DeshDental at Whitby Mall is pleased to announce that we now accept patients eligible for coverage under the new Canadian Dental Care Plan (CDCP) government program.

It's important to note that DeshDental at Whitby Mall will continue to adhere to our regular fee guide, not the CDCP fee guide. As there will likely be variations between the CDCP fee guide and the Dental Association fee guide, patients may encounter differences in coverage percentages.

While DeshDental at Whitby Mall will directly accept bulk payments from SunLife, the insurance provider for the CDCP plan, we expect patients to settle any remaining co-pay balance at the time of service.

Patients are responsible for understanding their CDCP plan coverage terms. DeshDental at Whitby Mall cannot provide specific details on coverage or percentage of coverage; this information is between the patient and the CDCP plan (Service Canada and SunLife).

1. What is the Canadian Dental Care Plan (CDCP)? ▼

At DeshDental at Whitby Mall, we're dedicated to keeping Whitby's residents smiling bright! If you're seeking clarity on the Canadian Dental Care Plan (CDCP), you've come to the right place. Let's break it down.

The CDCP, a federal initiative, extends coverage to Canadian residents lacking dental benefits and with a household income under $90,000 annually. However, it's essential to note: the CDCP isn't a free dental program but a valuable government dental benefit.

Designed specifically for individuals without existing dental coverage, the CDCP complements rather than replaces benefits offered through employment, educational institutions, or private plans. Managed by Health Canada and administered by Sun Life, it aims to bridge the gap in dental care accessibility.

At DeshDental at Whitby Mall, we believe in empowering our community with knowledge about available dental resources. Remember, eligibility and coverage decisions for the CDCP aren't made by dental professionals like Dr. Tariq Howlader & Associates, but rather by governing bodies.

If you have questions or seek further guidance regarding the CDCP or any dental concerns, our team is here to assist you every step of the way. Let's work together to ensure you receive the dental care you deserve!

2. How to Determine Your Eligibility for CDCP ▼

If you're wondering whether you qualify for the Canadian Dental Care Plan (CDCP), we're here to help you navigate the process.

The federal government is currently reaching out to the first groups of eligible citizens to provide information on the application process. If you haven't received a letter by May, it's possible that you may not be eligible, or at least not yet.

To confirm your eligibility, visit the official government website:

Check Eligibility on Government Website

Stay informed about your eligibility status and take advantage of the resources available to you. If you have any questions or need assistance, don't hesitate to reach out to our team at DeshDental at Whitby Mall. We're here to support you every step of the way.

Eligibility Requirements: To qualify for the CDCP, you must meet all 4 of these requirements:

  • You don't have access to dental insurance through employment, pension benefits, or private coverage
  • You and your spouse/common-law partner (if applicable) must have filed your tax returns in Canada
  • Your adjusted family net income is less than $90,000
  • You're a Canadian resident for tax purposes

3. How much does the CDCP cover? Will my dental care be free? ▼

No. The Canadian Dental Care Plan (CDCP) does not offer free dental care. It's a government dental benefit that assists in covering a portion of your dental expenses. Patients may be responsible for paying the remaining costs that are not covered.

Patient co-payments under the CDCP are determined based on their adjusted family net income:

Adjusted Annual Family Net Income Co-payment Required
Under $70,000 No co-payment - CDCP covers 100%
$70,000 - $79,999 40% co-payment - CDCP covers 60%
$80,000 - $89,999 60% co-payment - CDCP covers 40%

Important: DeshDental at Whitby Mall will bill our usual and standard fees. Apart from the potential co-payment, patients may also be required to cover any portion of our usual fees not covered by the CDCP.

Prior to scheduling your dental appointment, discuss the treatment costs with Dr. Tariq Howlader & Associates, including any expenses not covered by the CDCP.

4. What services will be covered under the CDCP? ▼

Desh Dental in Whitby is here to guide you through the services covered under the Canadian Dental Care Plan (CDCP). Understanding these services is crucial for maximizing your dental benefits.

Covered services include:

  • Scaling (cleaning), polishing, sealants, and fluoride treatments
  • Comprehensive examinations and X-rays
  • Fillings and root canal therapies
  • Complete and partial removable dentures
  • Oral surgery procedures, including extractions

It's important to note that some services may require preauthorization, necessitating prior approval based on Dr. Tariq Howlader & Associates's recommendations. Your dentist at Desh Dental will assess whether the proposed treatment falls under CDCP coverage. Services requiring preauthorization will be available starting November 2024.

