Using the plan at our office
If you are a member of the Canadian Dental Care Plan, you are welcome to use it here. Please bring your member card to your first visit. We will confirm your coverage with Sun Life, which administers the plan for the federal government, and send your claims to them ourselves.
A first visit under the plan is the same as anyone else's: an examination, any x-rays that are needed, and a talk with you about what comes next.
Are you eligible?
Many people ask whether they qualify. The plan is meant for people with no access to dental insurance and a household income below a set limit. As the rules stand now, the limit is an adjusted family net income of less than $90,000, and you need to be a resident of Canada for tax purposes who filed a return last year.
Having insurance available to you, through an employer or a partner's plan for example, rules you out even if you do not use it. Eligibility is decided by the government, not by a dental office, and the rules can change. You can check them and apply at canada.ca/dental.
What is and is not covered
- Covered: examinations and x-rays, cleanings, fillings, root canal therapy, extractions and dentures.
- Covered with approval first: some larger items, crowns included. We will apply on your behalf and wait for the answer before going ahead.
- Not covered: implants, whitening, veneers and other cosmetic work.
Keeping your coverage
Membership is renewed every year and relies on your tax return being filed on time. If your coverage lapses, the plan does not pay for care you receive in the gap, so we suggest checking your renewal before a long course of treatment.
How much the plan pays
The plan pays a share of its own established fee for each service. The share depends on your income:
- Income under $70,000: the plan pays its full fee.
- $70,000 to $79,999: the plan pays 60 per cent and you pay 40.
- $80,000 to $89,999: the plan pays 40 per cent and you pay 60.
The plan's established fee is not our fee. Like every patient here, you are charged the Ontario Dental Association's suggested fee, and for many services the plan's figure is below it. That gap is yours to pay, on top of any co-payment. We will work out both for you in writing before treatment begins, so you know where you stand; see fees and insurance.