The new Canadian Dental Care Plan: bringing dental coverage to lower income, uninsured Canadians.

According to many provincial healthcare providers in Canada, teeth don't qualify as a body part they're worried about.

Providing dentalcare is largely an issue that’s left up to employers to solve. But where does that leave those without supplemental insurance provided by their workplace? Those who work in industries where health programs aren’t standard, those who work part-time and don’t qualify, or lastly, the +1.5M unemployed Canadians?

Poor oral health can lead to numerous other health complications, mental health problems, and lower quality of life.[1] As dental heath is an important part of our overall health, it was determined that it should be included in our healthcare.

First, the government introduced the Canada Dental Benefit which provided eligible parents of children under 12 with a flat tax-free benefit of up to $650 annually. But now they have a new plan called the Canadian Dental Care Plan which will replace the Canada Dental Benefit and offer more coverage to more people.

The government anticipates this new plan will help up to 9 million uninsured Canadians access dental care.

Sun Life will administer the plan in conjunction with Health Canada.

Your most important takeaway is that to receive this benefit, you must file your previous year’s tax return. This is how the government will determine if you qualify or not.

Here's everything you need to know about the new Canadian Dental Care Plan: who qualifies, what’s covered, and how to access this benefit.

Qualifications.

You’ll be eligible for the Canadian Dental Care Plan if you:

• Are a resident of Canada.
• Have an adjusted family net income of less than $90,000.
• Don’t have private dental insurance.
• Filed your previous years’ income tax return.

What’s covered?

The Canadian Dental Care Plan (CDCP) helps cover costs for oral health services recommended by a dental provider. This includes:

• Preventive services, including scaling (cleaning), polishing, sealants, and fluoride.
• Diagnostic services, including examinations and x-rays.
• Restorative services, including fillings.
• Endodontic services, including root canal treatments.
• Prosthodontic services, including complete and partial removable dentures.
• Periodontal services, including deep scaling.
• Oral surgery services, including extractions.

This includes the following oral health providers:

• Dentists
• Denturists
• Dental hygienists
• Dental specialists

Oral health care providers will also be able to enroll directly with Sun Life on a voluntary basis to participate in the CDCP. Those providers must have a valid license and be in good standing in their province/territory to receive approval.

How much coverage can some get under this plan?

Coverage relies on adjusted net income. The thresholds for coverage access are:

• Full coverage: Those with adjusted net income less than $70,000.
• 60% coverage: Those with adjusted net income between $70,000 and $80,000. They’ll have a co-payment of 40%.
• 40% coverage: Those with adjusted net income between $80,000 and $90,000. They’ll have a co-payment of 60%.

How can people access this coverage?

The government will send letters to eligible seniors in December 2023 to encourage them to apply for the benefit by phone. They’ll start taking online applications in June 2024 for other categories of applicants.

After approval, eligible taxpayers will get a welcome package from Sun Life with their member card and coverage start date. Then, claimants will bill the plan directly for the cost of eligible treatment.

Group	Applications open
Seniors 87+	Mid-December 2023
Seniors aged 77 to 86	January 2024
Seniors 72 to 76	February 2024
Seniors 70 to 71	March 2024
Seniors 65 to 69	May 2024
Disabled persons with a certified T2201	June 2024
Children under 18	June 2024
All remaining eligible Canadian residents	2025

You may have more questions about this benefit. While the details are still being worked out, here are some answers to your pressing questions.

Q: What if I have coverage under my province/territory?

A: The Government of Canada has engaged provinces and territories on the CDCP and is encouraging them to maintain their existing dental programs and to continue investing in oral health. The CDCP is not intended to be a replacement for existing dental benefits offered through employer/pension-sponsored or private plans. It’s intended to fill existing gaps in coverage and complement existing provincial and territorial dental programs.

Q: What’s the definition of not having access to dental insurance?

A: You’d be considered someone who doesn’t have access to dental insurance if you don’t get dental coverage through your employer or a family member’s employer benefits, or through your pension or a family members’ pension, including health and wellness accounts. You’d also fit the description if you or a family member haven’t purchased dental insurance through a group plan from an insurance or benefits company.

Q: How quickly can I start seeing an oral health care provider?

A: Once your enrolment is approved into the CDCP, you could start seeing an oral health provider as early as May 2024 (starting with seniors). See the chart above with enrolment dates. Don’t book an oral health appointment until after your coverage start date in order to be covered under the plan, as they won’t reimburse for services received before the start date.

Q: I’m a public servant. Is this plan for me?

A: No. the government introduced the Public Service Dental Care Plan for federal public service employees and their eligible dependants.

Q: I’m eligible for this benefit but I haven’t filed my taxes. Is this a problem?

A: You must file your income tax return in order to qualify for this benefit. This is the proof the government needs to determine if you meet the income threshold. File your tax return as soon as possible so you can finalize your application.

If you still need to file your tax return and want to learn more about this new benefit, H&R Block Tax Experts are here to help! Find an office near you to book an appointment today.

¹ https://www.canada.ca/en/health-canada/news/2023/12/the-canadian-dental-care-plan.html