Canadian Dental Care Plan - Member eligibility review
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Access to dental insurance or coverage
The Canadian Dental Care Plan (CDCP) is an attestation-based program. When you apply or renew, you attest that you and your dependants (if applicable) do not have access to private dental insurance or coverage.
Even after you are enrolled in the CDCP, we may review your eligibility. For example, we may compare the information in your application with information reported on your or your spouse's or common-law partner's (if applicable) T4 or T4A slips.
If the information does not match, you may be asked to provide documentation to support a review.
If you or your dependants are declared ineligible for the CDCP, coverage will end. You may also have to reimburse the Government of Canada for the services paid by the plan while you or your dependants were ineligible.
To be eligible for the CDCP, 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 that 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.
Having access means that you have been offered a benefit plan, fund or other form of coverage through your work or pension plan. For example, other coverage may include:
- free dental care if you or a family member work in a dental office
- a payment to purchase dental coverage through a private plan
Your spouse or common-law partner and dependants may also have access through your private 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 private 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 or your spouse's or common-law partner's (if applicable) T4 or T4A slips.
Learn more:
How dental insurance or coverage is shown on your tax slips
Under the Dental Care Measures Act, employers and pension plan administrators must report whether they offer private dental insurance or coverage to you and your family in:
If you see the number 1 in either of these boxes, it means your work or pension plan reported that you do not have access to dental insurance or coverage through your work or pension plan.
If you see the number 2, 3, 4, or 5, it means your work or pension plan reported that you were offered some kind of dental insurance or coverage for you and your family.
We may review your eligibility if the information on your or your spouse's or common-law partner's (if applicable) T4 or T4A slips, or from other sources, does not match the information you provided on your or your dependants' CDCP application.
Note: Before you confirm that you or your dependants do not have access to private dental insurance or coverage, check the code in the T4 or T4A slips of your spouse or common-law-partner (if applicable). You or your dependants may have access to dental insurance or coverage through their work or pension plan. If you believe that your or your spouse's or common-law partner's work or pension plan has reported the code incorrectly, contact the employer or pension plan administrator to confirm or correct the information before completing your CDCP application or renewal.
Eligibility review for plan members
We may review your or your dependants' 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 or your dependants are selected for review, you'll receive a letter in the mail. It will ask you to submit documents from your or your spouse's or common-law partner's (if applicable) work or pension plan showing that you and/or your dependants do not have access to private dental insurance or coverage.
What to do if your or your dependants' eligibility is reviewed
- Read your letter carefully as it will help guide your next step
- Contact Service Canada to be removed from the CDCP if you have access to private dental insurance or coverage
- If you believe you or your dependants do not have access, contact the employer or pension plan administrator that reported it to provide proof
- Send the supporting documents by email or mail. We must receive them before the deadline in the letter
- By email: SPAC.cdcpmerdocuments-documentseamrcsd.PSPC@tpsgc-pwgsc.gc.ca
- By mail:
Oral Health Branch
Health Canada
Government of Canada
PO Box 10301
Matane, QC G4W 0A9
Important information:
- In the subject line of your email, please include the following: MER Documents - Full Name - Member ID
- You may choose to submit your documents by email or by mail. Please note that email may not be a secure method of transmitting personal information
- Please submit all requested supporting documents together in a single submission and through one channel only. Your eligibility review will be based on the documents included in that submission. Multiple, duplicate, or incomplete submissions will not be processed. Please ensure your submission includes all documents requested for your eligibility review
- Only PDF, TIF, JPEG, and PNG file formats are accepted for email submissions. Documents submitted in any other file format cannot be processed and may need to be resubmitted, which could delay the review of your eligibility
- To protect your privacy, please submit only the documents requested to support the review of your eligibility for the CDCP. Do not send additional documents or personal information that has not been requested
- This email inbox is used exclusively to receive supporting documentation for CDCP Member Eligibility Reviews. It is not monitored for inquiries and cannot respond to questions about your application, eligibility status, or the review process. Documents or messages unrelated to a Member Eligibility Review may not be reviewed, acted upon, or responded to
- You will receive an automatic email confirming that your message has been received. This confirmation does not indicate that your documents have been reviewed, accepted, or found sufficient to support your eligibility review
Supporting documents you can send
To prove that you or your dependants have no access to private dental insurance or coverage, you need to send the Canadian Dental Care Plan Member Eligibility Review Form, completed and signed by the work or pension plan that reported the access.
You still need to complete Section 1 of the form even if you choose to provide alternative supporting documents, such as a letter confirming one of the following:
- 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 or coverage information
- that you (or your spouse or common-law partner, if applicable) opted out of a pension plan's dental insurance or coverage before December 11, 2023, and cannot opt back in to the plan; or
- your (or your spouse's or common-law partner's, if applicable) last day of work, confirming that you are no longer offered dental insurance or coverage
All documents must:
- include your or your dependants' full name as listed on the CDCP application
- your or your dependants' CDCP Member ID, and
- be signed by an authorized representative, such as a:
- Business owner
- Chief Executive Officer
- Human Resources representative
- Pension plan administrator
Contact Service Canada if you:
- can't reach your work or pension plan
- have questions or need information about other acceptable documents
Deadline to submit
We must receive the supporting documents by the deadline indicated in your Notice of Eligibility Review letter. The deadline is 45 days from the date the letter is issued. Documents received after this deadline may not be considered.
If you do not take action
If we do not receive the supporting documents by the deadline, we will determine that you or your dependants are ineligible and you will receive a letter informing you that coverage has ended. You may have to reimburse the Government of Canada for the services paid by the plan while you or your dependants were ineligible.
If you or your dependants are declared ineligible
If you or your dependants are declared ineligible, you will receive a decision letter informing you that the 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 or your dependants are no longer a CDCP member.
You may be required to reimburse the Government of Canada for the services paid by plan while you or your dependants were ineligible. You will not be able to reapply for coverage until you:
- have sent documents for review
- have repaid the full amount owed, and
- meet all eligibility requirements at the time you apply
Learn more about privacy protection in the CDCP.