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Posted by Samuel Verreault, Group insurance plans advisor, April 26 2023
Health Insurance
Canadian Dental Care Plan: Expanding Access to Care

canadian-dental-care-plan

In the last federal budget, the Canada Dental Benefit announced in the fall of 2022 has been expanded into the Canadian Dental Care Plan (the Plan). This is a key measure of the budget, which is supported by a government investment of $13 billon over five years, followed by $4.4 billion in permanent annual funding. Eventually, the Canadian Dental Care Plan will provide universal access to dental and oral health care. But who will be covered at first and what are the eligibility criteria?

Starting with Children Under 12 

The Canada Dental Benefit implemented in 2022 is intended for children under 12 whose parents do not have access to a private dental insurance and have a family net income under $90,000 per year.

This interim benefit is available for dental care received during 2 preset periods. The first period concerns children under 12 as of December 1st, 2022 , who receive dental care between October 1st, 2022 and June 30, 2023. The second period extends from July 1st, 2023 to June 30, 2024 for children under 12 as of July 1st, 2023.  

Thus, the benefit can be claimed twice for the same child, providing he/she received dental care on two occasions, i.e. once for each period.

To date, more than 250,000 Canadian children benefited from this program since it was implemented.

Coverage Expansion Starting in 2023

By the end of 2023, the program will also be available to Canadians under 18, persons with disabilities, and seniors with an annual family income under $90,000.

And by 2025, the Canadian Dental Care Plan will cover all Canadians with an annual family income under $90,000 who do not have access to a private dental insurance.1

Eligibility Criteria 

To be eligible for the benefit, applicants must meet certain criteria, such as:

  • Have a child under 12 for whom they currently receive the Canada Child Benefit;
  • Have an adjusted family net income under $90,000;
  • Not have access to a private dental insurance for their child;
  • Have filed their 2021 tax return;
  • Have had or will have out of pocket expenses for their child’s dental care services incurred between October 1st, 2022, and June 30, 2023, for which the costs are not fully covered or reimbursed by another dental program provided by any level of government.

The eligibility criteria are set to change in the course of 2023, particularly with respect to eligible persons. Visit the Government of Canada website to learn more or to apply.

Benefit Amounts

The benefit payments are tax-free and vary based on the 2021 adjusted family net income, as per the table below:

2021 adjusted family net income Maximum benefit amount/child/period
Under $70,000 $650 (no co-pay)
$70,000 to $79,999 $390
$80,000 to $89,999 $260

Effective July 1st, 2023, an additional payment could be received for some children whose dental costs exceed the maximum benefit amount.

Overlap Between the Canadian Dental Care Plan and Other Programs?

If another level of government also provides a dental program, that program takes precedence over the federal Plan. For example, in Quebec, children under 10 receive free of charge certain services covered by the Régie de l’assurance maladie du Québec (RAMQ). The costs not covered by RAMQ could be covered under the Canadian Dental Care Plan, in accordance with the applicable rules and maximums. 

Impact on Private Plan Dental Coverage 

Will these new provisions have an impact on dental coverage under group insurance plans? It is too early to tell, as some details have yet to be disclosed by the federal government; but rest assured that we are closely following the developments and we will keep you informed.

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

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Samuel Verreault has been working in the business world, group insurance and personal insurance for over ten years. With a strong background in insurance, real estate, and online business, his experience allows him to assist his clients on many levels. Whether it is from a personal, tax, human resources or group insurance perspective, he is passionate and involved with his clients. He goes beyond the simple supplier relationship to become an essential partner in the growth of your business.
Samuel Verreault, Group insurance plans advisor