Coverage
2. What Denture Services Are Covered?
The CDCP covers a wide range of removable prosthodontic services, though many require pre-authorization from Sun Life (the program administrator) before treatment begins.
- Complete Dentures: Standard maxillary (upper) and mandibular (lower) dentures are covered once every 8 years (96 months).
- Partial Dentures: Covered to replace one or more missing teeth. These almost always require pre-authorization to confirm medical necessity.
- Immediate & Overdentures: Temporary dentures placed immediately after extractions or dentures that fit over natural teeth.
- Maintenance: Denture repairs, relines, and rebases are typically covered once every 2 years.
- Exclusions: The CDCP does not cover complex dentures (higher end) or implant-supported dentures or any procedures related to implants.
The Fee Gap
3. The "Gap": CDCP Fees vs. Provincial Fee Guides
A common misconception is that '100% coverage' means the dentures are free. In reality, the CDCP pays 100% of its own established fee schedule, which is often lower than the provincial fee guides used by dentists and denturists in BC and Alberta.
Alberta Context
Alberta does not have a mandatory fee schedule, meaning prices vary widely between clinics. If your denturist charges the Alberta Dental Association (ADA) Guide rate of $1,200 for a service, but the CDCP fee is set at $1,000, you are responsible for the $200 difference, even if you are in the 100% coverage tier.
British Columbia Context
In BC, most providers follow the BC Dental Association or Denturists Association of BC fee guides. Similar to Alberta, if the CDCP's established rate is lower than the provincial guide, the patient must pay the balance.
Process
4. Pre-authorization and Frequency Limits
To ensure your dentures are covered, your provider must submit a predetermination (pre-authorization) to Sun Life.
- Initial Placement: Most initial partial dentures require pre-authorization.
- Replacements: You cannot replace a functional denture simply for aesthetic reasons; it must meet the '8-year rule' or be clinically unserviceable.
- Healing Period: If you receive immediate dentures, the CDCP typically covers a 3-month period of post-insertion care, including minor adjustments.
Bottom Line
5. Summary of Out-of-Pocket Costs
When budgeting for dentures in AB or BC, your total cost will be:
- Your Co-payment: 0%, 40%, or 60% of the CDCP fee based on income
- The Fee Gap: The difference between what your provider charges and what the CDCP allows
- Non-covered Items: Any specialized materials or cosmetic upgrades not included in the standard CDCP grid
Income Tiers
Patient share by AFNI
|
CDCP Pays
|
Patient Pays
|
|
|---|---|---|
| AFNI under $70,000 | 100% of CDCP fee | Fee gap only |
| AFNI $70,000–$79,999 | 60% of CDCP fee | 40% + fee gap |
| AFNI $80,000–$89,999 | 40% of CDCP fee | 60% + fee gap |
| AFNI $90,000+ | Not eligible | Full cost |
| Read CDCP Page |
Where to Go
6. CDCP Denture Care at MyBite
Navigating federal benefits can be complex, but choosing the right provider makes the process seamless. MyBite Denture Solutions proudly accepts the Canadian Dental Care Plan (CDCP) at all of our locations across Alberta and British Columbia. We specialize in helping patients understand their specific coverage levels and managing the pre-authorization paperwork required by Sun Life.
Whether you need a new set of complete dentures, a partial denture, or a simple repair, our team is here to ensure you receive high-quality care with minimal financial stress. We invite all CDCP-eligible patients to visit any of our clinics for a free, no-obligation consultation. During this visit, we will assess your oral health needs, explain how the CDCP applies to your specific treatment plan, and provide a clear breakdown of any potential out-of-pocket costs.
Our Locations
Alberta: Calgary (Southport, Northland, Beddington), Airdrie.
British Columbia: Kelowna and Penticton.
References
Government of Canada: CDCP Dental Benefits Guide. Sun Life: CDCP Benefit Grids for Alberta & BC. Alberta Blue Cross: CDCP Information for Albertans. BC Dental Association: Understanding CDCP Costs.