Canadian Dental
Care Plan

Effective May 2024

To learn more please refer to the Government of Canada website linked below.

About CDCP

If you have private insurance or are eligible for insurance through your place of employment, you are NOT eligible for the Canadian Dental Care Plan.

Benefit Period:

The CDCP coverage period extends for 12 months, from July 1 to June 30 annually. Re-enrolment will be required, and will take place by July 1 of each year for clients who continue to be eligible for coverage under the CDCP.

CDCP Client:

An individual assessed by Service Canada to meet the CDCP eligibility criteria and who is enrolled in the Plan. The provider must verify that the individual has been deemed eligible for coverage prior to every appointment.

Exclusions:

IMPLANTS AND ALL IMPLANT-RELATED PROCEDURES are dental procedures that are outside the scope of the Plan and will not be considered for coverage nor considered for appeal.

Co-Payments

The Reekie Denture Clinic utilizes the current 2024 Denturist Association fee guide for billing.

The Canada Dental Care Program covers a portion of this fee guide.

Therefore, there will be a copayment to cover this difference.

When to apply?

The CDCP is being rolled out using a phased approach over several months. Starting with Seniors aged 70 and above. In May 2024, applications will shift to an online portal for eligible seniors 65 and older. Persons with a valid Disability Tax Credit certificate and children under the age of 18 will be able to apply online starting June 2024. All remaining eligible Canadian residents between the ages of 18 and 64 will be able to apply online starting 2025.

How to apply

Canadian residents who may qualify will be able to apply for the CDCP through Service Canada.

Each month, Service Canada contacts a new group of seniors, based on age. While applications remain open for those 77 years or older, in February, applications are expanding to seniors, aged 72 to 76. That means potentially eligible seniors aged 72 to 76 will receive letters inviting them to apply to the CDCP, with instructions on how to validate their eligibility and apply for the plan by phone.

Only those who meet the following criteria will receive a letter with instructions on how to apply.

Are 70 years old, or will be 70 years older or older by March 31, 2024
Have an adjusted family net income of less than $90,000 based on their and/or their spouse's or common-law partner's 2022 tax returns
Are a resident of Canada in 2022 for tax purposes

From December 2023 until the end of April 2024, seniors who receive invitation letters may call Service Canada to apply via an automated Interactive Voice Response (IVR) system. When applying, they will be asked for two pieces of identification, and whether they currently have access to any type of dental benefits. 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.

Removable Prosthodontic Policy

General Guidelines

The fee for complete and partial dentures includes a 3 month period of post-insertion care
Denture adjustments done on the same date of service and in conjunction with the delivery of new dentures, denture repairs, relines, rebases and/or tissue conditioning are included in the fees billed and paid for these services
The fee for immediate dentures includes the tissue conditioner, but not the processed reline/rebase
The overall cost of replacement for a denture may be adjusted in situations where the client's history shows that claims for reline/rebase were paid within 3 months prior to the request
The plan will consider coverage for denture labelling of new dentures by denturists

Removable partial dentures:

Preauthorization is required for initial placements of removable partial dentures (preauthorization is not required for replacements)
Removable partial acrylic dentures are covered once in any 5 year period (60 months) per arch
Removable partial transitional/provisional acrylic dentures are covered once in any 5 year period (60 months) per arch
Removable partial cast dentures are covered once in any 8 year period (96 months) per arch

Eligibility:

The Plan will consider coverage for a partial denture for teeth numbered 16 to 26 and 36 to 46 inclusive, under the following conditions:

General conditions:
- All basic treatments must be completed including:
  - Control of caries and of periodontal and periapical disease for all teeth, and
  - Restoration of major structural defects in the abutment teeth
- The space to be replaced is greater than or equal to the corresponding natural teeth (vertically and horizontally)
- If there is an existing partial cast denture, it must be at least 8 years old
- If there is an existing partial acrylic denture, it must be at least 5 years old

Specific conditions:
- There must be 1 or more missing teeth in the anterior sextant, or
- There must be 2 or more missing posterior teeth in a quadrant excluding second and third molars

Complete dentures:

The general principles of complete dentures are as follows:

preauthorization is not required for standard complete dentures and for transitional/provisional complete dentures. All other types of complete dentures require preauthorization
transitional/provisional complete dentures are covered once in a lifetime per arch. All other types of complete dentures are covered once in any 8 year period per arch