services, such as cleanings, exams, fillings, and some types of oral surgery. In fact, more than 90 per cent of claims, like basic cleanings or fillings, don’t require pre-authorization.
The CDCP will reimburse a portion of the cost of your treatment, but it may not pay the full amount. You may have to pay additional charges directly to the oral health provider, if:
- your adjusted family net income is between $70,000 and $89,999
- the cost of your oral health care services are more than what the CDCP will reimburse for these services, or
- you and your oral health provider agree to services that the CDCP doesn’t cover.
The plan does not cover cosmetic treatments like teeth whitening, orthodontics, and certain aesthetic procedures.
The plan currently allots only one hour of scaling per year for adults. Teenagers get just 15 minutes of scaling. This may not be sufficient for your needs, particularly if you have not had recent dental care.
Your claim for complex dental work may be rejected under CDCP
If you need coverage for major procedures like root canal treatments or dentures, it’s important to check the specifics of what your CDCP benefits include. For example, CDCP may limit denture replacement to every eight years.
While the vast majority of CDCP claims don’t need pre-authorization, it’s required for more complex and often more expensive procedures, like crowns or partial dentures. Clinics must submit extra documentation like X-rays and dental charts to show the work is medically necessary before it can be covered and completed.
The CDCP experienced and may continue to experience some growing pains. Health Canada said 52 per cent of requests for pre-authorized dental work between November 2024 and June 2025 was rejected.
CDCP is not necessarily a ‘free of charge’ program. Some patients depending on their CDCP coverage are getting an unexpected ‘balance owing’ bill as the program reimburses dental clinics at a rate lower than the provincial fee guides, which clinics most often use to set their rates.
For those requesting pre-authorization for procedures like crowns, the waiting time can be weeks or months. Pre-authorization applications for additional scaling needs are generally rejected entirely.
Patients, including seniors, should remember they need to reapply every year.
Exploring Dental Insurance Options
When CDCP is off the table or you are concerned about your level of dental coverage and cost, having your own dental insurance could be the key.
Dental insurance can reduce your out-of-pocket costs for routine and unexpected dental care, plus provide the peace of mind that comes from having the financial protection of insurance. With dental insurance, you have better access to the preventative care you need to keep your teeth healthy and beautiful. The better you take care of your teeth now, the lower your future costs for dental care will be.
Special Benefits Insurance Services makes it easy to obtain affordable dental insurance, which is important given the increasing cost of dental care. Our dental plans offer Basic Coverage, Comprehensive Basic and Major Services coverage.
We understand – dental insurance can seem complicated, especially in Canada, where the introduction of the limited Canadian Dental Care Plan Government funded options have added to the many private options available.
Dental insurance monthly premiums can vary widely depending on the level of coverage you choose based on:
- Generally, you’ll find that basic dental plans can be quite budget-friendly, offering core services like exams, cleanings and x-rays for a low monthly cost.
- If you’re seeking broader protection, such as coverage for fillings, root canals, crowns or even orthodontic work, expect your premiums to be higher—though these plans may save you more over time by reducing your out-of-pocket expenses when the unexpected happens.
- Plan costs vary depending on whether there are waiting periods for certain treatments like restorative and orthodontic procedures.
Taking the time to review the details will help you find the right balance between cost and comprehensive coverage for your specific dental health needs. All dental plans include basic services and most cover comprehensive services. Major services may not be included, so choose your plan as you need, and pay attention to maximums within your plan.
You can select coverage to fit your needs and budget for yourself and dependent family members.
There are no medical questions, but a waiting period may apply.
Missing out on CDCP support doesn’t close the door on affordable dental care
By combining your individual dental plan with good dental care preventive habits, you can design a cost-effective approach to your oral health that fits your budget and lifestyle. With a clear, proactive plan, you’ll maintain your smile—and your wallet—well into the future. Go online today to explore your options and get a quick quote.
