Information on the CDCP for oral health providers in Alberta
April 2026
Version 3.0
This fact sheet provides information about coordination of benefits between the Canadian Dental Care Plan (CDCP) and Alberta's dental programs.
Note: Individuals with private insurance are not eligible for the CDCP, and coordination of benefits with the CDCP cannot occur. If clients have dental benefits through a private plan, providers must not submit their claims to the CDCP.
| Program name | Contact information |
|---|---|
Low-income health benefits programs:
|
Health Benefits Contact Centre Toll-free: 1-877-469-5437 |
| Dental Assistance for Seniors Program | Alberta Supports Contact Centre Toll-free: 1-877-644-9992 |
Some patients may have CDCP coverage and dental coverage through an Alberta low-income health benefits program or the Dental Assistance for Seniors Program. If you have questions about how to coordinate their dental benefits, please contact Alberta Blue Cross, Alberta's third-party dental administrator.
| Name | Contact information |
|---|---|
| Alberta Blue Cross | For oral health providers Toll-free: 1-800-567-8104 |
Frequently asked questions
What is the payor order when a patient has coverage through both the CDCP and Alberta's provincial dental programs?
- The CDCP will be the primary payor for Alberta's low-income health benefits programs (Assured Income for the Severely Handicapped, Alberta Adult Health Benefit, Alberta Child Health Benefit, Income Supports, Children's Services, Child and Youth Support, Family Supports for Children with Disabilities and Supports for Permanency) and the Dental Assistance for Seniors Program.
- If coordination is possible, Alberta's programs (the low-income health benefits programs and Dental Assistance for Seniors Program) will serve as the secondary payor.
How will the CDCP and Alberta coordinate benefits?
Low-income health benefits programs
If patients are eligible for CDCP and dental benefits under Alberta's low-income health benefits programs, providers need to submit claims as follows.
- The claim should be submitted to CDCP first, through Sun Life. Sun Life will generate an Explanation of Benefits that shows the amount covered by the CDCP (Total Payable to Provider).
- Providers then need to submit the claim to Alberta Blue Cross as second payor. The claim will be processed according to relevant program policies and processes.
- For clients who are eligible for both the CDCP and Alberta's low-income health benefits programs, providers may be able to seek additional reimbursement for the portion of their fees not covered by the CDCP, up to the maximums in the provincial schedules, through coordination of benefits.
Example: Permanent dentition exam
- Patient has low-income health benefits program - Assured Income for the Severely Handicapped (AISH) dental coverage and CDCP coverage
- Provider charges: $143.85
- CDCP pays $118.64
- AISH eligible fee is $79.12
- AISH assesses balance remaining of $25.21
- Total paid to provider = $143.85
- Some services covered by the CDCP and by Alberta's low-income health benefits programs are subject to frequency limits. These frequency limits are not cumulative — neither the CDCP nor the low-income health benefits programs will provide coverage for services beyond their respective frequency limits. If a client's frequency limit under a low-income health benefits program has been met by CDCP coverage, the low-income health benefits program will not provide any additional services.
- CDCP clients will be responsible for paying any applicable co-payments and any remaining amounts not covered by the CDCP or Alberta's provincial dental programs.
- Balance billing is not permitted when an Alberta low-income health benefits program is used to supplement CDCP established fees. Alberta's fee schedules are posted on the Alberta Blue Cross dental provider website.
- Providers may charge for services that are not eligible under Alberta's provincial dental programs, or in cases where the program pays $0, such as situations involving coordination of benefits or services that exceed frequency limits.
Dental Assistance for Seniors Program
If patients are eligible for CDCP and dental benefits under Alberta's Dental Assistance for Seniors Program, providers need to submit claims as follows.
- The claim should be submitted to CDCP first, through Sun Life. Sun Life will generate an Explanation of Benefits that shows the amount covered by the CDCP (Total Payable to Provider).
- Providers then need to submit the claim to Alberta Blue Cross as second payor. The claim will be processed according to relevant program policies and processes.
- Note: The Dental Assistance for Seniors program does not provide full coverage of the fees charged by Alberta dental providers.
Example: Permanent dentition exam
- Patient has Dental Assistance for Seniors Program (DASP) coverage and CDCP coverage
- Provider charges: $143.85
- CDCP pays $118.64
- DASP eligible fee is $98.00
- DASP covers $0.00
- Total paid to provider $118.64
- Provider can balance bill the remaining $25.21 to the DASP client
- Some services covered by the CDCP and by Alberta's Dental Assistance for Seniors Program are subject to frequency limits. These frequency limits are not cumulative. Neither the CDCP nor the Dental Assistance for Seniors Program will provide coverage for services beyond their respective frequency limits. If a client's frequency limit under the Dental Assistance for Seniors Program has been met by CDCP coverage, the Dental Assistance for Seniors Program will not provide any additional services.
- CDCP clients will be responsible for paying any applicable co-payments and any remaining amounts not covered by the CDCP or Alberta's provincial dental programs.
What if services require preauthorization under the CDCP?
- Some services require prior approval through preauthorization before coverage by the CDCP is confirmed. Certain services always require preauthorization, and some services above CDCP frequency limits can be requested through preauthorization.
- Providers should refer to the CDCP Dental Benefits Guide for services covered by the CDCP and its policies, including criteria, guidelines and limitations.
- Providers should also refer to the CDCP Dental Benefit Grids for the list of procedure codes that always require preauthorization (under "Schedule B" or identified with a "P"). This includes treatment for services available without prior approval but above established frequency limits.
- Oral health providers need to submit all required and relevant documentation directly to Sun Life. Please refer to the CDCP Dental Benefits Guide for documentation requirements.
- If a service requires preauthorization, the preauthorization request must always be submitted to the CDCP, regardless of whether the service is covered or has been preauthorized by another federal or provincial dental program.
Resource
For more guidance on the claims submission process for CDCP, including preauthorization, post-determination, and reconsideration steps, please refer to the Sun Life claims submission information resource.