Canadian Dental Care Plan 2023

Based off a 2017 study conducted and reported by the Canadian Dental Association, approximately 32% of Canadians do not have any dental coverage. In 2018, 1 in every 5 Canadians reported avoiding dental care because of the cost. For these reasons, the government of Canada has proposed the Canadian Dental Care Plan. Over the next several weeks, we will be diving into this program and explaining what it entails, how you may qualify, the coverage breakdown, how to apply, and how you may incorporate it within your dental clinic.

What is the Canadian Dental Care Plan?

In 2022, the Canadian government announced their plan to offer dental coverage for qualifying Canadians. The Plan will be rolled out in phases but is estimated to be available for all eligible Canadians by 2025. As of 2022, children under the age of 12 from uninsured, low- and middle-income families are eligible. In 2023, the Plan will be available to uninsured Canadians under 18 years old, seniors and people with disabilities who have an annual family income of less than $90,000. By 2025, the Plan will be implemented to cover all uninsured Canadians with an annual family income under $90,000.

What is the Canada Dental Benefit?

The Canada Dental Benefit is the first stage of the government’s plan to offer dental coverage for families with income under $90,000 and will allow eligible children under 12 to get the dental care they need while a comprehensive national dental care program is developed. This plan was introduced to help Canadians get access to dental care, without comprising other essential needs due to the post-COVID impacts of global inflation. If your family’s adjusted annual income is under $90,000 and you have an uninsured child under 12, you may have access to $260 – $650 per child for dental work completed between October 1, 2022, to June 30, 2023.

Did You Know?

• Visiting the dentist: Regardless of coverage, Canadians with lower household income were less likely to go to a dentist than those in higher income households.
• In the past year, most Canadians have seen a dental professional (74.7%). However, 22.4% avoided going at least once due to the cost.
• Those without insurance were about three times as likely as those with insurance to avoid seeing a dental professional because of cost (39.1% versus 13.7%).

Coverage Breakdown

The breakdown of coverage per child under 12 based on full or half custody is below:

Coverage is available for the following benefit periods:

1. Period 1 – October 1, 2022 to June 30, 2023
2. Period 2 – July 1, 2023 to June 30, 2024

Note: the plan is being rolled out in a targeted and phased approach. The government is focusing on more vulnerable groups and looking to have more comprehensive care by 2025 for all Canadians that are uninsured and make less than $90,000 as a family.

The Canadian Community Health Survey (CCHS)

The Canadian Community Health Survey was conducted in 2018 and revealed the importance of addressing access to dental care for Canadians, particularly in youth. Some important statistics are as follows:

• 57% of 6- to 11-year-olds have or have had a cavity;
• 59% of 12- to 19-year-olds have or have had a cavity;
• The average number of teeth affected by decay in children aged 6 to 11 & 12 to 19 is 2.5;
• 32% of children aged 6 to 11 have one or more sealants (dental sealants are thin coatings that are painted on your molars and can prevent cavities for many years).

What makes this plan different from other programs that the government has rolled out in the past?

• The coverage is based on the provincial fee guide, unlike other social assistance programs that have reduced remuneration rates compared to the provincial fee guide.
• The criterion for coverage covers a wider range of Canadians, unlike the current programs
• The benefits covered under this plan are broad when it comes to dental care

Applying for the Canada Dental Benefit (CDB)

Applications are now open and can be completed through the CRA My Account portal. Go to Canada.ca/dental for more information. If you are unable to apply online, call the CRA at 1-800-715-8836.

When you apply, you will need to confirm that:

• Your child does not have access to private dental care coverage
• You will have out-of-pocket dental care expenses and will use the CDB to pay for those expenses
• You understand that you may have to provide receipts to prove the CDB was used to pay for out-of-pocket dental care expenses

You will also have to provide the CRA with:

• The name and address of your child’s dentist or dental hygienist
• The date (month) of the appointment
• Information on your employer and your partner/spouse’s employer, if applicable

Incorporating the Dental Care Benefit in Your Practice

Unlike the typical social assistance programs that currently exist, the Canada Dental Care Plan has corrected a few issues with the other government programs:

• The coverage is based on the provincial fee guide, unlike the other programs that cover reduced fees;
• The annual limits per child are sufficient to cover initial exams, x-rays and basic restorative work before exhausting the benefit amounts; and
• The benefit is paid to the patient directly after they show proof of receipt and/or appointment with the provider, reducing the administrative work required from the office staff.

As the government is trying to find ways to get target support to vulnerable communities, this plan also ensures that the providers are adequately compensated for the treatment provided. Traditionally, dental practices may have opted to not accept social programs within their practice or limited the amount they would take on. However, this benefit takes away several of the issues that have been identified by the providers with the other programs. This will also address the gap in Canadians who do not have coverage and are not going to the dentist due to cost. Not only can the provider confidently provide services to Canadians who otherwise would not have received dental treatment, they can also feel good about contributing to better oral health to more Canadians.

The key for this program to have further success will depend on the ease of submitting and receiving the benefit, as well as ensuring that dentists have a voice at the table to shape the program so that it is providing the services to the right people, while not marginalizing the providers who are the ones performing the work. Only time will tell if this program will remain on the promising path to addressing a significant issue among Canadians struggling to make ends meet, while still providing care to their oral health needs.

Sources:

https://pm.gc.ca/en/news/news-releases/2023/03/31/getting-canadians-dental-care-they-need

https://nationalpost.com/news/federal-budget-dental-coverage-all-eligible-canadians

https://cda-adc.ca/EN/about/media_room/news_releases/2023/03_28_CDA_welcomes_significant_funding_dental_care.asp

https://www150.statcan.gc.ca/n1/pub/82-625-x/2019001/article/00010-eng.htm

https://www.electricteeth.com/ca/dental-statistics/)

https://www.oda.ca/visiting-the-dentist/government-dental-programs/canadian-dental-care-plan/