Costs, Fee Guides and 2026 Coverage
CDCP co-payments and extra charges: what you still pay at the dentist
How CDCP co-payment tiers and provider extra charges add up, with worked examples for fillings, a crown and a denture, and how to ask about costs before treatment.
Under the Canadian Dental Care Plan you can owe money at the dentist in three ways: a co-payment of 0%, 40% or 60% of the CDCP's established fee, depending on your adjusted family net income; an extra charge if your provider's fee is higher than the CDCP fee; and the full cost of any service the CDCP does not cover that you agree to receive, such as an implant. If your adjusted family net income is under $70,000 you have no co-payment, but extra charges can still apply. The plan cannot be billed by you directly, so the only way to know your share in advance is to ask your provider to explain what the CDCP will pay and what you will be charged before treatment begins.
This guide is part of the dental implant cost overview. The fee amounts below are illustrative, not actual CDCP grid fees.
The three parts of your bill
| Part | What it is | Who sets it |
|---|---|---|
| CDCP payment | The CDCP's share of its established fee | The CDCP benefit grid for your province and provider type |
| Co-payment | 0%, 40% or 60% of the CDCP fee | Your adjusted family net income tier |
| Extra charge | Provider's fee minus the CDCP fee | Your provider |
| Non-covered service | Full fee | Your provider |
Co-payment tiers
According to Canada.ca:
| Adjusted family net income | CDCP pays (of its fee) | Your co-payment |
|---|---|---|
| Under $70,000 | 100% | 0% |
| $70,000 to $79,999 | 60% | 40% |
| $80,000 to $89,999 | 40% | 60% |
Your tier is based on your adjusted family net income from the previous year's tax return, so it can change when you renew. Members renew each spring; coverage periods end on 30 June.
Worked examples (illustrative fees)
Example 1: two fillings, no co-payment
CDCP fee per filling: $150. Your dentist's fee per filling: $175. Income tier: under $70,000.
- CDCP pays: 2 × $150 = $300
- Co-payment: 0
- Extra charge: 2 × ($175 − $150) = $50
Example 2: a crown, 40% co-payment
A crown approved through preauthorization. CDCP fee (professional fee plus lab): $1,100. Dentist's total: $1,350. Tier: $70,000 to $79,999.
- CDCP pays 60% of $1,100 = $660
- Co-payment 40% of $1,100 = $440
- Extra charge: $1,350 − $1,100 = $250
- You pay $440 + $250 = $690
Example 3: a partial denture, 60% co-payment
CDCP fee: $1,000. Denturist's fee: $1,000. Tier: $80,000 to $89,999.
- CDCP pays 40% = $400
- Co-payment 60% = $600
- Extra charge: 0
- You pay $600
Example 4: extraction then implant
CDCP fee for a surgical extraction: $300; the dentist charges $300. Tier: under $70,000. The patient then chooses an implant at an illustrative $4,800.
- Extraction: CDCP pays $300, you pay 0
- Implant: excluded, you pay $4,800
You can reproduce these with the dental plan cost-share calculator: set the deductible to 0, your share to your co-payment percentage, enter the CDCP fee as the eligible cost, and add the extra charge.
Why extra charges happen
- Fees differ. Providers set their own fees; CDCP fees come from its benefit grid, which is not the same as provincial association fee guides.
- Lab fees. For crowns and dentures, the CDCP pays a "reasonable and customary" lab fee; if the lab charges more, the difference may be passed on.
- Upgrades. Choosing a material or option that the plan does not cover, such as a precision attachment partial denture, means paying the difference or the full cost.
- Services over the limit. A third cleaning or an extra X-ray beyond frequency limits, without preauthorization, may not be paid.
The Dental Benefits Guide encourages providers to avoid charging CDCP clients for costs the CDCP covers, and for sedation and certain other cases asks providers to discuss in advance what amounts may be charged. In practice, any provider can tell you in advance; ask.
Questions to ask before treatment
- Do you participate in the CDCP, and will you bill the plan directly?
- Which of the planned services are covered and which are not?
- What is the CDCP fee for each service, and what is your fee?
- What will I pay at the visit, including my co-payment?
- Is preauthorization needed, and has it been approved?
- If I choose an alternative (for example an implant instead of a denture), what does that change?
If you also have another plan
Access to private dental insurance makes you ineligible for the CDCP. Coverage under some government social programs, such as provincial programs for social assistance recipients, does not, and the plans may coordinate. See provincial public dental programs.
FAQ
I am in the 0% tier. Why did I get a bill?
Most likely an extra charge (your provider's fee is higher than the CDCP fee) or a non-covered service. Ask for an itemised receipt showing the CDCP payment.
Can I pay the dentist and claim from the CDCP myself?
No. CDCP clients cannot submit claims for reimbursement; the provider submits the claim.
Do co-payments count for the medical expense tax credit?
Amounts you pay out of pocket for eligible dental services, including co-payments and extra charges, can be included. See timing dental payments for the tax credit.
What if I think I was overcharged?
Raise it with the office first, then use the CDCP's feedback channels or your regulator. See CDCP problems and complaints.
Sources
- Canadian Dental Care Plan — co-payment tiers, extra charges and coverage
- Sun Life CDCP information — benefit grids by province and provider type
- Canada Revenue Agency — medical expense tax credit
