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Services Covered
CDCP Coverage: Services Covered
The Canadian Dental Care Plan (CDCP) is designed to provide extensive dental coverage in Canada, ensuring that individuals maintain healthy teeth and gums while preventing and treating oral health issues. Below, you will find comprehensive information on the CDCP coverage, including details on the services provided under this plan.
Services Covered by the CDCP
The Canada Dental Care Plan Service coverage includes a broad range of dental care services, which are crucial for maintaining oral health and addressing various dental issues. Here are some of the key services included:
These services aim to evaluate your oral health status and prevent cavities and gum disease. Covered services include:
– Comprehensive, routine, specific, and emergency dental exams
– X-rays
– Teeth cleaning (scaling)
– Fluoride applications
– Sealants
– Comprehensive, routine, specific, and emergency dental exams
– X-rays
– Teeth cleaning (scaling)
– Fluoride applications
– Sealants
Restorative services are essential for treating decayed or fractured teeth. Covered services include:
– Permanent and temporary fillings
– Pain control for diseased teeth
– Treatments for cavities
– Permanent and temporary fillings
– Pain control for diseased teeth
– Treatments for cavities
These services treat severely decayed, infected, or broken teeth. Covered services include:
– Root canal treatments
– Pulpectomies (initial step of a root canal treatment)
– Procedures to reduce infection and provide temporary pain relief
– Retreatment of previously completed root canal treatments (requires preauthorization)
– Root canal treatments
– Pulpectomies (initial step of a root canal treatment)
– Procedures to reduce infection and provide temporary pain relief
– Retreatment of previously completed root canal treatments (requires preauthorization)
These services address the areas around the teeth, including gums and supporting bone. Dental Care coverage in Canada Plan includes:
– Deep cleaning under the gumline
– Treatment of abscesses
– Bonding for mobile teeth (requires preauthorization)
– Post-surgical evaluations (requires preauthorization)
– Non-surgical gum disease management
– Deep cleaning under the gumline
– Treatment of abscesses
– Bonding for mobile teeth (requires preauthorization)
– Post-surgical evaluations (requires preauthorization)
– Non-surgical gum disease management
For more extensive restorative needs, the Canada Dental Plan details cover:
– Posts and post-removal
– Repairs to crowns and rebonding of crowns and posts
– Crowns (requires preauthorization)
– Cores to support crowns (requires preauthorization)
– Posts for crowns (requires preauthorization)
– Posts and post-removal
– Repairs to crowns and rebonding of crowns and posts
– Crowns (requires preauthorization)
– Cores to support crowns (requires preauthorization)
– Posts for crowns (requires preauthorization)
These services replace missing teeth. – Canada Dental Plan coverage include:
– Complete dentures (standard and temporary)
– Denture repairs, relines, and rebases
– Placing lining in dentures for comfort and healing
– Complete immediate and overdentures (requires preauthorization)
– Initial placement and replacement of partial dentures (requires preauthorization)
– Complete dentures (standard and temporary)
– Denture repairs, relines, and rebases
– Placing lining in dentures for comfort and healing
– Complete immediate and overdentures (requires preauthorization)
– Initial placement and replacement of partial dentures (requires preauthorization)
These services involve surgical interventions in the mouth and jaw. Covered services include:
– Removal of teeth and roots
– Surgical removal of tumors and cysts
– Surgical incisions and drainage
– Treatment of jaw bone fractures
– Removal of teeth and roots
– Surgical removal of tumors and cysts
– Surgical incisions and drainage
– Treatment of jaw bone fractures
These services support other dental procedures and include:
– Minimal sedation (conscious)
– Moderate sedation (requires preauthorization)
– Deep sedation (requires preauthorization)
– General anesthesia (requires preauthorization)
– Minimal sedation (conscious)
– Moderate sedation (requires preauthorization)
– Deep sedation (requires preauthorization)
– General anesthesia (requires preauthorization)
Starting in 2025, the CDCP will cover some orthodontic services for cases of medical need based on strict criteria. These services will include a maximum spending limit.
How Much Will Be Covered?
The CDCP reimburses a percentage of the cost based on established CDCP fees and your adjusted family net income. You may need to pay additional charges if:
- Your adjusted family net income is between $70,000 and $89,999
- The cost of your services exceeds the established CDCP fees
- You agree to services not covered by the CDCP
Co-payments:
Your co-payment percentage depends on your adjusted family net income. Here is a breakdown:
Additional Charges:
You may face additional charges if the CDCP fees differ from what providers charge or if you agree to treatments not covered by the plan.
Frequently Asked Questions (FAQ)
The CDCP covers a wide range of oral health services, including preventive, restorative, endodontic, periodontal, major restorative, removable prosthodontic, oral surgery, and anesthesia/sedation services.
Some services require preauthorization, where prior approval is needed based on the recommendation of the oral health provider. This ensures that treatments are covered under the plan and considers individual oral health history and medical conditions.
The CDCP reimburses a percentage of the cost based on established fees and adjusted family net income. However, individuals may need to pay additional charges directly to the oral health provider if the costs exceed the established CDCP fees.
No, CDCP fees differ from provincial and territorial oral health associations’ suggested fee guides. The CDCP only pays for services covered within the plan at established fees. Any additional charges may be the responsibility of the individual.
Services requiring preauthorization will become available in November 2024. This process ensures that recommended treatments are covered under the CDCP and considers individuals’ oral health history and medical conditions.