Government of Canada
announces new option for all providers to deliver care.
OTTAWA,
ON, April 17, 2024 /CNW/ - To date more than
1.7 million Canadian residents have been approved to receive oral
health care services through the Canadian Dental Care Plan (CDCP).
We thank the more than 5,000 oral health providers who have already
agreed to help CDCP clients get the care they need, and the many
more who continue to join every day.
Today, informed by consultation and conversations with oral care
providers and with their associations across Canada, we are taking a number of new actions
so that all providers can deliver care to CDCP
clients.
Choice for providers and their
clients
The participation of oral health providers across the country in
this plan is encouraged so we can build a foundation for more
equitable access to oral health care – and make a difference in the
lives of nearly 9 million Canadians. We understand that some oral
health providers may choose not to participate fully as a CDCP
provider but would still like to provide care to CDCP clients. As
of July 8, 2024, oral health
providers will be able to direct bill Sun Life for services
provided on a claim-by-claim basis without formally signing up for
CDCP. This will make it easier for providers to treat patients and
submit CDCP claims to Sun Life for direct reimbursement, whether or
not they choose to formally participate. This also means that CDCP
clients can see any oral health provider they choose for their
care, as long as the provider agrees to direct bill Sun Life for
services provided under the plan.
Emergency care and
preauthorization
We know that providers want their patients to be able to get
emergency care when they need it. The Government of Canada designed the CDCP's basket of services
with the CDCP eligible population in mind, including their need to
access care in emergencies. There are no limitations on emergency
examinations under the plan, and almost all services that could be
done on an emergency basis do not need preauthorization. After
November when preauthorization comes into effect, in rare cases
where a service that would normally need preauthorization is needed
on an emergency basis, providers can submit any needed minimal
documentation after the fact.
In addition, to further streamline administrative processes
under the CDCP, we continue to work with provider associations to
determine where additional refinements to preauthorization
requirements might be helpful for CDCP clients who have
longstanding special needs (for example, through the use of blanket
or multi-year preauthorization when a patient's underlying health
condition is unlikely to change, rather than seeking
preauthorization each time).
To make sure that oral health providers have the details they
need, the 2024 CDCP Dental Benefit Grids are now published, which
outline the fees that the CDCP will pay to oral health providers
for all procedures covered under the plan. The CDCP fee structure
is based on similar federal programs and will be reassessed
annually. Health Canada will work
with oral health provider associations to inform our work related
to fees for 2025 and beyond.
The CDCP will help make the cost of dental care more affordable
for Canadian residents who do not currently have access to dental
insurance. CDCP clients are reminded that they may have to pay
additional charges in addition to any co-payment, and to always ask
their oral health provider about any costs that will not be covered
by the plan.
The Government of Canada is
committed to making it as easy as possible for oral health
providers to render services to CDCP clients so they get the care
they need and deserve.
More information is available on Canada.ca/dental and the Sun
Life website for oral health professionals looking for accurate and
clear information regarding the plan.
Quotes
"The support and participation of oral health providers across
the country is essential to the success of the Canadian Dental Care
Plan. We know that providers have been asking for more information,
and we are pleased to release these new details today. We thank the
oral health associations who consulted with us, and we look forward
to continuing to work with them as we move forward. Every patient
that is seen, and every provider that participates, is positive
progress towards providing good oral health for all
Canadians."
The Honourable Mark Holland
Minister of
Health
"The Canadian Dental Care Plan is a major step forward in making
dental care accessible and affordable. Oral health providers across
the country play an essential role in the delivery of this
important initiative and the Government of Canada is committed to supporting them
throughout their engagement. We encourage all eligible providers to
participate. Together, we can help Canadians access affordable
dental care."
The Honourable Jean Yves Duclos
Minister of Public
Services and Procurement Canada
"Canadians and their families are relying on the Canadian Dental
Care Plan and providers from across the country to deliver quality
oral health care. We are working to ensure the claims and billing
process is as smooth and seamless as possible. This plan will have
a meaningful impact on the health and wellbeing of Canadians."
Dave
Jones
President, Sun Life Health
Quick Facts
- With this new information for providers, CDCP clients can
reach out to oral health professionals in their community to find
one who is willing to provide care to them under the
CDCP. CDCP clients can find a participating oral health
provider in their region using Sun Life's Provider Search.
- CDCP clients are being reminded that the CDCP will help ease
the cost of oral health care, but they may have to pay additional
charges including a co-payment (if applicable) based on their
household income. CDCP clients are encouraged to always ask their
oral health provider about costs that will not be covered by the
plan before they receive services.
- The 2024 CDCP Dental Benefit Grids were published on
April 11, which outline the fees that
the CDCP will pay to oral health providers for all procedures
covered under the plan.
- Most services covered under the CDCP will be
available in May 2024 when the first
cohort of successful CDCP applicants will begin to receive
services. Some oral health services such as crowns, which require
preauthorization will be available beginning in November 2024.
- Before the end of April, specific instructions for the
coordination of benefits with each province and territory and with
federal plans will be available for providers.
- There is misinformation circulating about the plan in the oral
health community. Information about the CDCP for oral health
providers is available on the Sun Life website, and
Canada.ca/dental. Health Canada
today also released an article addressing some of the main
misconceptions on LinkedIn.
Associated Links
- Sun Life Direct
- CDCP Dental Benefit Grids
- Dental Benefits Guide
SOURCE Health Canada (HC)