The Canadian Dental Care Plan (CDCP) provides a landmark change to Canada’s covered health care services, aiming to make dental care accessible and affordable. But it is important to understand if you qualify for coverage under the government program or if you still need dental insurance to cover the costs of dental health care.
Who is eligible for the Canadian Dental Care Plan?
Beginning June 2025, all Canadians are eligible to apply for the CDCP. Eligibility is based on various factors, if you do not have access to dental insurance through:
- your employment or pension benefits or a family member’s employment or pension benefits, including health and wellness accounts
- a professional or student organization
- personal dental insurance coverage bought by you or a family member
If you’re eligible for dental coverage through your employment benefits or through a professional or student organization, you’re not eligible for CDCP (even if you decide not to take it or use it).
You and your spouse/common-law-partner reside in Canada and (if applicable) must have filed your tax returns in Canada so that your family income can be assessed for the previous year.
Your adjusted family net income must be less than $90,000.
You need to meet all the eligibility criteria to qualify for the CDCP.
What is covered under the CDCP?
The Canadian Dental Care Plan (CDCP) will help pay a portion of the cost of a wide range of oral health care services when they are recommended by an oral health provider, including
- Diagnostic and preventive services to check and keep your teeth, gums and mouth healthy, and prevent cavities and gum disease and detect mouth conditions (like cancer) like dental exams, x-rays, cleaning (scaling) and fluoride applications
- Basic services to treat your gumline and teeth including cavities and broken teeth with fillings, root canals, cleaning and bonding
- Major services to restore teeth when they’re too damaged to be fixed, with crowns and replacement of missing teeth with dentures, or removal of teeth and surgery
- Anesthesia or sedation services.
In the future, orthodontic services may be added to the list of covered services.
For more information on services covered, consult the CDCP Dental Benefits Guide.
How does the CDCP compare to having dental insurance?
Your experience as a dental patient may be quite different if you are using the CDCP government plan vs. your dental insurance coverage.
First, you must qualify for CDCP based on your age and household income, however anyone can apply for any level of dental insurance benefit they need! And individuals coming off a group plan may apply for special plans designed just for them. Not all oral health providers are enrolled in the CDCP program; you would need to ask if the provider is enrolled in the program, otherwise you may be faced with unexpected out-of-pocket payments
With your dental insurance, you know that your provider will accept reimbursement from your plan for the benefits you are covered for
The CDCP program will cover 40% to 100% of covered dental care costs (based on eligible fees under the program). Households with income of less than $70,000 will be covered fully, those with household incomes of $70,000 to $79,999 will be covered for 60% of costs (and need to co-pay 40%) and households with income between $80,000 to $89,999 will be covered for 40% of the costs (and need to pay 60%).
Individual dental coverage is not based on earnings; some plans cover up to 80% of eligible costs, providing you with greater out of pocket cost protection than the CDCP may offer.
The CDCP fee schedule may not be the same as what providers charge. You may have to pay fees in addition to the potential co-payment if:
- the cost of your oral health care services is more than what the CDCP will reimburse for these services
- you and your oral health provider agree to services that the CDCP doesn’t cover.
Examples of CDCP Payments vs. Dental Insurance
Take a look at these government examples of CDCP co-payments and additional charges on the CDCP-PaymentFactsheet-EN.pdf
First, there is Jane who has an adjusted family net income of $32,000. She is covered 100% by CDCP. When Jane has an appointment to get her teeth cleaned, she still needs to pay her provider $11 which is not covered by CDCP. If Jane had dental insurance coverage, she may not have to pay out of pocket at all.
Next, there is Hakeem and his spouse, Anita, have an adjusted family net income of $76,000 and CDCP covers 60% of their care. This means that their family must pay 40% of the costs when Hakeem goes to get his teeth cleaned. If Hakeem had dental insurance for himself and his family, he would only be paying 20% of the costs out of pocket for his cleaning.
Finally, Kate and her spouse have an adjusted family net income of $82,000, and CDCP covers only 40% of their care. Kate must pay the other 60% of dental care costs they have. Under their own dental insurance plan, there would be only a 20% co-pay, and they could be covered more than 40% of costs for major care and could have orthodontic coverage too.
And for families with a household income of $90,000 or more, dental insurance is the only option for protection against out-of-pocket oral health care costs.
You must requalify for the CDCP every year, but dental insurance continues for life as long as you pay your premiums
If your household income changes or you forget to renew your coverage with CDCP, you may be left having to pay out of pocket unexpectedly.
Dental insurance is coverage you can depend on. It continues for your lifetime, as long as you continue to pay your monthly premium. And, most importantly, in many instances it covers more of the dental care costs you will face than the government program – giving you peace of mind that you can take care of you and your families oral health.
Dental insurance provides more than just dental coverage, unlike CDCP
Dental plans also provide a great range of other coverage for healthcare expenses, not just dental coverage, such as
- durable medical equipment including 100% coverage for diabetic medical supplies like, needles and syringes, up to the yearly maximum benefit level
- vision care
- registered specialists and therapists including chiropractors, chiropodists, naturopaths, registered massage therapists, physiotherapists, acupuncturists, and registered psychologists or psychotherapists
- homecare and nursing or personal support workers, therapists, and dieticians
- prosthetic appliances
- accidental dental
- accidental death and dismemberment
- ambulance
- hearing aids
- travel medical insurance.
Together, the comprehensive range of benefits built into a dental insurance plan provides a strong foundation that helps you manage healthcare expenses and get regular dental care too.
Want to ensure you have the dental cost protection you need?
At SBIS, we can provide you with a broad range of dental insurance options. We work with GreenShield Canada, GMS, and Manulife to offer competitive rates on coverage that can protect your family’s oral health for years to come. Give us a call or check us out online today.
