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Federal dental plan - Letter from Service Canada
December 29, 2023
10:17 am
Alexandre
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One of my elderly relatives received letter in the mail from Service Canada this week, inviting to apply for Federal dental plan.

Letter says that first wave of invitations will go to people older than 70 with family income under $90,000 based on 2022 tax return, but not to all at once. My relative is way above 80, his wife is just 6 months younger but she hasn't got letter yet.

First group of invitees can only apply over the phone. My relative told me that applying was easy: he phoned the number provided, didn't wait on hold, was greeted by automated system. No human interaction.

He was asked to enter Application Code that came in letter, his SIN number. Answered few questions regarding eligibility, mostly about already having dental insurance.
The process took less than five minutes.

After applying and considered to be eligible, he was told confirmation letter from Service Canada will arrive in 15 business days. After that, if letter confirms his eligibility, he should expect package from the Sun Life Assurance Company in about 3 months, which will include details about benefits, when they begin and how much of costs will be covered.

December 30, 2023
9:40 am
Doug
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Yes, invitations are being rolled out in phases, from oldest to youngest. Those 65-70 should expect to receive invitation letters in the mail sometime in late April, most likely, with general availability open to those 18+ without an existing private dental care plan, either paid for by their employer or self-funded, beginning in May 2023.

There is an annual eligibility test, based on the prior year's adjusted net income (which is family income, not individual income like the OAS clawback test, so is much lower). If your income is above $90,000, I'm not sure if your Sun Life dental care account will be cancelled or if claims just won't be paid (i.e., "paid at 0%"). The latter would be nicer and cleaner, in my opinion. Keep in mind, though, to receive 100% reimbursement, your family net income must be below $70,000. If it's between $70-90,000, it'll be reimbursed at between 40-60%, with you responsible for the other 40-60% of costs.

You'll be covered for things like dental cleanings, scaling, planing, some root canal work (including root canals), filings, tooth extractions, etc. What won't be covered will be things like crowns, onlays, partials, dentures, or orthodontics.

My concern is that this plan is a pretty premium plan to what many low income employed individuals (i.e., Wal-Mart Canada Corp. or Loblaw Companies Ltd.) have and, as such, they won't be eligible for it, so we've essentially created a two-tiered system wherein if your company has notionally done the right thing and provided a plan, those workers will effectively be penalized because of those employer trying to do the right thing versus employers that have provided nothing, those workers will get a very good plan. Thus, companies will be incentivized to no longer provide dental care plans and offload workers to the Canada Dental Care Plan, or, in the case of Loblaw, the UFCW will have to decide if they'd be willing to give up the guarantee of a dental care plan in their CA with the hope the federal government won't ever take this away...

Cheers,
Doug

December 30, 2023
10:07 am
lifeonanisland
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Doug said
You'll be covered for things like dental cleanings, scaling, planing, some root canal work (including root canals), filings, tooth extractions, etc. What won't be covered will be things like crowns, onlays, partials, dentures, or orthodontics.

No, that's not what's being covered.

"The CDCP will help cover the cost of various oral health-care services, with the focus on "those deemed medically necessary by an oral health-care professional," an information officer with the general information line for the government of Canada told CBC News.

Services covered under the Canadian Dental Care Plan include:

Preventive services, including scaling (cleaning), polishing, sealants and fluoride.
Diagnostic services, including examinations and X-rays.
Restorative services, including fillings, crowns and dentures.
Endodontic services, including root canal treatments.
Prosthodontic services, including complete and partial removable dentures.
Periodontal services, including deep scaling.
Oral surgery services, including extractions.

​​​​​​Some of these services will be available in the fall of 2024. Other services such as teeth whitening, implants and mouth guards will not be covered under the plan."

December 30, 2023
12:20 pm
Norman1
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Doug said
You'll be covered for things like dental cleanings, scaling, planing, some root canal work (including root canals), filings, tooth extractions, etc. What won't be covered will be things like crowns, onlays, partials, dentures, or orthodontics.

lifeonanisland said

No, that's not what's being covered.

"The CDCP will help cover the cost of various oral health-care services, with the focus on "those deemed medically necessary by an oral health-care professional," an information officer with the general information line for the government of Canada told CBC News.

 

That's right: CDCP will help but not necessarily cover those things.

CDCP won't cover the cost completely if the provider is not willing to perform the treatment for the CDCP fee schedule price. CDCP: What services are covered warns about that:

How much will be covered

Oral health providers are encouraged to follow the CDCP fees, which are not the same as the provincial and territorial fee guides, so their patients do not face additional charges at point of care.

Patients should always confirm what costs will not be covered by the plan and that they will be expected to pay with their oral health provider before receiving care.

December 30, 2023
1:00 pm
Alexandre
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When I get my hands on Sun Life package for my relative, I'll share most interesting parts here. Unless someone beats me to it or media publishes more details.

I asked my relative more questions about letter and phone call. Letter came on two pages, French and English, but on call he was asked what language he prefers for future communications. He said he is hopeful that'll cut amount of printed papers he'll be getting by half.

He was initially reluctant to call phone line, because he expected usual call centre level of service: "Your call is important to us. All our agents are currently busy serving other customers."
He was pleasantly impressed by not having that experience.

Each entry he made over phone required confirmation. He enters SIN, for example, they repeat it back and ask to confirm if it is correct. It gives chance to correct mistake.
I wonder what would have happened if someone accidentally enters "I have dental insurance" and confirms that entry: is it game over or would it be possible to redo this? I am not asking my relative to test that.sf-smile

He now diligently checks mailbox for the letter addressed to his wife.

