What treatments and services are covered? The CDCP will help cover the cost of various preventative oral health care services, as recommended by an oral health provider. Services that could be covered under the CDCP include scaling (cleaning), polishing, sealants and fluoride, as well as: z diagnostic services, including examinations and X-rays z restorative services, including fillings z endodontic services, including root canal treatments z prosthodontic services, including complete and partial removable dentures z periodontal services, including deep scaling z oral surgery services, including extractions Note that some of these services will not be available until later in 2024. How will billing, reimbursement and co-payments function? Some plan members covered by the CDCP will be required to make co-payments. In this case, the government definition of co-payment is the percentage of the government rate that will not be reimbursed by the CDCP, which plan members will pay directly to the oral health provider. Plan members with net adjusted household annual income under $70,000 will be eligible for 100% of the government rate for their CDCP-covered dental care. Plan members whose household income is between $70,000 and $79,999 are entitled to 60% of the government rate. For those between $80,000 and $89,999, the CDCP will reimburse 40% of the government rate. To limit the out-of-pocket expenses for patients, dentists who participate as service providers in the CDCP and provide oral health care services will bill the CDCP directly for reimbursement, rather than having patients seek reimbursement from Sun Life for services covered under the program. Co-payments and any other non-covered costs of care will be paid directly to the dentist by the plan member. The CDCP will only pay for oral health care services covered within the plan at the established CDCP government rates, which have not yet been announced. While Health Canada encourages dentists to bill patients based on the CDCP benefit, dentists can bill their usual and customary fees. Health Canada is advising plan members to confirm the fees with their dentist when booking their appointment. How can dentists participate in the CDCP? In early 2024, oral health providers will be able to participate on a voluntary basis. The government will launch a provider awareness campaign, with the support of Sun Life, that will invite providers to participate. Dentists who are licensed and in good standing to practise in the province or territory where the services will be given will be able to participate in the CDCP. Participation in this program remains voluntary; providers can assess whether the CDCP is right for their practice. Will the CDCP integrate with provincial or territorial dental programs? At this stage, we do not know how the CDCP will work with existing provincial government programs. The federal government has said patients can apply for CDCP if they are eligible, even if they are covered under another government program, and that they will ensure there is no duplication of coverage. Your PTDA can provide more guidance and information about how the CDCP will impact dentists in your community. Look for more details on the CDCP as they are released by the federal government at: www.canada.ca/en/services/ benefits/dental/dental-care-plan 10 | 2024 | Issue 1
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