How does the Canadian Dental Care Plan work?

The Canadian Dental Care Plan (CDCP) has opened the door to dental care for millions of Canadians who didn't have insurance before. But the mechanics — who qualifies, how much is covered, what you pay, what happens at the dentist — can feel confusing. This guide walks through the whole process from start to finish, the way we explain it to patients at Beechwood Dental Studio every week.

Step 1: Check if you're eligible

To qualify for the CDCP you must be a Canadian resident, have filed your tax return for the previous year, have an adjusted family net income under $90,000, and have no access to dental insurance through an employer, pension, school or a private plan. If you have provincial or territorial dental coverage, you can still apply — the CDCP coordinates with those programs. The plan is now open to eligible Canadians of all ages, including children under 18, adults, seniors and people with a valid Disability Tax Credit certificate.

Step 2: Apply

Applying takes about 15 minutes online through the Government of Canada website, or by phone at 1-833-537-4342. You'll need your Social Insurance Number, date of birth and your most recent tax information. Service Canada checks your eligibility against your tax return automatically — you don't need to submit income documents yourself. Each adult in a household applies individually; parents or guardians apply on behalf of children.

Step 3: Receive your welcome package

If you're approved, Sun Life — the insurer that administers the plan for the government — mails you a welcome package with your member card, your coverage start date, and your co-payment level. Coverage typically begins within a few weeks of approval. Keep that card handy: your dentist needs the member ID and your coverage start date to submit claims.

Step 4: Understand your co-payment

Your co-pay is based on your adjusted family net income, and it stays the same for the whole benefit year:

One important detail: the CDCP pays according to its own fee schedule, which is set a little below the Ontario Dental Association suggested fee guide that most dentists use. If a dentist's fee for a service is higher than the CDCP fee, you may be asked to pay the difference as well. At Beechwood we show you any expected balance before treatment so there are no surprises.

Step 5: Find a dentist who accepts the plan

Dentists participate in one of two ways. Some have formally enrolled with Sun Life and can bill the plan directly. Others accept CDCP patients on a claim-by-claim basis. Beechwood Dental Studio accepts the CDCP and offers direct billing, so you simply bring your card and we handle the submission.

Step 6: Know what's covered

The CDCP covers a broad range of essential services: exams, cleanings, x-rays and fluoride; fillings; root canals; crowns; extractions; full and partial dentures; and some gum treatments. Preventative care is covered right away. Some bigger services — crowns, partial dentures, certain root canals and some periodontal work — require pre-authorization. That means we submit the plan to Sun Life first and wait for approval before treating, which usually takes one to two weeks. Cosmetic work like whitening and veneers isn't covered, and orthodontics such as Invisalign is covered only in limited, medically necessary cases.

Step 7: What happens at your appointment

At the front desk, we take a copy of your CDCP member card and confirm your coverage start date. After your visit, we submit the claim electronically to Sun Life. The plan's portion is paid directly to us. If you have a co-payment or a fee difference, you pay that at the time of your visit — we'll always tell you the amount in advance. You'll receive an explanation of benefits from Sun Life showing what was covered.

Step 8: Renew every year

CDCP eligibility is reassessed annually based on your most recent tax return. You'll be asked to confirm or renew your coverage each year, so filing your taxes on time is the single most important thing you can do to keep your coverage uninterrupted.

Frequently asked questions

Can I use the CDCP and private insurance together?

No. If you have access to private dental insurance through work or another source, you’re not eligible for the CDCP — even if that plan has limited coverage or you choose not to enrol in it.

Do I pay anything at a cleaning if my income is under $70,000?

In most cases, no. Preventative services like exams, cleanings and x-rays are covered at 100% of the CDCP fee. If a dentist’s fee is above the CDCP schedule you may be asked for the difference; we’ll tell you in advance if that applies.

How long does pre-authorization take?

Typically one to two weeks. We submit the request with supporting x-rays and notes, and we’ll call you as soon as Sun Life responds so we can book your treatment.

What if I’m approved mid-year?

Your coverage starts on the date in your welcome package. Care received before that date isn’t reimbursed, so wait for your card before booking non-urgent treatment — but call us right away if you’re in pain.

Is there an annual maximum?

The CDCP doesn’t have a dollar maximum the way many private plans do, but it does have frequency limits — for example, how often cleanings or x-rays are covered. We track those for you so you never run into a surprise.