8 Tips To Maximize Your CDCP Coverage

Understanding the Canadian Dental Care Plan (CDCP)

The CDCP is a federal initiative designed to provide essential dental care to Canadians lacking private insurance and within specific income brackets. The plan covers many dental services, from preventive care to more complex procedures. By understanding the plan’s offerings and strategically planning your dental care, you can maximize the benefits and minimize out-of-pocket expenses.

Tip 1: Confirm your eligibility

To maximize your dental coverage, it’s crucial first to confirm your eligibility:

• Income threshold: The CDCP is available to families with an adjusted family net income of less than $90,000 per year. You may be eligible for full or partial coverage depending on your income.

• No private insurance: The plan is designed for individuals who do not have access to private dental insurance.

• Age and residency: The plan covers different age groups and requires that you be a resident of Canada.

Tip 2: Use preventive services regularly

Preventive dental care is the foundation of good oral health and is fully covered by the CDCP for eligible individuals. Regular use of these services can prevent more severe and costly dental issues in the future.
• Routine examinations: Schedule bi-annual dental check-ups to monitor your oral health. Early detection of issues can prevent the need for more extensive and expensive treatments.

• Cleanings (scaling and polishing): Regular cleanings help remove plaque and tartar, preventing gum disease and tooth decay.

• Fluoride treatments and sealants: These are particularly effective for children, providing extra protection against cavities.

Tip 3: Plan for basic and restorative services

The CDCP covers a variety of basic and restorative services, such as fillings and root canals. These treatments can be costly, but by maximizing your plan’s coverage, you can significantly reduce expenses.

• Fillings: If you require a filling, choose a material covered by the CDCP, such as amalgam or composite resin, to avoid additional costs.

• Root canals: Ensure your dentist preauthorizes the treatment if needed, as this will prevent delays and confirm that the procedure is covered.

Tip 4: Understand co-payments and cost sharing

Depending on your income, you may be responsible for a co-payment for certain services. Here’s how to manage and minimize these costs:

• Know your co-payment percentage: Families with incomes between $70,000 and $89,999 are subject to co-payments ranging from 40% to 60%. Be aware of this when planning for more expensive treatments.

• Combine services: If possible, combine multiple treatments into a single visit to reduce the number of co-payments.

Tip 5: Utilize additional and specialized services wisely

The CDCP also provides coverage for more specialized dental services, such as crowns, bridges, orthodontics, and oral surgery. However, these services may require reauthorization.

• Preauthorization: Your dentist must submit a treatment plan to Sun Life for approval for more complex treatments. Ensure this is done well in advance to avoid delays.

• Consider alternatives: If a particular treatment is not fully covered, discuss alternatives with your dentist that may offer similar results at a lower out-of-pocket cost.

Tip 6: Schedule regular check-ups and follow-ups

Regular dental check-ups are essential for maintaining oral health and maximizing your coverage. Follow-ups after treatments ensure that your oral health remains in good condition and can prevent the need for additional, costly procedures.

• Preventive focus: Emphasize preventive care during your visits to catch issues early.

• Keep track of visits: Maintain a record of your dental visits and treatments to monitor your use of the CDCP and plan future care accordingly.

Tip 7: Educate yourself and stay informed

Understanding your coverage, staying informed about changes to the CDCP, and knowing your rights as a patient will help you maximize your dental care.

• Stay updated: Regularly check the official Government of Canada Dental Care Plan website for updates or changes to the plan.

• Ask questions: Don’t hesitate to ask your dentist or the CDCP customer service team to clarify what is covered and how to best utilize your benefits.

Tip 8: Leverage pediatric and senior services

If you have children or are a senior, take full advantage of the specialized services available under the CDCP.

• Children: Utilize preventive services like fluoride treatments and sealants, which are particularly beneficial for younger patients.

• Seniors: Focus on maintaining oral health to prevent issues that could complicate other health conditions.

Conclusion

Maximizing your dental coverage through the Canadian Dental Care Plan requires a proactive approach to oral health, understanding the plan’s benefits, and careful planning. By following the steps outlined above, you can ensure you and your family receive the dental care you need while minimizing costs. For further assistance or detailed information, consult the official CDCP resources or speak with your dental care provider.