Less than a year after the federal Liberals announced a new dental care program for mixed reviews, the government is making changes in hopes of attracting more service providers.

Since its launch, the federal government says the Canadian Dental Care Plan (CDCP) has seen enrollment from 11,800 dental care providers with Sun Life Financial to participate officially. To increase this number, Ottawa is now allowing service providers to seek reimbursement from Sun Life on a per-claim basis, thus eliminating the previous requirement to enroll in the program itself.

While speaking in Dartmouth today, Health Minister Mark Holland said that the government heard from many dental professionals who wanted another way to participate due to "bad experiences" with other programs in the past.

Holland mentioned that in discussing the changes, he hopes the ability to participate in the program on a per-claim basis will lead to a rapid increase in the number of dentists who accept CDCP patients.

He explained the hesitation some dentists have in enrolling: "One of the things I've heard is that they, you know, have been burned by other programs, and they haven't had positive experiences," "Making sure they see and feel that this program is really listening to them and responding to their needs and exists for them is a fair partnership, and that’s very important."

Before the change made today, clients seeking coverage under the plan could only request treatment from participating dentists and other providers listed on the insurance company's website. Officials speaking on background say they hope this change will make it easier for clients to see the dentist of their choice.

One official from the Canadian Ministry of Health, speaking on background during a technical press conference, said, "There are service providers, and we wanted to listen to them, who have concerns about the need to officially enroll with Sun Life but want to see CDCP clients. They can submit a claim, and it will be processed by Sun Life."

The first phase of the $13 billion program was launched on May 1 to serve seniors aged 70 and older. Since then, the Canadian Ministry of Health says that coverage has been approved for more than two million eligible individuals and nearly 250,000 seniors have received treatment.

Eligibility has now expanded to accept applications from seniors aged 65 and older, adults with a valid Disability Tax Credit (DTC), and children under the age of 18. The Canadian Ministry of Health states that just under 10,000 applications have been received for individuals with a valid DTC and just under 25,000 applications have been received for children under 18 years old.

Ottawa has said eligibility will expand further in 2025.

Dentists, dental hygienists, and dental specialists have largely supported the publicly funded dental insurance program, but some had concerns about eligibility, in addition to billing agreements with Sun Life.

What is covered?

The CDCP covers a wide range of oral health care services including routine cleanings, root treatments, fillings, and diagnostic services such as X-rays. The amount paid by the federal program is based on your family's adjusted net income and the amount charged by the service provider.

Individuals with an adjusted family net income of less than $70,000 will receive 100 percent of the costs of eligible oral health care services covered through the designated CDCP fees. This percentage of eligible oral health services covered drops to 40 percent for individuals whose families’ adjusted net income is between $80,000 and $89,999.

Although there is no copayment, officials from the Canadian Ministry of Health have confirmed that clients may have to pay out of pocket if they choose to receive services not covered by the federal program or if they choose to see a provider charging more than what the program covers.

Canadian Ministry of Health officials explained that all providers, whether they enroll in the program or not, will now be able to submit a claim to Sun Life, receive an estimate on the amount that will be reimbursed to the client, and seek reimbursement for the claim on a per-claim basis.

Canadian Ministry of Health officials added that they are tracking the differences between what the CDCP covers, what providers charge, and the amount that clients must pay out of pocket.