CDCP Coordination Of Benefits: The Relation With Ontario Dental Programs
The Canadian dental industry has experienced significant changes over the last two years due to the introduction of a new benefit program. People from different age groups have been registering for the Canadian Dental Care Plan (CDCP). A common query that comes to their minds when applying is related to the CDCP coordination of benefits.
You may wonder if you can coordinate CDCP with other dental programs like Healthy Smiles Ontario and the Ontario Disability Support Program. Let’s explore the world of CDCP coordination of benefits to enhance your understanding of this plan.
CDCP Coordination Of Benefits: Is It Allowed In Ontario?
The Canadian Dental Care Plan coordination of benefits involves the interactions of CDCP and other government plans. The other programs may be:
Provincial dental care plans
Territorial oral health programs
Federal social programs
When you have dental care coverage under different Canadian programs, your plans may be coordinated. The main purpose of combining the programs is to avoid duplication.
Imagine you’re getting teeth polishing done under the CDCP, but you’re also participating in another benefit program that covers polishing. Coordination of benefits ensures you're covered by only one program for a specific portion of fees, avoiding duplicate reimbursement.
CDCP Coordination Of Benefits: When Is It Restricted?
People believe CDCP coordination of benefits can be done for all dental programs in Canada. That’s not true. You cannot coordinate benefits with a private dental plan.
CDCP coordination of benefits is also not allowed with a dental care program funded by your employer. If you have access to private benefits, you’ll be considered to have dental insurance already.
The CDCP eligibility criteria strictly state that applicants cannot have active dental insurance when applying. This is why coordination of benefits is not allowed for employer-funded dental benefits.
CDCP Coordination Of Benefits: Plans You Can Coordinate CDCP Benefits With In Ontario
CDCP coordination of benefits is allowed for various plans in Ontario, including:
1. Healthy Smiles Ontario
Healthy Smiles Ontario is a free dental program mainly for teenagers and children in Canada. It states that kids and teenagers under 17 are eligible if they’re:
Ontario residents
Members of a low-income household
Upon successful registration, your children can enjoy X-rays, teeth assessments, dental fillings, root canals, and gum surgery. All these services are also offered under the CDCP, which is why coordination of benefits with Healthy Smiles Ontario is allowed.
2. Ontario Disability Support Program (ODSP)
The Ontario Disability Support Program offers dental coverage to handicapped residents of Ontario and their spouses. It allows you to receive teeth exams, dental cleanings, permanent fillings, and temporary fillings.
Just like the Healthy Smiles Ontario, services under the ODSP also overlap with the CDCP benefits. This is why adult members of the Ontario Disability Support Program can coordinate coverage with the CDCP.
3. Ontario Works
Ontario Works is a dental benefit program governed by First Nations committees and municipalities. It is mainly for low-income households that are receiving social assistance in the province.
Members of Ontario Works can receive the following treatments from a dentist in Bridgeport:
Root canals
Complete dentures
Lining in dentures
Emergency dental care
Tooth extraction
Preauthorized dental sedation
Dental care services such as root canals, complete dentures, and preauthorized sedation overlap with CDCP benefits. To maximize your care and prevent duplication of reimbursement, Ontario Works can be coordinated with the CDCP.
Which Plan Is Not Available For CDCP Coordination Of Benefits?
There is no coordination between the Ontario Seniors Dental Care Program (OSDCP) and the CDCP in 2025. This means that additional fees cannot be adjusted into either plan.
If you’re seeking to use CDCP for your dental treatment, the plan will cover a specific portion. The remaining fees should be covered by you. OSDCP coverage cannot be applied to the additional dental costs.
However, you’ll be given a choice when meeting a dentist in Bridgeport. You can compare the percentage of costs that will be covered under the CDCP and OSDCP for the same treatment.
If you find that one of the plans is offering greater cost reductions, you can select that to pay for your dental treatment. No dentist in Bridgeport can force you to use one specific plan for the bills, especially if the treatment is covered under various programs.
How To Coordinate CDCP Benefits With Healthy Smiles Ontario And Ontario Disability Support Program?
CDCP coordination of benefits with Healthy Smiles Ontario and Ontario Disability Support Program has the same criteria. You’ll have to comply with the following steps for both:
Submit a claim to the CDCP through Sun Life so that they generate the total payable amount to you under the plan
Now you must submit your claim to Accerta (secondary insurer) within 30 days of the dental service
Your claim will be processed according to Ontario government program policies
If you’re deemed eligible for CDCP coordination of benefits with the other programs, you can seek additional reimbursement. This can cover the portion of dental fees that the Canadian Dental Care Plan didn’t cover.
How To Coordinate CDCP Benefits With Ontario Works?
Ontario Works is a social assistance dental coverage program for low-income households. This is why you must contact the Ontario Works office to understand how your plan works with the CDCP.
If the office allows you to coordinate benefits with the CDCP, you may file a claim through Sun Life. The specificities of coordination depend on your dental treatment and the cooperation of the Ontario Works authorities.
CDCP Coordination Of Benefits: Is It Allowed In Canadian Provinces Besides Ontario?
CDCP coordination of benefits is available in various Canadian provinces. These include:
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Quebec
Prince Edward Island
All these areas have specific dental care programs offered to only provincial residents. Most of these overlap with the CDCP services, allowing coordination.
The same steps remain more or less the same for each province. You’ll have to file a claim with the CDCP and get it processed if you’re eligible for coordination of benefits.
FAQs
What Is The Difference Between CDCP And Healthy Smiles?
CDCP is a federal government plan that offers dental care to children, adults, and seniors who don’t have prior insurance. Meanwhile, Healthy Smiles Ontario is a provincial plan that offers dental benefits to youth aged 17 or below.
What Is An Example Of Coordination Of Benefits?
When you have CDCP and Ontario Works coverage, the benefits will be coordinated to ensure the CDCP covers a specific portion. The remaining portion of your fees can be adjusted under your Ontario Works coverage to maximize your benefits.
How To Maximize CDCP Coordination Of Benefits?
The best way to maximize CDCP coordination of benefits is to file timely claims with the CDCP and Accerta.
Does CDCP Coordination Of Benefits Work For Treatments Requiring Preauthorization?
You can enjoy the CDCP coordination of benefits for dental procedures requiring preauthorization. First, you must submit applications to the CDCP and the secondary insurer to receive authorization. Then, you can file claims of coordination with the same agencies for the benefits.
CDCP Coordination Of Benefits: Combine Plans And Enjoy Exceptional Care At KWC Dental
CDCP coordination of benefits is a great way to ensure thorough dental coverage, especially if you’re enrolled in provincial and federal dental programs.
After filing claims and receiving approval, you can come to KWC Dental for your coordinated benefits. We’ll accommodate you as per Canadian laws and healthcare policies.
Contact us today to meet our dentist in Bridgeport and get an essential procedure done under the CDCP coordination of benefits!