The CDCP has developed their own fee guide, which determines the fees the CDCP will pay for services covered under the plan. These fees can differ from provincial or territorial fee guides. Not all patients will receive complete financial assistance through the CDCP due to required co-payments, so it is important to ask about costs not covered by the plan. These co-payments are the portion of treatment costs you would be expected to cover out of pocket, and the percentage is determined by your family's net annual income shown on the previous year's tax return. Co-payment or fees not covered are paid directly to the dental office.
Table on co-payments based on adjusted family net income.
Please note the percentages covered are for the CDCP fee guide, which is sometimes lower than the provincial guides.
| Net Family Income |
Covered by CDCP |
Covered by Patient |
| Below $70,000 |
100% |
0% |
| $70,000 - $79,999 |
60% |
40% |
| $80,000 - $89,999 |
40% |
60% |
Additionally, when a dentist follows their established fee structure, it may be higher than the CDCP’s fees, in which case there is a gap in payments. The gap can be filled by balanced billing, where the patient is billed for the difference between the CDCP fees and the fee their dentist would charge a patient who does not qualify for coverage under the plan.
For example, if a dentist follows the provincial fee guide and charges $100 for a recall dental exam but the CDCP fee structure only covers $90 the patient is responsible for the $10 difference. In the same example, for a patient with a net family income of $85,000, the plan would cover $36 (40% of the CDCP established fee) and the patient would be responsible for $54 (the remaining 60% of the CDCP established fee) plus the additional $10. Please note these figures are for illustration only.