In conclusion: if you get that letter and believe you qualify, don't delay - call them right away. Right now it is fast, no holds while on the phone, takes less than 5 minutes of your time. Just make sure you have Application Code from letter and your SIN number on hand.

December 31, 2023
10:11 am
Doug
British Columbia, Canada
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Norman1 said
CDCP won't cover the cost completely if the provider is not willing to perform the treatment for the CDCP fee schedule price. CDCP: What services are covered warns about that:

How much will be covered

Oral health providers are encouraged to follow the CDCP fees, which are not the same as the provincial and territorial fee guides, so their patients do not face additional charges at point of care.

Patients should always confirm what costs will not be covered by the plan and that they will be expected to pay with their oral health provider before receiving care.

  

Good point, Norman. I missed that, or it didn't completely sink in, that the Canada Dental Care Plan will follow its own fee schedule. All, or nearly all, B.C. dental practitioners follow the B.C. Dental Fee Guide, so unless the B.C. Dental Fee Guide is lower than the CDCP fee schedule, that should result in lower than expected reimbursement rates, regardless of the reimbursement rate one is in.

Cheers,
Doug

December 31, 2023
11:49 am
lifeonanisland
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Doug said

Good point, Norman. I missed that, or it didn't completely sink in, that the Canada Dental Care Plan will follow its own fee schedule. All, or nearly all, B.C. dental practitioners follow the B.C. Dental Fee Guide, so unless the B.C. Dental Fee Guide is lower than the CDCP fee schedule, that should result in lower than expected reimbursement rates, regardless of the reimbursement rate one is in.

Cheers,
Doug  

Yes. But unlikely to be much of a difference.

December 31, 2023
5:53 pm
julio
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1. When calling the government dental enrolment line, there is no live agent to deal with, only phone prompts. Good to know for POAs.

2. Fee guide. Only thing is to wait for it. There are quite a few in Ontario alone. Some "disadvantaged group" fee guides pay fees that are lower then a e.g. lab fee alone. Or frequency limitations, etc... If a dentist takes these as patients, the dentist would be subsidizing their treatment. And billing the patient "extra" is forbidden, even if the patient INITIALLY agrees. Of course, change of mind can later come into play. Let's wait for this fee guide details and then one can discuss it.

January 12, 2024
9:27 am
Alexandre
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Confirmation letter arrived today: my relative qualifies.

Letter summary:

You qualify, nothing else is needed from you at this time. Welcome package from Sun Life Assurance will arrive in the next three months. Welcome package will include membership card and coverage details.
Start date of dental benefits coverage will be provided in the welcome package. Dental services received before start date will not be reimbursed by this dental plan.

January 12, 2024
3:34 pm
dommm
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My family adjusted net income in 2022 is over the $90,000 threshold but my family adjusted net income this year 2023 will be considerably lower than $70,000. Does this mean I will have to wait until 2025 to be eligible?

January 12, 2024
3:56 pm
Loonie
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It says eligibility is based on previous year's tax return, so perhaps when you get your Notice of Assessment for 2023 you may be able to apply as that is the year prior to the current one. I don't think you can do anything before that at least.

January 13, 2024
4:40 am
Alexandre
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Eligibility is also based on age of an applicant. Most adults age 18 to 64 will have to wait till 2025 regardless of income.
See Canadian Dental Care Plan - When can you apply

Right now it is possible to apply by invitation letter only. That letter is based on income from 2022 tax return.
People who are eligible to apply starting in May 2024 will be able to do so online. I am assuming this is when it'll be possible to find when 2023 tax return will be taken into consideration.

January 13, 2024
10:33 am
Doug
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dommm said
My family adjusted net income in 2022 is over the $90,000 threshold but my family adjusted net income this year 2023 will be considerably lower than $70,000. Does this mean I will have to wait until 2025 to be eligible?  

No, likely not. 2022 was used because it`s the most recent income tax year. The feds just took all year to come up with this, after the NDP threatened to pull their support, most likely. Trudeau and Liberals down in the polls makes a world of difference to Jagmeet Singh`s sphere of influence. sf-cool

You should be eligible in 2024 if your 2023 family adjusted net income is below $90,000. If it`s below $70,000, you qualify for 100% reimbursement rates*

Cheers,
Doug

* According to CDCP fee guide, not your provincial and territorial fee guide your dentist office likely uses

January 13, 2024
10:34 am
Doug
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Loonie said
It says eligibility is based on previous year's tax return, so perhaps when you get your Notice of Assessment for 2023 you may be able to apply as that is the year prior to the current one. I don't think you can do anything before that at least.  

Yep, exactly. 🙂

More details at:

https://www.highinterestsavings.ca/forum/your-stories/federal-dental-plan-letter-from-service-canada/#p94562

January 21, 2024
12:58 pm
Alexandre
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Alexandre said
One of my elderly relatives received letter in the mail from Service Canada this week, inviting to apply for Federal dental plan.

My relative is way above 80, his wife is just 6 months younger but she hasn't got letter yet.

His wife got invite in the mail this week. They both enrolled now and waiting for next step, which should be package from insurance provider.

May 24, 2024
11:56 am
Alexandre
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My elderly relative and his wife are now card carrying members of CDCP.

He has not been at his dentist for a while, so they suggested Complete Exam and Cleaning. They gave him estimates, and this is for Ontario.

Without insurance (full price)
Complete Exam: $340
Cleaning: $235

With CDCP, he pays
Complete Exam: $45
Cleaning: $26

To emphasize, his out of pocket total expenses are $71, out of $575.

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