Canadian Dental Care Plan (CDCP)

The Canadian Dental Care Plan (CDCP) aims to help reduce financial barriers to oral health care by covering eligible services for eligible Canadian residents without existing dental coverage.

Coverage Overview

The CDCP covers select dental services at pre-set rates, which may differ from standard fees charged by dental or denturist clinics. Individuals covered under the CDCP may have to pay any additional costs directly to the oral health provider.

Additional charges may apply if:

A co-payment is required based on your income tier *
Your provider’s fees exceed CDCP-approved rates
You choose services that are not covered by the CDCP (full cost applies)

* A co-payment is the portion of the CDCP fee not covered by the plan and is paid directly to your provider.

Before receiving care, always confirm which services or costs are not covered by the CDCP. Services not covered by the CDCP must be paid in full by the client.

Access to Dental Coverage

By accessing the CDCP, you attest that you do not currently have, and have not previously had, access to private or other dental insurance, regardless of enrolment or use. If a review finds you were ineligible, you will be required to personally repay any benefits received under the plan to the Government of Canada.

Predetermination and Previous Approvals

Services such as partial dentures, immediate dentures, and dentures with soft-liners require approval before proceeding with treatment. Approval times vary depending on Sun Life’s processing volume. Claims will be paid based on the active coverage on the date the service is completed — NOT the coverage % on preauthorization or estimates approved before your coverage has changed or was renewed. This could mean that the co-pay or balance billing might change. The patient must be eligible on the date of service for the plan to cover the claim. The patient will be responsible for any fees incurred for services received outside an active coverage period..

Eligibility & Renewal:

Eligibility is reassessed annually by the appropriate government authority.
You must renew your CDCP coverage annually to maintain uninterrupted access to benefits.
It is not the responsibility of Ottawa Valley Denture Clinic to ensure your eligibility.

I acknowledge that I have read and understand the statements above.

I acknowledge.

Signature(Required)

Consent for Claims & Information Sharing

Sun Life administers the CDCP on behalf of Health Canada. By signing below, you authorize your provider to submit claims, verify coverage, and exchange necessary information with Sun Life related to your CDCP benefits. This consent remains in effect until revoked in writing.

Patient or Authorized Decision-Maker Name:(Required)

First Last

Signature(Required)

Coordination of Benefits

To ensure accurate coordination of benefits, please indicate any additional programs you are enrolled in:

Are you enrolled in other dental benefit programs (e.g., NIHB, ODSP, Ontario Seniors Dental Care Plan)?(Required)

Yes
No

Please specify:(Required)

Agreement & Acknowledgements

By signing below, you agree to the following:

I confirm that I have active CDCP coverage, which must be renewed annually, and accept responsibility for any fees incurred outside my coverage period. Services received outside of coverage will NOT be covered, and no retroactive reimbursement will be provided.
The denturist is an independent provider and has no control over CDCP program changes or administrative processes, including predetermination delays or external lab turnaround times, which may affect when I receive my denture.
I confirm that I will inform the clinic of any changes to my eligibility status and coverage before starting new or concluding existing treatment plans.
I am responsible for all fees not covered by the CDCP, including co-payments, balance billing, missed appointment fees, and any charges resulting from program changes or updates during the coverage period or at the time services are provided. The CDCP does not cover cancellation or no-show fees.
I am responsible for any fees not paid by Sun Life due to inaccurate or incomplete coverage information.
If it is later determined that I was ineligible for CDCP coverage, I agree to personally repay any benefits received under the plan to the Government of Canada

We strive to complete your treatment before your coverage renews. However, due to circumstances beyond our control, this cannot be guaranteed.

Name of person completing this form:(Required)

First Last

Signature(Required)