Canadian Dental Plan update

We’ve been getting calls and notes from clients about the new Canadian Dental Care Plan (CDCP).  The reason for them generally fall under 2 categories…

  1.  How to code T-4’s as s required this time of year.  You can find info on our past blog posts here…

Canada is rolling out its dental care program. Here’s what you need to know

2. Can/Will the CDCP replace our dental benefits?  It us highly unlikely unless you want your employees to have a much reduced (or no) benefit.  So far we have identified a few issues.

  1. Most employees will not be eligible until the final phase launching in 2025
  2. Many employees will be prevented from using the plan due to the household income test
  3. Most dentists are NOT expected to sign up to provide service.  In fact, many of the provincial dental associations are advising not to sign up for the national plan.This means patients may have to search out a new dentist.
  4. The funding model has now been released and shows the dentists would be paid up to 40% less than a regular patient, so a big part of the cost is being paid for by dentists, not just the government.  I grabbed a few often used codes and compared to the last ODA fee guide I had (and adjusted for inflation) to check this.

Code 11111 scaling – Private plan would pay ~ $71.63,  CDCP would pay $63.00 –  12% LESS     

Code 02111 x-rays –  Private plan would pay ~ $38.66,  CDCP would pay $29.08 – 25% LESS

Code 21114 filing – Private plan would pay ~ $365.00,  CDCP would pay $209.54 – 41% LESS

5. The co-insurance on most private dental plans is 80%.  The CDCP varies based on income from 100% (household income of <$70k) down to 60% (household income of $70-80k) and even 40% (household income of $80-90k) before disallowing access.  This will provide substantially lower coverage for many employees.
6. At this point, the government has said they will NOT integrate the federal plan with private plans, so this is really only intended for those with no coverage.
If you’d like to discuss any part of the program, the implications to employees or employers, or jsut get a better understanding, please give me a call.
Dave 905-886-9203