Tejal Somvanshi
The Canadian Dental Care Plan (CDCP) is falling short of expectations as costs soar beyond initial projections. First introduced with a $13 billion price tag over five years, dental experts now warn expenses could reach $35 billion – nearly three times higher than planned.
“$35-60 may not seem like a lot but when your annual income on disability is less than $14,000 it may as well be a grand,” said Winnipeg resident Olesia Romaniuk, who skipped a needed dental cleaning despite qualifying for “100 percent coverage” under the CDCP.
This disconnect between government promises and patient experiences has become common. Many Canadians discover that “100 percent coverage” actually means the program covers only about 85 percent of Ontario’s suggested dental fees, leaving patients to pay the remaining 15 percent – a crucial detail often missing from government communications.
Health Canada reported patients saved over $850 in out-of-pocket costs during the program’s first year. However, initial government projections budgeted only about $280 per eligible Canadian annually. This huge gap suggests the program will cost taxpayers far more than anticipated.
Dental offices face mounting paperwork burdens, especially for treatments requiring pre-approval. The Canadian Dental Association reports 80 percent of dentists have problems with pre-authorization requests, with only 30 percent being approved.
After six months waiting for crown approval, British Columbia resident Mark Achbar had his claim denied by Sun Life Financial, the program’s administrator. “I still don’t have my crown,” said Achbar, who went through five temporary crowns during the lengthy process.
Dr. Anita Gartner, president of the British Columbia Dental Association, highlighted that dental offices are “submitting claims for eligible services to Sun Life Financial, but managers dealing with the submission are being denied without reason.” Some dentists report rejection rates as high as 90 percent for complex procedures.
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Another growing concern involves employer-provided dental plans that most Canadians currently use. If employers drop these benefits because of the CDCP, program costs could increase by an additional $3.5 billion by 2025, according to a technical brief from Canada’s dental associations.https://www.karmactive.com/canada-expands-dental-care-4-5-million-adults-aged-18-64-now-eligible/
The program’s co-payment structure creates additional confusion. Families earning under $70,000 receive full CDCP coverage but still face costs because the plan pays below market rates. Those making $70,000-$79,999 must pay a 4https://www.karmactive.com/canada-expands-dental-care-4-5-million-adults-aged-18-64-now-eligible/0 percent co-payment, while those earning $80,000-$89,999 face a 60 percent co-payment.
Despite these issues, the program continues expanding. In March 2025, Health Minister Kamal Khera announced all remaining eligible Canadians aged 18-64 could apply starting in May 2025. This expansion will add up to 4.5 million more Canadians to the program.
Some positive changes for 2025 include increasing the annual reimbursement limit from $2,500 to $3,000 and adding orthodontic services for medical necessity cases. However, certain services are being removed from coverage.
The pre-authorization process remains particularly problematic. “Procedures for crowns, bridges and some specialized treatments require dentist offices to get cases pre-approved, by sending in paperwork which adds to the burden of the front desk,” explained David Brown, president of the Ontario Dental Association. Many requests “were taking weeks or days to adjudicate” and often came back “not always approved.”
As the CDCP moves forward, its true costs and effectiveness remain uncertain. For millions of Canadians without dental insurance, the program offers necessary help – but patients are learning that “covered” dental care still comes with unexpected costs and administrative hurdles that the government didn’t clearly explain.
Healthcare, Public Health, Canada, Health Alert, Health Risks, Government, Policy
