Canadian Dental Care Plan - Member eligibility review

Access to dental insurance or coverage

The Canadian Dental Care Plan (CDCP) is an attestation-based program. This means we rely on what you tell us (attest) to make our decisions. If you tell us that you do not have access to private dental insurance or coverage, we may accept your application. However, we continue to review applications after we accept them. If what you tell us doesn't match your T4 or T4A slips, you may be selected for review. If found ineligible, you will be removed from the plan and may have to repay any amounts claimed for services provided to you under the plan during the time you were ineligible.

To be eligible, you cannot have access to private dental insurance or coverage, including health spending accounts which cover dental costs, through any of the following:

• your work or pension plan
• a family member's work or pension plan
• a professional or student organization
• insurance or coverage purchased by yourself or a family member for dental costs, including any purchased enhancements, supplementary or top-up insurance that provides dental care coverage

The only exception is you may be eligible if you are retired and opted out of your dental insurance or coverage through your pension plan before December 11, 2023, and cannot opt back in.

Your spouse and dependants may also have access through your dental benefit plan, fund or other form of coverage. If so, they are not eligible for the CDCP because your access covers them.

You are not eligible for the CDCP if you have dental insurance or coverage, even if:

• you have never used it
• you decided not to enrol in it
• you have to pay a premium for it
• you opted out of your pension dental insurance or coverage after December 11, 2023 (whether or not you can opt back in)
• it does not cover the full cost of your dental care

Health Canada may verify this information by reviewing documentation, such as your T4 or T4A slips.

Learn more:

• Find out if you are eligible

Eligibility review for plan members

We may review your eligibility for the CDCP at any time, which could change your eligibility status.

We do this review to ensure only people who qualify for the plan receive coverage.

If you are selected for review, you'll receive a letter in the mail. It will ask you to submit documents from your work or pension plan showing that you have no access to private dental insurance or coverage.

Documents you can send

You will need to send one of the following documents to prove that you have no access to dental insurance or coverage:

• Canadian Dental Care Plan Member Eligibility Review Form [PDF, 1.15 MB]

• A letter from your work or pension plan, confirming:

  • you are not offered dental insurance or coverage and the effective date
  • you do not qualify for their dental insurance or coverage and the effective date
  • the date your dental insurance or coverage ended or became unavailable
  • updated insurance information
  • your opt-out date and confirmation that you cannot opt back in to your plan, or
  • your last day of work

All documents must:

• include your full name as listed on your CDCP application,
• your CDCP Member ID, and
• be signed by an authorized representative, such as a:
  • business owner
  • Chief Executive Officer
  • Human Resources representative
  • pension plan administrator

Mail your documents to:

Oral Health Branch
Health Canada
Government of Canada
P.O. Box 10301
Matane QC G4W 0A9

Contact Service Canada if you:

• can't reach your work or pension plan
• have questions or need information about other acceptable documents

If you do not take action

If you do not submit your documents by the deadline, we will determine that you are ineligible and you will receive a letter informing you that your coverage will end. You may have to reimburse the Government of Canada for the services paid by the plan while you were ineligible.

If you are found ineligible

If you are found ineligible, you will receive a decision letter informing you that your coverage will end. This means that oral health services will no longer be covered under the plan. You should inform your oral health provider that you are no longer a CDCP member.

You may have to reimburse the Government of Canada for the services paid by plan while you were ineligible. You will not be able to reapply for coverage until you:

• repay the full amount owed, and
• meet all eligibility requirements at the time you apply

If you believe that you should not have been found ineligible and you have additional or new information that you'd like to share with Health Canada, you are welcome to mail them.