Coverage Gaps, Costs and 2026 Rules
Canadian Dental Care Plan: who qualifies, co-payments and how it fits with private dental insurance
CDCP eligibility explained: the $90,000 income limit, the no-access-to-dental-insurance rule, co-payment tiers, extra charges, renewal and when private dental cover is better.
The Canadian Dental Care Plan (CDCP) is a federal program that pays for dental care for Canadian residents who have no access to private dental insurance and an adjusted family net income under $90,000. You and your spouse or common-law partner must have filed your previous year's tax returns. If your adjusted family net income is under $70,000 you pay no co-payment for covered services at CDCP fees; between $70,000 and $79,999 you pay 40%; between $80,000 and $89,999 you pay 60%. Any access to private dental coverage disqualifies you, even a plan you buy yourself, never use, or that only covers part of your costs. The plan is run by Health Canada and Employment and Social Development Canada, and Sun Life processes claims on the government's behalf.
This guide is part of the private health insurance in Canada overview. Check the details on Canada.ca before you apply; rules are described as of October 2026.
The four eligibility conditions
According to the Government of Canada's eligibility page, you must meet all of these:
- No access to private dental insurance. Access includes coverage through your job, a pension plan, a family member's plan, a professional or student organization, or insurance you buy yourself. Declining an employer plan that you could have joined still counts as access. A narrow exception applies to some retirees who opted out of pension dental coverage before 11 December 2023 and cannot opt back in.
- Tax returns filed in Canada for the previous year, by you and your spouse or common-law partner.
- Adjusted family net income under $90,000. This is family net income (line 23600) minus Universal Child Care Benefit and RDSP income received, plus any of those amounts repaid.
- Residency in Canada for tax purposes, for you and your spouse or partner.
Coverage through a federal, provincial or territorial social program (for example, a provincial dental program for social assistance recipients) does not disqualify you; the plans may coordinate.
How to check for "access" on your tax slips
Employers and pension plans now report dental coverage access. Look at box 45 of your T4 (employment) or box 015 of your T4A (pension). Code 1 means no access to dental coverage was reported; codes 2 to 5 mean coverage was offered to you or your family. Check your spouse's slips too. If a slip looks wrong, ask the employer or pension administrator to correct it.
Co-payment tiers
| Adjusted family net income | CDCP pays (of CDCP fee) | You pay (co-payment) |
|---|---|---|
| Under $70,000 | 100% | 0% |
| $70,000 to $79,999 | 60% | 40% |
| $80,000 to $89,999 | 40% | 60% |
| $90,000 or more | Not eligible | — |
The co-payment is a percentage of the CDCP fee for the service, not of what your dentist charges. If the dentist's usual fee is higher than the CDCP fee, you may also pay the difference. Providers who see CDCP patients are expected to tell you about any extra charges before treatment, so ask.
Worked example: a filling and a cleaning
A couple in Nova Scotia with adjusted family net income of $76,000 (40% co-payment tier). Illustrative figures:
- Exam, cleaning and x-rays: dentist's fee $310, CDCP fee $260
- One filling: dentist's fee $220, CDCP fee $190
CDCP pays 60% of the CDCP fees: 60% x ($260 + $190) = 60% x $450 = $270. Co-payment: 40% x $450 = $180. Difference between dentist's fees and CDCP fees: ($310 + $220) - $450 = $80. Total paid by the couple: $180 + $80 = $260 of a $530 bill.
If their income were $65,000, the co-payment would be zero and they would pay only the $80 difference, or nothing if their dentist bills at CDCP fees. The amount they pay is an eligible medical expense for the tax credit; see the medical expense tax credit worked example.
What is covered
The Canada.ca coverage page lists:
- Preventive and diagnostic: exams, x-rays, cleaning (scaling), fluoride, sealants
- Basic: fillings, root canals, non-surgical gum treatment
- Major: crowns and partial dentures with preauthorization, complete dentures, extractions, surgical removal of cysts and tumours
- Sedation: some with preauthorization
- Orthodontics: not currently available
Services beyond the plan's frequency limits, crowns, partial dentures, root canal re-treatments and deep sedation need preauthorization, and not every request is approved. Ask your dentist to submit it before treatment.
CDCP versus private dental insurance
| Question | CDCP | Private dental plan |
|---|---|---|
| Premium | None | Monthly premium |
| Income test | Under $90,000 adjusted family net income | None |
| Waiting periods | Frequency limits and preauthorization | Often a waiting period for major work |
| Orthodontics | Not available | Sometimes, usually with a lifetime maximum |
| Dentist choice | Dentists who accept CDCP patients | Any licensed dentist |
| Can you have both? | No: having a private plan makes you ineligible | — |
For most eligible households under $70,000, CDCP is far cheaper than any individual dental plan. Above $70,000 the co-payment and possible fee differences narrow the gap, but a private plan's premium plus its own coinsurance often still costs more; work it through in dental insurance vs paying yourself.
Renewing and changes
Eligibility is reviewed every year. For the 2026–27 benefit year, existing members were asked to renew in the spring of 2026 by attesting again that they have no private dental coverage. If you gain access to a private plan, for example a new job with dental benefits, you no longer qualify and should update your status; giving false information can lead to removal and repayment of claims paid while you were ineligible. If you lose private coverage, you may become eligible. Check the current renewal and application dates on Canada.ca, as they are announced each year.
Mistakes to avoid
- Buying an individual dental plan and then applying for CDCP. The plan you bought counts as access.
- Assuming "no claims" means "no access". A plan offered by your employer that you declined still disqualifies you.
- Not asking about fee differences before treatment.
- Missing the renewal and finding your coverage lapsed at the next appointment.
Frequently asked questions
Can my children get CDCP if my employer offers family dental coverage?
No. If a family member's plan gives the children access to dental coverage, they are not eligible, even if you choose not to enrol them.
Do I need a referral or a special dentist?
You need a dental provider who accepts CDCP patients. Ask when booking. No referral from a doctor is needed.
Does CDCP count as taxable income?
CDCP benefits are not reported as income on your return. Only what you pay yourself counts as a medical expense for the credit.
What about Quebec?
CDCP applies in Quebec on the same federal criteria. Quebec's own public dental coverage for young children and social assistance recipients may coordinate with it.
Sources
- Canadian Dental Care Plan on Canada.ca — eligibility, coverage, co-payments and renewal
- Health Canada — program background
- Canada Revenue Agency — adjusted family net income and tax slips
- Canadian Dental Association — information for patients on dental care
