April 17, 2024 | Ottawa, ON | Government of Canada
To date more than 1.7 million Canadian residents have been approved to receive oral health care services through the Canadian Dental Care Plan (CDCP). We thank the more than 5,000 oral health providers who have already agreed to help CDCP clients get the care they need, and the many more who continue to join every day.
Today, informed by consultation and conversations with oral care providers and with their associations across Canada, we are taking a number of new actions so that all providers can deliver care to CDCP clients.
Choice for providers and their clients
The participation of oral health providers across the country in this plan is encouraged so we can build a foundation for more equitable access to oral health care - and make a difference in the lives of nearly 9 million Canadians. We understand that some oral health providers may choose not to participate fully as a CDCP provider but would still like to provide care to CDCP clients. As of July 8, 2024, oral health providers will be able to direct bill Sun Life for services provided on a claim-by-claim basis without formally signing up for CDCP. This will make it easier for providers to treat patients and submit CDCP claims to Sun Life for direct reimbursement, whether or not they choose to formally participate. This also means that CDCP clients can see any oral health provider they choose for their care, as long as the provider agrees to direct bill Sun Life for services provided under the plan.
Emergency care and preauthorization
We know that providers want their patients to be able to get emergency care when they need it. The Government of Canada designed the CDCP's basket of services with the CDCP eligible population in mind, including their need to access care in emergencies. There are no limitations on emergency examinations under the plan, and almost all services that could be done on an emergency basis do not need preauthorization. After November when preauthorization comes into effect, in rare cases where a service that would normally need preauthorization is needed on an emergency basis, providers can submit any needed minimal documentation after the fact.
In addition, to further streamline administrative processes under the CDCP, we continue to work with provider associations to determine where additional refinements to preauthorization requirements might be helpful for CDCP clients who have longstanding special needs (for example, through the use of blanket or multi-year preauthorization when a patient's underlying health condition is unlikely to change, rather than seeking preauthorization each time).
To make sure that oral health providers have the details they need, the 2024 CDCP Dental Benefit Grids are now published, which outline the fees that the CDCP will pay to oral health providers for all procedures covered under the plan. The CDCP fee structure is based on similar federal programs and will be reassessed annually. Health Canada will work with oral health provider associations to inform our work related to fees for 2025 and beyond.
The CDCP will help make the cost of dental care more affordable for Canadian residents who do not currently have access to dental insurance. CDCP clients are reminded that they may have to pay additional charges in addition to any co-payment, and to always ask their oral health provider about any costs that will not be covered by the plan.
The Government of Canada is committed to making it as easy as possible for oral health providers to render services to CDCP clients so they get the care they need and deserve.
