Canadian Dental Care Plan : a challenge
Mélissa Gélinas
While providing help to the 6 million Canadians registered, the multi-billion dollar Canadian Dental Care Plan (CDSP) can also be a real headache for dental professionals. Indeed, some have the obligation to manage problems with funding, eligibility and various administrative aspects. In Outaouais, the situation was reported by a denturist Daniel Gaudreau, of the Lapointe Dental Centre.
A financial headache
According to Mr. Gaudreau, the non-compliance with certain financial agreements is largely responsible for the problem. Indeed, the commitments and responses provided following the estimates would not always be met by Sun Life.
"For example, it can happen that out of an estimate of $1,500 for a dental prosthesis, the patient has to pay $500," he explains. "So we have written proof that the insurer will have to reimburse $1,000, but when the time comes for the claim, the rules change and, instead of the patient paying $500, he now has to pay $800," he continues. This $300 increase would be explained by an increase in laboratory fees in the meantime. However, neither the patient nor the professional was informed. As a result, the burden falls on dental professionals who find themselves having to pay for these new costs.
On the other hand, according to him, it also happens that some patients receive a positive response from the insurer as well as their insurance card, even though they are not eligible. "Some said they received a letter a little later explaining that they already had access to a private insurance plan, which did not allow them to benefit from the RCSD," he says.
In short, he maintains that the DCSN is nevertheless excellent news for the population who could not afford to consult a dental professional. However, there are still some shortcomings to be corrected in order to avoid unpleasant surprises.
About the CDSN
Launched by the federal government in May 2024, the DCSN allows Canadian residents of all ages who do not have private dental insurance with an annual net family income of less than $90,000 to benefit from a dental insurance plan.
This covers between 40% and 100% of the costs depending on the family's net annual income. Note that additional fees may apply.
The Plan also covers a range of oral health care services aimed at preventing and treating certain diseases. However, there are several criteria, terms and conditions and requirements that must be met.
In addition, it is important to emphasize that membership is not automatically renewed. It is therefore necessary to re-register each year to reassess the eligibility situation.
For more information on the CDKN: www.canada.ca