Dental coverage for seniors/disabled | Your stories | Discussion forum

I have heard that most dentists do not participate in the program. I think less than 20% do. So, even if you qualify and sign up, you may not be able to continue to see your own dentist who has all your records, etc. People are complaining about that and I don't blame them.

MG said
I have heard that most dentists do not participate in the program. I think less than 20% do. So, even if you qualify and sign up, you may not be able to continue to see your own dentist who has all your records, etc. People are complaining about that and I don't blame them.   

Way less than 20%, from a family member in the practice.

CAD said
Did anybody sign up for this new dental coverage?
Did anybody do any dental work under this coverage?
How is it supposed to work?  

Yes, yes and yes. See here: https://www.highinterestsavings.ca/forum/your-stories/federal-dental-plan-letter-from-service-canada/

You can now sign up online, it should be even easier than by the phone.

Maybe the 20% number is regional. I live in rural Southwestern Ontario. When I used the Sunlife link provided by Alexandre, there are 174 dentists within 50 kilometres of me who are participating in the CDCP.

I signed up and just received my Welcome Package and ID card last week.

The 20% opt-in number is both outdated and partial; dentists nor "fully enrolled" can still bill individual cases to the Sun-Life-administered plan. My dentist was a bit confused about all the assorted coverage dates but it appears I will be covered by July 8. He didn't talk about fee schedules or yearly maximums.

Dentists have had a lot of time on their hands since COVID-19 killed patient demand and the expectation by patients that coverage is coming. I expect more widespread adoption.

Alexandre said

This sounds too low. CDCP is structured same way as standard dental insurance from full time employment. It is provided by large health insurance company.
…

That's not true. CDCP is not structured like a standard dental insurance plan.

If it was smartly structured that way, then there would be no special dentist sign up required and no special workflow. Dentist would just add the insurance company, plan number, and member number from the card to their current patient billing system.

Even after July 8, CDCP won't be a standard plan and requires the dentist to accept payment directly. Two dentists I've had refuse that kind of arrangement to avoid dealing with hassles involving deductibles and annual coverage limits. I and other patients pay fully and are given the forms to claim reimbursement. One even does electronic claim transmission so that patients don't have to file the claim!

As well, standard plans don't have politicians saying that the coverage is 100% when it is actually 100% of a fee schedule that's 10% to 20% below the dental fee schedules that regular plans cover.

Alexandre said

This sounds too low. CDCP is structured same way as standard dental insurance from full time employment. It is provided by large health insurance company.

You can find a Canadian Dental Care Plan (CDCP) provider near you with this link: https://www.sunlife.ca/sl/cdcp/en/member/provider-search/

In 2025, when widespread rollout of CDCP is scheduled, dentists who do not accept patients with this dental plan will have a lot of free time on their hands.  

Even if you prefer your current dentist, that's not necessary as the out of pocket difference between the CDCP fee guide and, say, the B.C. Dental Association fee guide is not especially significant, especially if you're on the 100% coverage rate.

My dentist even breaks that down what CDCP clients would be out of pocket:

https://newlookdental.ca/now-accepting-the-new-canadian-dental-care-plan/

It's not needed for me personally as I have an even better plan through my employer.

Cheers,
Doug

Doug said

Surprisingly, that GoC website is scant on detail. For example, what happens if you leave your job from an employer who paid dental benefits and you have no employer now or your new employer doesn't pay benefits? Surely they're going to have some sort of manual adjudication and not be based solely on previous year's T4/T4A slip!

There will be some manual auditing as one of the disqualifiers is access to another dental plan.

Canadian Dental Care Plan: Do you qualify mentions that one must "not have access" to another plan through some specific channels. For example, one still has access to another dental plan and does not qualify for CDCP, if one could have been covered by spouse's dental plan at work but decided not to pay extra for the spousal coverage:

What does not having access to dental insurance mean?

This means you do not have access to any type of dental insurance or coverage through:

• your employment benefits or a family member’s employment benefits, including health and wellness accounts
• a professional or student organization
  • Note: If you’re eligible for dental coverage through your employment benefits or through a professional or student organization, you’re not eligible for CDCP. This is true even if:
    • you decide not to take it
    • you have to pay a premium for it
    • you don’t use it
• your pension benefits or a family member’s pension benefits
  • this includes federal, provincial and territorial government employer pension plans
  • Exception: You may be eligible for the CDCP if you’re retired and:
    • you opted out of pension benefits before December 11, 2023, and
    • you can’t opt back in under the pension rules
• coverage purchased by you or a family member or through a group plan from an insurance or benefits company
  • if you purchased your current dental insurance policy privately  (and not as part of any of the coverage described above), you’re not eligible for the CDCP while that coverage is in effect.

Norman1 said

Alexandre said

This sounds too low. CDCP is structured same way as standard dental insurance from full time employment. It is provided by large health insurance company.
…

That's not true. CDCP is not structured like a standard dental insurance plan.

If it was smartly structured that way, then there would be no special dentist sign up required and no special workflow. Dentist would just add the insurance company, plan number, and member number from the card to their current patient billing system.

Even after July 8, CDCP won't be a standard plan and requires the dentist to accept payment directly. Two dentists I've had refuse that kind of arrangement to avoid dealing with hassles involving deductibles and annual coverage limits. I and other patients pay fully and are given the forms to claim reimbursement. One even does electronic claim transmission so that patients don't have to file the claim!

Based on your experience, it appears different dentists treat CDCP differently.

The one where my elderly relatives are, and to whom I drove one of them just this week for an appointment, treats CDCP same way as my dentist treated my employer dental plan:

1. An estimate is provided to patient which splits total costs to what insurance pays and patient pays;
2. Service provided to patient;
3. Patient charged for their part, payment by credit card is accepted.

That is as hassle free as possible.

By the way, they said patient does only need to bring CDCP card first time. Next time, this information will be in dentist billing system.