Nearly half of the 5.2 million Canadians approved under the federal Canadian Dental Care Plan (CDCP) have yet to see a dentist, Health Minister Marjorie Michel acknowledged Thursday.
“It’s still a new program,” Michel told reporters when pressed on the uptake rate. “It’s like, you can go to your doctor, and you don’t feel the need to go tomorrow morning, but you still can go to the doctor. It’s just the same,” she said, as reported by CBC and CTV News.
The CDCP, launched in December 2023, aims to extend publicly funded dental care to low- and middle-income families. In May, Ottawa opened enrolment to the final cohort — Canadians aged 18 to 64. To date, 3.6 million applicants have been approved for coverage for the 2024–25 benefit year, according to Health Canada.
Balance billing under scrutiny
When asked about dentists’ use of “balance billing” — charging patients the difference between the CDCP’s reimbursement and their usual fees — Michel said her office is “monitoring very closely how fees are applied.”
“My department is working closely also with the providers to make sure that we can understand the cost, why the costs are applied, and we will improve within time,” she added. “But it’s still a work in progress.”
The Canadian Dental Association has said the program is improving, but warned in September that political messaging continues to fuel misconceptions that the plan is entirely free. Families with household incomes under $90,000 qualify, but only those earning less than $70,000 avoid co-payments.
Related: Dental program improving, industry says, but misconceptions about ‘free’ care persist
Related: First national survey: Most oral health providers can handle increase in CDCP patients
Preauthorization bottlenecks
Another challenge has been the program’s preauthorization system. In an email to Oral Health Group, Health Canada said the total approval rate for preauthorization requests in August was 41.7 per cent, including incomplete submissions. Excluding incomplete requests, the approval rate rose to 52.2 per cent.
Commonly missing documentation includes radiographs, periodontal charting and treatment plans, particularly for crown procedures. By contrast, preauthorization requests for partial dentures are more often complete. Other reasons for denial include failing to meet clinical criteria, duplicate requests, or ineligible services.
“It is also important to note that the vast majority of services covered under the CDCP do not require preauthorization,” Health Canada said.
However, the Alberta Dental Association has reported that about 70 per cent of treatment claims in that province are being rejected — even when preauthorized — creating further confusion for dentists and patients.
Related: Alberta’s dentists are in ‘limbo’ amid federal vs provincial dental programs ‘confusion’
Uptake still growing
While most dentists across the country have signed onto the plan, patients are still grappling with rollout issues, including delays in accessing care even for those who are insured.
Related: Dental care tops list of delayed treatments, even for insured Canadians, survey finds
Michel also emphasized Prime Minister Mark Carney’s commitment to the CDCP, noting it remained untouched in his first federal budget. In September, Carney said Ottawa will continue to support national social programs such as dental care, child care and pharmacare, even as tough spending decisions loom in the fall budget.
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