Since our last communication, the Government of Canada has clarified the Canadian Dental Care Plan (CDCP) eligibility requirements for those with private or individual dental insurance.

Eligibility

The CDCP will be available to all Canadian families and individuals with an adjusted net family income of less than $90,000. To be eligible for the CDCP, applicants cannot currently have dental insurance.

If the applicant purchased their current dental insurance policy as part of a private or individual insurance product – such as a Personal Health Insurance (PHI) or Health Coverage Choice (HCC) plan – they’re not eligible for the CDCP while that dental coverage is in effect.

Clients need to meet eligibility requirements each year to continue to qualify for the CDCP. If a Client is eligible for the CDCP, the Government of Canada will mail them a letter when it’s their turn to enrol.

What the CDCP means for Clients with in-force PHI and HCC plans

PHI and HCC are private insurance plans with optional or built-in dental coverage. If a Client is eligible for the CDCP, and they currently have dental coverage through a PHI or HCC plan, they should consider their individual needs carefully.

If their plan has optional dental coverage, they can request to remove this by submitting Form 4366 – Remove optional benefit (for PHI and HCC)​. Please note, once the optional benefit is removed it cannot be added back to the plan.

For Clients with combined health and dental coverage plans, there currently isn’t a way to remove the dental coverage. They would need to cancel their current plans first to enrol in the CDCP. Clients should know that based on their income there may be a co-payment required with the CDCP.

Clients who cancel PHI or HCC plans before enrolling in the CDCP may still re-apply for PHI later if they become ineligible for the CDCP for any reason (such as a change in income level).

However, Clients who've previously had a PHI or HCC plan will only be eligible for PHI plans that are underwritten. In certain circumstances, the Client could have exclusions applied to their coverage, or may no longer be eligible for the product. Clients should be aware of these possibilities when determining the coverage solution that is best for them. 

If a Client decides to cancel their current plan that includes dental coverage, but they’re still interested in having extended health coverage, they could apply for another product or plan that doesn’t include dental. It’s important to do this before cancelling any existing coverage.

We understand these options may not offer the best outcome for all Clients. We’re investigating the possibility of alternative solutions, and we’ll share more information as it becomes available.

What the CDCP means for Clients applying for new PHI and HCC plans

For a Client applying to a new plan, we recommend they consider choosing coverage that offers optional dental. This will provide more flexibility, especially if they anticipate becoming eligible for the CDCP. Options include:

Personal Health Insurance:

  • Standard plans
  • Enhanced plans

Health Coverage Choice (for those leaving a group benefits plan):

  • Health Choice B plans
  • Health Choice C plans

More information about these plans is available on the Personal Health Insurance and Health Coverage Choice product pages.

Questions? Contact Individual.Health.Product@sunlife.com