Important update regarding the Canada Dental Care Plan (CDCP)

What Does the CDCP Cover for Denturists?

Although the CDCP advertises 100% coverage for dental procedures, it is important to understand that this coverage is based on their specific fee schedule, which does not align with the Denturist Association of Ontario's current fee guide. As a result, some procedures may not be fully covered.

Additionally, certain services are excluded from the program, such as implants. There are also limitations on specific treatments, for example, repairs are only covered once every 12 months. While the program can be beneficial, it is essential to recognize that not all services may be fully covered.

Why Haven't I Received a Response Regarding My Pre-Authorization?

We understand that delays in pre-authorization can be frustrating, and we want to assure you that we are doing everything we can to assist. Unfortunately, Sun Life was not prepared to review pre-determinations as of November 1st, 2024, as initially promised. As with any new program, there have been challenges, including the need for re-training their staff.

Currently, pre-determinations are taking up to 30 business days for review, and we are still encountering issues with missing documentation, despite the documents having been submitted. When this occurs, the review process is delayed further, as the documents must be resubmitted, effectively resetting the 30-day timeline.

Please know that we are diligently following up with Sun Life on your behalf. They are experiencing a backlog, and while they have apologized for the delays, significant improvements are still pending. We continue to advocate for faster resolutions and are actively working on your behalf.

Overview from our end:

As dental providers, we continue to bear the full burden of the program's administrative challenges. Despite our efforts to escalate these concerns with Sun Life and our associations, we are now taking further steps to raise awareness at a higher level. It is essential for the success of this program—and the well-being of our seniors—that these administrative issues be addressed.

Health Canada is responsible for overseeing the program’s administration, and we hope to see improvements that will provide better support for both patients and dental professionals moving forward.

What Can You Do?

In the meantime, we kindly ask for your continued patience. Rest assured, we are regularly following up and will keep you informed of any developments. We understand the importance of timely dental care and remain committed to advocating for you and working toward solutions.

Thank you for your understanding and trust as we navigate these challenges together. We truly appreciate your ongoing support and are here to assist with any questions or concerns you may have about the program.