Canadian Dental Care Plan– Seniors or Disability or Children Now Qualify
Last December 2023, the federal government announced the introduction of the new Canadian Dental Care Plan (CDCP). The Plan will help make the cost of dental care more affordable for eligible Canadian residents. About nine million Canadians do not have access to dental care coverage. They have no access to dental insurance through their work, a pension plan, or a private plan.
The CDCP will provide coverage for those without access to dental insurance and who have a family income of under $90,000.
The application process started in December 2023, starting with the oldest of seniors and now all seniors 65 and older can apply if you haven’t already.
And the application process recently opened to families with children under 18 and those who have a valid Disability Tax Credit Certificate.
You can currently apply through Service Canada if you are:
- 65 or older;
- 18 to 64 and have a valid Disability Tax Credit Certificate;
- Family with children under age 18;
- 16 or 17 and live independently from your parents.
You must have filed your 2023 tax return and have received your 2023 Notice of Assessment.
Disability Tax Credit
Starting June 27, 2024, all adults 18 to 65 with a valid Disability Tax Credit Certificate can now apply. Check your Disability Tax Credit status. Is it indefinite and you do not need to re-apply? Or is there an expiry date? If it expired 2023 or earlier and you believe you still qualify, make sure you get a new Disability Tax Credit Certificate completed by your doctor and submitted to CRA.
Applying on behalf of your child
Also starting June 27 2024, families with children under the age of 18 can also apply. You can apply on behalf of your child if you are the parent or legal guardian of the child, and the child is under 18 years old.
If you have shared custody of a child, do not submit multiple applications for a single child. Only one parent should apply per child.If you have a shared custody agreement for the child, eligibility for the plan and the amount covered is based on the parent or legal guardian that applies to the Plan. The child’s eligibility and amount covered may change if another parent or legal guardian applies for that child.
You Do NOT have access to any type of dental insurance
You are only eligible for the CDCP if you do not have access to any type of dental insurance or coverage through:
- your employment benefits or a family member’s employment benefits, including health and wellness accounts;
- your pension benefits or a family member’s pension benefitsthis includes federal, provincial and territorial government employer pension plans;
- a professional or student organization (chamber of commerce or university);
- coverage purchased by you or a family member or through a group plan from an insurance or benefits company;
- if you purchased your current dental insurance policy privately, you’re not eligible for the CDCP while that coverage is in effect.
Exception: You may be eligible for the CDCP if you’re retired andyou opted out of pension benefits before December 11, 2023, andyou can’t opt back in under the pension rules.
The tax slips issued by your employer or pension payor now indicate if you have access to a health plan or not.
Dental coverage through government social programs
If you have dental coverage through a provincial, territorial, or federal government social program, you can still qualify for the CDCP. If you qualify, your coverage will be coordinated between the plans to make sure there are no duplication or gaps in coverage.
Apply online or by phone
You’ll need to provide all of the following information about yourself and your spouse or common-law partner (if you have one) and your child’s (if applicable):Social Insurance Number (SIN), date of birth, full name(s), and home and mailing address. You and your spouse or common-law partner (if applicable) must have filed your tax return for 2023 and have received your Notice of Assessment.
You are encouraged to apply online. If you can’t apply online, you may apply by phone: 1-833-537-4342.
Applying with the help of someone you trust
You can ask a trusted person to help you apply online or by phone. This could be a:friend, relative, caregiver, translator, orinterpreter, or friendly tax professional!
If you apply by phone, you must be able to give clear consent that you agree to let them help you.
The applicant will immediately be notified whether they have been successful in applying and are eligible. They will also receive a letter confirming this information.
Dental coverage through government social programs
If you have dental coverage through a provincial, territorial, or federal government social program, you can still qualify for the CDCP. If you meet all the eligibility criteria, your coverage will be coordinated between the plans to ensure there are no duplication or gaps in coverage.
Sun Life is the Provider
Once an individual is determined to be eligible, Service Canada will share the applicant’s information with Sun Life, who will enroll eligible applicants in the CDCP and will send them a welcome package, including information on the CDCP, coverage details, their member card, and the start date of their coverage.
What is covered?
The plan will cover services by dentists and dental hygienists, as well as specialists including oral surgeons and periodontists. Examples of services that will be covered include cleaning, polishing, sealants and fluoride; examinations and x-rays; fillings and root canals; prosthodontic services such as complete and partial removable dentures; deep scaling and extractions.
When booking an appointment with an oral health provider, ask if they have enrolled in the CDCP.
Co-payments
Exactly how much will be paid? Only a percentage of eligible expenses will be paid at the established CDCP fee rates. This will depend on the family income as follows:
- no co-payment for those with family income under $70,000; the plan will cover 100% of the expenses (up to the maximum CDCP fee rates);
- a 40% co-payment for those with family income between $70,000 and $79,999;
- a 60% co-payment for those with family income between $80,000 and $89,999.
Fee Schedule
The CDCP will only pay for oral health care services covered within the plan at the established CDCP fees. These fees are not the same as the provincial and territorial oral health associations suggested fee guides that providers often use to charge for oral health services. People covered under the CDCP may have to pay any additional charges directly to the oral health provider.
When booking your appointment, ask the oral health provider if your bill will be higher than the established CDCP fee so you know what your actual out of pocket costs may be.
Anni Markmann is a Personal Income Tax Professional and Certified Financial
Planner; living, working, and volunteering in our community. Contact Ste
Anne Tax Service at 204.422.6631 (phone or text!) or 36 Dawson Road in
Ste Anne (near Co-op) or info@sataxes.ca