The CDCP, explained simply

• You have no access to private dental insurance: not through your work or pension plan, a family member's work or pension plan, a professional or student organization, insurance purchased by you or a family member (including supplementary or top-up insurance), or a health spending account that covers dental costs. You are considered to have access even if you never used it, decided not to enrol, have to pay a premium, opted out of your pension plan's dental coverage after December 11, 2023, or it doesn't cover the full cost.
• You file your tax return in Canada — and so does your spouse or common-law partner, if applicable.
• Your adjusted family net income is less than $90,000.
• You are a Canadian resident for tax purposes (and so is your spouse).
• There is no age requirement: the four conditions apply to everyone, children and adults alike.
• Coverage through a provincial, territorial or federal government social program (for example, dental care covered by RAMQ) doesn't count as private insurance and doesn't exclude you: you could still qualify, and the plans may coordinate to avoid duplication.

Before applying, check your situation on the official eligibility page on canada.ca — and look at box 45 of your T4 or box 015 of your T4A: code 1 means you have no access to dental insurance through your employer or pension plan.

"Adjusted family net income" is your family net income (line 23600 of your return and your spouse's), minus any UCCB and RDSP income received (lines 11700 and 12500), plus any UCCB and RDSP amounts repaid (lines 21300 and 23200). The percentages apply to the CDCP established fees, not to the clinic's own fees. In canada.ca's words, "a co-payment is the percentage of the CDCP fees that isn't covered by the CDCP, and that you will have to pay directly to the oral health provider," and "additional charges may still apply" if the provider charges more than those fees.

• Diagnostic: dental exams (complete, routine, specific and emergency) and X-rays
• Preventive: cleaning (scaling), fluoride applications and sealants
• Restorative: permanent and temporary fillings, pain control for diseased teeth and other cavity treatments
• Endodontic: root canal treatments, pulpectomies and procedures to reduce infection or relieve pain (re-treating a root canal requires preauthorization)
• Periodontal: cleaning under the gumline, treating abscesses and non-surgical gum disease management (bonding mobile teeth and post-surgical evaluations require preauthorization)
• Major restorative: posts, crown repairs and re-bonding; crowns, cores and posts for crowns (preauthorization required, ages 18 and up)
• Removable dentures: standard and temporary complete dentures, repairs, relines, rebases and tissue conditioning; partial, immediate and overdentures (preauthorization required)
• Oral surgery: tooth extractions (check the details and limits on canada.ca)

Not everything is covered, and many services have frequency limits. For example, crowns are only for clients 18 and up, at most 4 in any 120 months and 1 per tooth in any 96 months; a complete denture is covered once per arch in any 96 months, and its repairs once per arch in any 12 months. Services marked "preauthorization" must be approved by the plan before treatment. The complete, up-to-date list is on the "Coverage" page on canada.ca.

1. 01

   Check your eligibility

   Go through the four conditions above. Check box 45 of your T4 or box 015 of your T4A, and your spouse's slips: code 1 means no access to dental insurance; 2, 3, 4 or 5 means your employer or pension plan offers coverage.

2. 02

   Gather your information

   Your Social Insurance Number (SIN), date of birth, address, your dental insurance situation (yours and your spouse's) and confirmation that your tax returns have been filed. Have the details of any family members included in the application handy too.

3. 03

   Apply online or by phone

   You apply with the government, not at the clinic: online at canada.ca or by phone at 1-833-537-4342. When you apply, you attest that you have no access to private dental insurance; false information leads to removal of you and your family from the plan.

4. 04

   Wait for the decision

   The government notifies you of its decision by letter. If you are eligible, Sun Life then sends your member details, including your coverage start date. Keep them: they are what the clinic will ask for. For processing times and the status of your file, check on canada.ca.

5. 05

   Book with a participating clinic

   Wait for the start date on your letter, then choose a participating clinic and mention your CDCP coverage when you book. To find out how the plan applies to your visit with us, give us a call.

• Mention your CDCP coverage when you book and confirm that the clinic participates in the plan.
• Bring your Sun Life letter or member number, along with a piece of ID.
• Before treatment, ask what is covered, what needs preauthorization and whether the fees are higher than the plan's rates.
• Know your income tier: it sets your co-payment of 0%, 40% or 60%, paid directly to the clinic.