Great news for many Canadians—but the fine print still matters.
Big changes are underway in dental care across Canada, and they’re worth paying attention to. As of May 2025, the Canadian Dental Care Plan (CDCP) is expanding to include new age groups—a major step toward more accessible, affordable care for millions of Canadians.
At Dental Pathways, we applaud this milestone. We believe in a future where no one has to delay essential dental work because of cost. But while the Canadian Dental Care Plan is a promising development, it’s not without its limitations—some of which patients may not fully realize until they’re facing a treatment plan that’s only partially covered or delayed.
If you missed our original post describing the Canadian Dental Care Plan, you can read it here: What the Canadian Dental Care Plan (CDCP) Covers—and Where It Falls Short.
In this article, we break down what’s changing in the Canadian Dental Care Plan, what it does and doesn’t cover, and what options you may have if your needs fall outside the scope of this plan.
What Is the Canadian Dental Care Plan (CDCP) and Who is Eligible?
The CDCP is a federal initiative designed to provide dental coverage for Canadians who:
- Have an annual family net income below $90,000
- Do not have access to private dental insurance
- Are Canadian residents with a valid tax return
It aims to reduce out-of-pocket dental expenses for eligible individuals through a government-managed benefits plan administered by Sun Life.
What Groups Have Been Eligible (Until Now)?
Before the most recent changes, the CDCP was available to:
- Seniors aged 65+
- Children under 18
- Adults with a valid Disability Tax Credit certificate
Application rollout began in late 2023, and services under the plan started being delivered as early as May 2024, based on the age group eligibility.
New Eligibility Updates: Who Can Apply Now?
As of May 2025, the CDCP has expanded access in a phased rollout for additional age groups:
- May 1: Adults aged 55 to 64 can apply
- May 15: Adults aged 18 to 34
- May 29: Adults aged 35 to 54
This brings Canada closer to the goal of near-universal dental coverage for low- and middle-income households—a milestone worth celebrating.
For the latest updates and application details, visit the official: Government of Canada CDCP page.
Where the Canadian Dental Care Plan Falls Short: A Closer Look
At Dental Pathways, we’ve looked closely at how the CDCP works in real life situations—especially for patients needing more complex or costly treatment. While the Canadian Dental Care Plan has made real progress, there are still important gaps in coverage. Here are a few realities Canadians should be aware of:
1. You Must Be Uninsured to Qualify
To receive CDCP benefits, you must not have access to private dental insurance. That’s a fair starting point—but many Canadians with insurance still find that their plans fall short of what they need. Most policies barely cover more than routine cleanings and checkups—and when it comes to major procedures, annual maximums are often used up quickly, leaving patients to pay out of pocket when they need coverage the most.
2. Not All Treatments Are Covered—And Some Require Pre-Authorization
The CDCP covers a range of basic dental services, including exams, cleanings, X-rays, fillings, and simple extractions. These are important for maintaining oral health—but they’re also among the least expensive treatments most Canadians face.
More complex procedures—such as crowns, posts and cores, extensive root canals, dentures, periodontal therapy, and sedation—typically require pre-authorization. Approval isn’t always guaranteed and depends on the treatment, documentation, and income level. In some cases, only partial coverage is offered.
Other treatments fall entirely outside the scope of the CDCP. This includes cosmetic dentistry procedures like dental veneers and laser teeth whitening, as well as restorative treatments such as dental implants, zirconia implants, and full-mouth restorations. Even when medically necessary, these are not eligible for reimbursement under the plan.
For patients facing major dental needs, these exclusions often mean one of two options: pay out of pocket—or delay treatment at the risk of worsening oral health.
3. Pre-Authorizations and Wait Times
For treatments that do require pre-authorization, wait times can stretch anywhere from 6 to 8 weeks—or longer. Dental practices have reported that the approval process is complex, and minor submission errors can lead to significant delays—leaving both patients and providers frustrated while essential care is put on hold.
4. Balance Billing: CDCP Reimbursement Rates Are Below What Dentists Typically Charge
Here’s something many patients don’t realize: the CDCP sets fixed payment rates for each treatment—but these rates are often lower than what dentists typically charge in Canada. In fact, CDCP reimbursements usually cover only 74% to 86% of standard fees, based on provincial dental fee guides.
So even when a treatment is approved, the plan only pays up to its set amount. Patients are responsible for the difference—known as balance billing—on top of any income-based co-pay they may owe, depending on eligibility.
5. Middle-Income Patients May Still Face Significant Costs
The Canadian Dental Care Plan can often provide meaningful support for lower-income Canadians, but coverage decreases as income rises. For those earning between $80,000 and $89,999—the highest eligible bracket—patients can expect to pay, on average, more than 50% of the total cost of their treatment. That’s still a substantial expense for anyone needing more than basic or preventive care.
A Real Life Example: Two Dental Crowns
Let’s say a patient needs two dental crowns—a common restorative procedure that typically costs around $3,300 at a Canadian dental clinic.
For this example, we’ll assume the CDCP reimburses 80% of the clinic’s fee guide rate for this treatment. That leaves the patient responsible for the remaining 20% balance—$660—known as balance billing.
The remaining $2,640 is subsidized by the CDCP based on income eligibility, as shown below:
| Annual Income | Coverage | CDCP Pays | Patient Pays |
| $68,000 | 100% | $2,640 | $660 |
| $75,000 | 60% | $1,584 | $1,716 ($1,056 + $660) |
| $85,000 | 40% | $1,056 | $2,244 ($1,584 + $660) |
This example assumes:
- The dental provider participates in the CDCP (not all do)
- The procedure is eligible and approved in advance
- There are no delays or issues with documentation
Even with all of that in place, patients at middle and higher income tiers can still expect to wait—and pay more than 50% of the total cost out of pocket.
For Canadians Still Facing Gaps in Coverage, We’re Here to Help
At Dental Pathways, we support what the CDCP is working to achieve—and we hope it helps as many Canadians as possible access the care they need. But for those who don’t qualify, or who require treatments that fall outside the scope of the Canadian Dental Care Plan, we’re here to help.
We connect Canadians to trusted, high-quality dental care in Turkey—often for 70% to 86% less than what they’d pay at home. For patients needing dental crowns, veneers, implants, or full-mouth restorations, it could be the difference between delaying treatment and finally moving forward with confidence.
