What is the CDCP?
The Canadian Dental Care Plan is a federal program that helps pay for dental care for eligible Canadian residents who do not have access to dental insurance. The plan is run by the Government of Canada, and claims are processed by Sun Life on its behalf.
Who qualifies
According to the Government of Canada, you may qualify if:
- your adjusted family net income is less than $90,000;
- you have no access to private dental insurance, including a health spending account that covers dental costs;
- you and your spouse or common-law partner (if you have one) filed a Canadian tax return for the previous year; and
- you are a Canadian resident for tax purposes.
Members must confirm each year that they still have no access to private dental coverage. Apply or check your status on canada.ca. Our office cannot enrol you in the plan.
Oral surgery the CDCP covers
The plan's oral surgery category includes:
- tooth and root removal, including wisdom teeth;
- surgical removal of tumours and cysts (see oral pathology);
- surgical incisions, including drainage of infections; and
- treatment of broken jaw bones.
Sedation and anesthesia: nitrous oxide and oral sedation are covered. Conscious (IV) sedation, deep sedation and general anesthesia need preauthorization from the CDCP before treatment, and approval is not guaranteed. We submit the request for you when sedation is recommended.
Co-payments by family income
- Under $70,000: the CDCP pays 100% of its established fee. You pay no co-payment.
- $70,000 to $79,999: the CDCP pays 60%. You pay 40%.
- $80,000 to $89,999: the CDCP pays 40%. You pay 60%.
Our fees may differ from the CDCP established fees. If a service costs more than the plan reimburses, or you choose a service the plan does not cover, you may owe the difference. We will go over any expected out-of-pocket cost with you before treatment, so there are no surprises.
How to use your CDCP coverage with us
- Get a referral. Ask your dentist to send our referral form, or call us.
- Tell us you are a CDCP member when we call to book, and bring your member information to your appointment.
- Consultation. We assess your needs and explain which parts of your treatment the plan covers.
- Preauthorization, if needed. For sedation or other services that need approval, we send the request and let you know the answer.
- Treatment. We bill the CDCP directly for covered services. You pay any co-payment or uncovered amount.
Before your visit, read what to expect at your first visit and our insurance information. If you also have coverage through a provincial or federal program, let us know so the plans can be coordinated.
CDCP questions
Does Dental Specialty Group Waterloo accept the Canadian Dental Care Plan?
Yes. Our Waterloo oral surgery office sees patients who are covered by the Canadian Dental Care Plan (CDCP). Tell us you are a CDCP member when you book, and bring your member information to your consultation.
Does the CDCP cover wisdom teeth removal?
Oral surgery, including tooth and root removal, is a covered service category under the CDCP. Coverage depends on your eligibility, your co-payment level and the plan's rules for the specific procedure. We will review what applies to your treatment before surgery.
Does the CDCP cover IV sedation or general anesthesia?
According to the Government of Canada, nitrous oxide and oral sedation are covered, while conscious sedation, deep sedation and general anesthesia require preauthorization from the plan. Approval is not guaranteed. If it is not approved, you can still choose to go ahead and pay for the sedation directly.
Will I have to pay anything out of pocket?
Possibly. Members with an adjusted family net income of $70,000 to $89,999 pay a co-payment. You may also owe a difference if our fee for a service is higher than the CDCP established fee, or if you choose services the plan does not cover. We will explain any expected out-of-pocket cost before treatment.
Do I need a referral to use my CDCP coverage here?
Most patients come to us on referral from their dentist, orthodontist or physician. Ask your dentist to send our referral form, or call our office to discuss your situation.
Does the CDCP cover dental implants?
Dental implants are not listed among the CDCP's covered service categories on canada.ca. If you need an implant, we can give you a written estimate so you can plan, and check whether any related surgical steps may be eligible.
Plan details are summarized from the Government of Canada's CDCP pages and can change. Always check the current rules on canada.ca. Coverage for your treatment is decided by the CDCP, not by our office.