For a comprehensive list of all covered services, visit the CDCP Dental Benefits Guide.

Note: Limited orthodontic services for eligible clients can be requested at a date to be determined. Some services like cosmetic treatments (including teeth whitening), veneers, implants, and fixed bridges are not covered under the CDCP.

5. Can the CDCP replace my existing dental coverage through work or school? ▼

No. The CDCP is designed for Canadian residents who do not have dental benefits. To qualify for the CDCP, you must not have access to any type of dental insurance or coverage through:

  • Employer-provided benefits, including health and wellness accounts for yourself or family members
  • Professional or student organizations
  • Pension benefits (for previous employers or family members), unless retired before December 11, 2023, and unable to opt back in under pension rules
  • Privately purchased coverage or through group plans from insurance or benefits companies

Important to note: If you're eligible for dental coverage through employment benefits or an organization, you're ineligible for the CDCP, regardless of usage.

Employers are now required by the Canada Revenue Agency to report dental insurance coverage on T4/T4A forms, ensuring transparency for employees and their families.

Dr. Tariq Howlader & Associates emphasizes the importance of evaluating existing coverage before considering CDCP enrollment. Cancelling current coverage could lead to unforeseen costs, as CDCP care may prove more expensive than private insurance. Understand all details and costs to make the best decision for you and your family.

For comprehensive eligibility details, visit canada.ca/dental.

6. Will I lose my dental coverage at work when the CDCP comes out? ▼

We don't know and this should concern us all.

Currently, two-thirds of Canadians enjoy dental coverage through their employment, educational institutions, or group plans. These plans afford individuals the freedom to choose their dentist and dictate their dental care.

We believe that the CDCP should improve access to care for people who don't have benefits. The CDCP should not take away dental benefits that people already have.

It's important to maintain your existing coverage if you have it, as private insurance often provides more comprehensive coverage and flexibility than the CDCP program.

7. What is the Canada Dental Benefit (CDB)? ▼

The Canada Dental Benefit (CDB) was a temporary program that provided direct payments to eligible families to help cover dental costs for children under 12 years old. This program was separate from the CDCP and has been replaced by the permanent Canadian Dental Care Plan (CDCP).

The CDB was available for families with adjusted family net income under $90,000 who did not have access to private dental insurance. It provided up to $650 per child per year for two years (2022-2023 and 2023-2024).

The CDCP is the permanent, comprehensive program that has replaced the temporary CDB program. If you were eligible for the CDB, you may also be eligible for the CDCP, which provides broader coverage for all eligible family members, not just children.

8. How do I apply for the CDCP? ▼

The application process for the CDCP is managed by Service Canada. The government is rolling out the program in phases, contacting eligible Canadians directly by mail or phone.

Application steps:

  • Wait for a letter or phone call from Service Canada if you're eligible
  • Follow the instructions provided in the letter
  • Complete the application online or by phone
  • Receive your CDCP card and coverage information

If you believe you're eligible but haven't been contacted, you can check your eligibility status online at canada.ca/dental.

Once enrolled, you'll receive information about your coverage and how to use it at participating dental offices like DeshDental at Whitby Mall.

9. When can I start using my CDCP coverage? ▼

The timing for when you can start using your CDCP coverage depends on when you're enrolled and when your coverage becomes active. The program is being rolled out in phases:

  • Seniors (70+): Started in May 2024
  • Seniors (65-69): Started in June 2024
  • Adults with disabilities: Started in June 2024
  • Children under 18: Started in June 2024
  • All remaining eligible Canadians: Starting in 2025

Once you receive your CDCP enrollment confirmation and card, you can begin using your coverage at participating dental offices. Coverage typically begins on a specific date provided in your enrollment materials.

At DeshDental at Whitby Mall, we're ready to accept CDCP patients as soon as their coverage is active. Contact us to verify your coverage and schedule your appointment.

10. What services are NOT covered under the CDCP? ▼

It's important to understand what services are excluded from CDCP coverage. The following services are not covered under the CDCP:

  • Cosmetic treatments, including teeth whitening
  • Veneers (composite or ceramic)
  • All ¾ crowns
  • Inlays/onlays in composite, precious metal, or ceramic
  • Fixed prosthodontics (bridges and all bridge-related procedures)
  • Dental implants and all implant-related procedures
  • Bone grafts
  • Periodontal appliances, including bruxism appliances (night guards)
  • Mouth guards
  • Crown lengthening
  • Temporomandibular joint (TMJ) therapy and appliances
  • Precision attachment partial dentures
  • Extensive rehabilitation

If you need any of these services, you'll be responsible for the full cost. Our team at DeshDental at Whitby Mall can discuss payment options and alternatives with you.

