Navigating The New Federal Dental Plan
- Brett Brohman
- Dec 6, 2023
- 4 min read
Updated: Sep 24
CANADIAN DENTAL CARE PLAN (CDCP)
What is the “Canadian Dental Care Plan?” (CDCP)
In the 2023 Budget, the federal government provided further details about the Canadian Dental Care Plan (CDCP), aimed at offering dental care benefits to uninsured individuals in Canada with a household income of less than $90,000 annually. For those with a household income below $70,000 per year, the plan will provide complete coverage.
By the end of 2023, the plan will start providing coverage to seniors and persons with disabilities and, by the end of 2025, the CDCP will be fully implemented to cover all uninsured Canadians.
Health Canada will administer the CDCP, with support from a third-party benefits administrator.
Canadians with access to dental coverage or benefits will not be eligible for CDCP.
What does this mean for Employers?
CDCP will be available to uninsured Canadians with an annual household income of less than $90,000 and with no co-pays for those with a household income under $70,000. With the implementation of CDCP, the federal government aims to establish a sustainable and effective long-term initiative that delivers excellent oral health care to those in greatest need, without affecting the current oral health care system, including employer-provided benefits, which constitute the primary source of dental care for most Canadians.
Changes to tax reporting with CDCP
With the introduction of the Canadian Dental Care Plan (CDCP), employers are required to report on an employee's T4 statement regarding whether an employee, former employee or any of their dependents (starting December 31st 2023) have access to dental insurance or any form of dental coverage, which includes Health Care Spending Accounts provided by their employer.
This reporting will be mandatory beginning the 2023 tax-reporting cycle and will to be required on an ongoing basis.
Considerations
Providing health and dental benefits remains instrumental for employers in attracting and retaining top talent. The CDCP is specifically designed for Canadians without existing private dental insurance. Even post-launch, a significant number of employees will continue to value the comprehensive and extended dental benefits provided by their employers, as many households may not meet the eligibility criteria for CDCP.
Also, employers currently have the incentive of showing dental benefits as a deductible expense for business. The Canadian Life and Health Insurance Association is proposing a 35% tax credit for small businesses as a strong advantage to keep their existing insurance plans in place for their employees, however, this is not official yet.
CANADIAN DENTAL BENEFIT (CDB)
What is the “Canada Dental Benefit?” (CDB) – Current plan for Children under 12
The CDCP is not planned to be fully implemented until 2025, so as an interim measure the federal government launched the CDB.
The CDB offers tax-free, upfront payments to assist in covering dental expenses for children under 12 who do not have access to private dental insurance and whose annual household income is below $90,000.
The Canada Revenue Agency (CRA) manages the distribution of payments, using adjusted income to assess eligibility and determine the benefit amount. To qualify, individuals must have filed their taxes for the preceding year.
Benefit Amounts Canadian Dental Benefit
Adjusted Family Net Income | Amount |
Less than $70,000 | $650 |
$70,000 to $79,999 | $390 |
$80,000 to $89,999 | $260 |
$90,000 or more | Not Eligible |
This program provides a maximum payment of $650 per eligible child per year for two years.
Update November 1, 2024
CDCP Final Coverage
The Canadian Dental Care Plan will pay based on Co-insurance vs dollar amounts.
Adjusted family net income | Amount Paid By CDCP |
Less than $70,000 | 100% |
$70,000 to $79,999 | 60% |
$80,000 to $89,999 | 40% |
$90,000 or more | Not Eligible |
Services covered will include the following:
Diagnostic and preventive services
These are services to check your oral health status, keep your teeth, gums and mouth healthy, and prevent cavities and gum disease and detect mouth conditions (like cancer) earlier. CDCP covers:
· dental exams, including complete, routine, specific and emergency exams
· x-rays
· cleaning (scaling)
· fluoride applications
· sealants
Basic services
Restorative services
These services treat cavities and broken teeth. CDCP covers:
· permanent fillings
· temporary fillings
· pain control for diseased teeth
· other treatments for cavities
Endodontic services
These services treat teeth that are severely decayed, infected or broken. CDCP covers:
· root canal treatments
· pulpectomies (first step of a root canal treatment)
· procedures to reduce infection and relieve pain
· re-treatment of previously completed root canal treatment (requires preauthorization)
Periodontal services
These services treat areas around the teeth, including gums and bone. CDCP covers:
· cleaning under the gumline
· treating abscesses
· bonding for mobile teeth (requires preauthorization)
· post-surgical evaluations (requires preauthorization)
· non-surgical gum disease management
Major services
Restorative services
These services restore teeth when they’re too damaged to be fixed with basic fillings. CDCP covers:
· posts and post removal
· repairs to crowns and re-bonding of crowns and posts
· crowns (requires preauthorization)
· cores (to support crowns) (requires preauthorization)
· posts for crown (requires preauthorization)
Removable prosthodontic services
These services replace missing teeth. CDCP covers:
· complete dentures, including standard and temporary dentures
· denture repairs, relines and rebases
· placing lining in dentures to condition oral tissues (for comfort and healing)
· complete immediate and overdentures (requires preauthorization)
· partial dentures (require preauthorization)
Oral surgery
These services remove teeth or tumours and fix other problems in the mouth and jaw that need surgery. CDCP covers:
· removal of teeth and roots
· surgical removal of tumours and cysts
· surgical incisions, including draining
· treatments for broken jaw bones
Anesthesia or sedation services
These are services to sedate you and control your pain while another service is being performed. CDCP covers:
· minimal sedation (conscious)
· moderate sedation (requires preauthorization)
· deep sedation (requires preauthorization)
· general anaesthesia (requires preauthorization)
Orthodontic services
These are not available yet. In 2025, they will add orthodontic services to the CDCP. These services will only be covered in cases of medical need based on strict criteria. There will be a maximum spending limit for them.
We're here to help!! Should you have any inquiries, please contact Regroup Beyond Benefits at 1-888-824-0010 or via email at servicenow@regroupbenefits.com.
