The Canadian Dental Care Plan (CDCP) is a federal government dental benefit designed to provide basic oral health care to Canadians who do not have access to private dental coverage.
It is not traditional insurance, and it is not designed to replace employer‑sponsored dental plans.
✅ Critical Eligibility Rule
If you have access to any type of dental benefit, you do NOT qualify for the CDCP.
This includes:
- Employer‑sponsored dental insurance
- Health Spending Accounts (HSAs)
- Flexible benefit plans that can be used for dental care
- Retiree or pension dental coverage
Even if an employee chooses not to enroll, or rarely uses the benefit, they are still considered to have access to private coverage and therefore ineligible for the CDCP.
The CDCP is not aimed at employees with benefits. It is targeted specifically at Canadians who have no private dental options at all.
Who Qualifies for the CDCP?
An individual may qualify only if all of the following are true:
- They do not have access to any private dental coverage, including through an HSA
- Their household income is under $90,000
- They have filed their most recent tax return with the CRA
If any form of dental benefit exists through employment, CDCP eligibility is lost.
What Changed in 2025–2026?
2025 marked the full rollout of the CDCP. Key developments included:
- Expansion to uninsured adults aged 18–64, completing the phased rollout
- Millions of Canadians enrolled nationwide
- Clarification and correction of income-based eligibility calculations
- Confirmation that access to private benefits disqualifies eligibility
- Release of updated Dental Benefits Guides outlining coverage, limits, and pre‑authorization rules
By mid‑2025, the CDCP became a full, standing public program.
Now… What Does the CDCP Cover?
The CDCP focuses on essential oral health services, including:
- Exams, cleanings, and X-rays
- Fillings
- Gum disease treatment
- Root canals
- Extractions
- Dentures and partials (with limits)
❌ Cosmetic services, such as whitening, are not covered.
Some major procedures require pre‑authorization. Meaning the provider must check with Sun Life Assurance Company of Canada (who administers and adjudicates the plan) using clinical criteria set by Health Canada.
Important Note: CDCP Does NOT Pay 100% of Costs for Everyone
This is one of the most misunderstood aspects of the program.
1. Coverage Is Income-Based
CDCP coverage varies by household income:
- Under ~$70,000: up to 100% of eligible costs
- $70,000–$79,999: approx. 60%
- $80,000–$89,999: approx. 40%
Even eligible members may still face out-of-pocket costs.
2. Reimbursement Is Based on Fee Guides
The CDCP reimburses based on provincial dental fee guides or a CDCP fee schedule.
In practice:
- If a dentist charges more than the guide, CDCP pays only up to the guide amount
- The patient pays the difference
For more information on fee guides check out our blog on Canadian Dental Fee Guide Review
Since many dentists charge above these rates, CDCP members may pay:
- Income-based co-payments
- Additional amounts billed above the guide
Employer dental plans often reduce these gaps and offer better predictability.
Who Is the CDCP Really For?
The CDCP supports Canadians who previously had no dental coverage, such as:
- Lower-income individuals and families
- People without employer benefits
- Seniors, students, and precariously employed workers
For these groups, the CDCP reduces financial barriers and improves health equity.
What This Means for Employers and Workplace Dental Benefits
The CDCP Did Not Affect Dental Plans Currently in Place
That’s because employee benefits are not the demographic the CDCP is designed to support.
The plan was created to fill public coverage gaps, not replace employer-sponsored dental benefits.
✅ Employer Dental Benefits Still Deliver Value
They continue to:
- Apply regardless of income
- Cover employees and their families
- Provide higher reimbursement than fee guides
- Reduce surprise dental costs
- Support recruitment, retention, and total rewards strategy
In short: The CDCP fills a gap. It doesn’t replace employer dental benefits.
🧾 Important Payroll & Compliance Note: T4 Reporting (Code 3)
Employers must also be aware of a T4 reporting requirement:
If an employee, spouse and dependents have access to dental benefits, this must be reported as Code 3 in Box 45 of the T4.
This applies even if the employee waives the coverage.
Access (not usage) is what matters. This includes:
- Employer dental plans
- HSAs
- Flexible benefits
CRA just launched a helpful CRA T4 guide in December 2025, that’s worth a look.
Final Thoughts
The Canadian Dental Care Plan is a welcome development in public oral health but it’s not a substitute for well-designed workplace dental plans.
For employers, now is the time to:
- Communicate eligibility rules clearly to employees
- Ensure accurate T4 reporting
- Review your dental plan to maximize value in this new environment
Questions to Ask:
- Does your plan include orthodontics or specialists?
- Is your plan still competitive for recruitment?
- If it worth considering adding a Health Spending Account to help support current coverage?
Need a plan review or help communicating benefits better?
We’re here to help you get it right.