11. Do I need preauthorization for CDCP services? ▼

Some services under the CDCP require preauthorization before treatment can begin. This means your dentist must submit a treatment plan to Sun Life (the CDCP administrator) for approval before providing certain services.

Services that typically require preauthorization include:

  • Root canal treatments
  • Dentures (complete and partial)
  • Oral surgery procedures
  • Some periodontal treatments
  • Limited orthodontic services (when available)

Routine services like cleanings, exams, X-rays, and simple fillings typically do not require preauthorization.

Your dentist at DeshDental at Whitby Mall will help determine if preauthorization is needed for your treatment and will submit the necessary documentation on your behalf. The preauthorization process can take several days to weeks, so plan accordingly.

12. Can I use the CDCP with other dental insurance? ▼

If you have dental coverage through a provincial, territorial, or federal government social program, you can still qualify for the CDCP. If you qualify, your coverage will be coordinated between the plans to ensure there are no duplication or gaps in coverage.

However, if you have private dental insurance through employment, pension benefits, or a private plan, you are not eligible for the CDCP.

Important: You cannot have both private dental insurance and CDCP coverage at the same time. The CDCP is specifically designed for those without access to private dental benefits.

If you provide false information on your application, you and your family may be removed from the plan. If you weren't eligible for the CDCP, you may have to repay the full cost of services received.

13. How do I find a dentist who accepts CDCP? ▼

Not all dental offices accept CDCP coverage. To find a participating provider, you can:

  • Check the CDCP provider directory on the Sun Life website
  • Call dental offices directly and ask if they accept CDCP
  • Contact Sun Life's CDCP Contact Centre at 1-888-888-8110

Good news: DeshDental at Whitby Mall accepts patients eligible for CDCP coverage! We're here to help you access the dental care you need.

When you call to book an appointment, let us know you have CDCP coverage, and we'll help verify your eligibility and explain how the process works at our office.

14. What if my CDCP claim is denied? ▼

If a service is denied coverage under the CDCP, you have the right to request a reconsideration. Here's what you need to know:

  • Your dentist must submit the reconsideration request on your behalf
  • You must provide additional or new clinical information or documentation
  • Requests must be submitted within 60 days of the denial
  • There is one level of reconsideration available, and the decision is final

Note that services identified as exclusions (like cosmetic treatments or implants) cannot be reconsidered, as they are never eligible for coverage.

If a claim is denied because a frequency limitation has been reached, your dentist can submit a post-determination request with additional documentation explaining why the service is medically necessary.

Our team at DeshDental at Whitby Mall will work with you to provide the necessary documentation and support throughout the reconsideration process.

15. What should I bring to my dental appointment if I have CDCP? ▼

When you visit DeshDental at Whitby Mall with CDCP coverage, please bring:

  • Your CDCP card or enrollment confirmation
  • Valid government-issued photo ID
  • Your Social Insurance Number (SIN) for verification
  • Any previous dental records or X-rays (if available)
  • Payment method for any co-payments or uncovered services

Our team will verify your coverage before your appointment and explain any costs you may be responsible for. We'll also check your coverage limits and frequency restrictions to ensure you receive the maximum benefit from your CDCP plan.

16. Are there frequency limitations on CDCP services? ▼

Yes, the CDCP has frequency limitations on certain services to ensure appropriate use of benefits. These limitations are based on rolling periods.

Common frequency limitations include:

  • Recall exams: Once every 12 months
  • Dental cleanings: Typically twice per year (every 6 months)
  • X-rays: Varies by type (bitewing X-rays typically every 12-24 months)
  • Fluoride treatments: Frequency depends on age and risk factors

If you need a service more frequently than the limitation allows, your dentist can submit a preauthorization request with documentation explaining why additional services are medically necessary.

Our team at DeshDental at Whitby Mall will help you understand your coverage limits and work within the CDCP guidelines to provide you with the best possible care.

Still Have Questions?

If you have additional questions about the CDCP or your dental care, our team at DeshDental at Whitby Mall is here to help. We can assist with:

  • Understanding your CDCP coverage
  • Verifying your eligibility
  • Explaining treatment costs and co-payments
  • Submitting preauthorization requests
  • Coordinating your dental care

Remember: While we can help you understand how to use your CDCP benefits, specific questions about eligibility, coverage percentages, and plan details should be directed to Service Canada or Sun Life.