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In Ontario, patients covered under the Canadian Dental Care Plan (CDCP) may still have to pay a difference after their treatment because:

CDCP Only Covers a Percentage of Fees – The plan covers a portion of the cost, but not 100%. Patients are responsible for any remaining balance if the dental clinic charges more than the CDCP fee schedule.

Co-Payments for Higher-Income Patients – Patients with an adjusted family net income of $70,000 or more have to pay a co-payment (e.g., 40% of the cost).

Non-Covered Services – Some dental treatments may not be covered under CDCP, requiring patients to pay out-of-pocket.

Clinic’s Fees May Be Higher Than CDCP Rates – If a dental office charges more than the CDCP set fees, the patient may need to pay the difference unless the clinic agrees to follow the CDCP rates.

Lab Fees and Extra Charges – Some procedures (e.g., dentures, crowns) involve lab costs that may not be fully covered, leading to additional charges for the patient.

Does CDCP cover root canal treatment?

Yes, the Canadian Dental Care Plan (CDCP) covers root canal treatments as part of its endodontic services. This includes procedures like pulpectomies (the first step of a root canal treatment), treatments to reduce infection and relieve pain, and re-treatment of previously completed root canals (which requires preauthorization).

However, certain criteria must be met for a root canal to be eligible for coverage:

• Tooth Eligibility: The CDCP covers root canal treatments on incisors, canines, bicuspids, first and second molars, and third molars only if the first and second molars are missing and the third molar is in occlusion with a prosthetic or natural molar.
• Tooth Restorability: The tooth must have adequate periodontal support, sufficient remaining non-diseased tooth structure, and should not require additional treatments like crown lengthening or orthodontic procedures.

  It's important to note that while the CDCP covers a significant portion of dental treatment costs, patients may still be responsible for co-payments or any costs exceeding the plan's coverage limits. The amount of co-payment depends on your adjusted family net income.

  Before undergoing treatment, it's advisable to consult with your dental provider to understand the specifics of your coverage and any potential out-of-pocket expenses.

Does CDCP cover major dental treatments ( crown,implant etc.)?

The Canadian Dental Care Plan (CDCP) provides coverage for certain major dental treatments, including crowns, with specific conditions and limitations. However, dental implants and any implant-related procedures are not covered under the CDCP.

Crowns:

• Coverage: The CDCP covers various types of single-unit crowns, such as cast metal, porcelain/ceramic-fused to metal, and porcelain/ceramic crowns.
• Preauthorization: All crown procedures require preauthorization before treatment.
• Eligibility Criteria: Coverage is considered when there is significant loss of tooth structure that warrants a crown, and the tooth is deemed strong and healthy enough to be restored. Crowns intended solely for cosmetic purposes are not covered.
• Frequency Limitations: The plan allows for up to four crowns per client within any 120- month (10-year) period and one crown per eligible tooth within any 96-month (8-year) period.

Dental Implants:

• Exclusions: The CDCP explicitly excludes coverage for dental implants and all implant- related procedures. These services are considered exclusions and are not eligible for reconsideration.

It's important to consult with your dental care provider to understand the specifics of your coverage under the CDCP and to determine any potential out-of-pocket expenses. Preauthorization is essential for certain procedures, so ensure that all necessary approvals are obtained before proceeding with treatment.

Does CDCP cover Dentures?

Yes, the Canadian Dental Care Plan (CDCP) covers various denture-related services, including:

• Complete Dentures: Standard and temporary full dentures are covered.
• Partial Dentures: Removable partial dentures are included, but they require preauthorization before treatment.
• Denture Repairs, Relines, and Rebases: Maintenance services such as repairs, relining, and rebasing of existing dentures are covered.
• Tissue Conditioning: Applying a lining to dentures to condition oral tissues for comfort and healing is included.
• Immediate and Overdentures: Complete immediate dentures and overdentures are covered, with preauthorization required.

It's important to note that some services, like partial dentures, require preauthorization, meaning prior approval is needed before proceeding with the treatment.

Additionally, the CDCP has frequency limitations for denture replacements. For example, complete standard dentures are eligible for replacement once every eight years. However, more frequent replacements may be considered in specific circumstances through preauthorization.

Coverage levels under the CDCP are determined by your adjusted family net income:

• Less than $70,000: 100% coverage
• $70,000 to $79,999: 60% coverage
• $80,000 to $89,999: 40% coverage

Families with an income of $90,000 or more are not eligible for the CDCP.

Before proceeding with denture treatments, it's advisable to consult with your dental care provider to understand the specifics of your coverage, any necessary preauthorization, and potential out-of-pocket expenses.

If you have CDCP coverage and are looking for a dentist in Kanata, we’re here to help! Call us 613-519-1400 today to book your appointment. Dr.Taner Cakmak and his professional team would be happy to help you.

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Dentist