Finding a dentist
Not every dental clinic participates in the CDCP. Participation is voluntary for providers, and a clinic that treated one CDCP patient may not accept the next. Finding a participating provider is therefore a step in its own right, not something to assume.
Start with your current provider
If you already have a dentist, denturist, or hygienist, ask them directly: "Do you participate in the Canadian Dental Care Plan, and will you bill Sun Life directly for my covered treatment?" If the answer to either part is no, the plan cannot pay for treatment there, even if you are a member. If the answer is yes, ask the fee question as well: "Do you charge the CDCP established fee, or more than that?" The answer decides whether you will owe a fee gap on top of any co-payment.
If you need a new provider
Canada.ca provides a provider search tool for finding participating oral health providers. Ask friends, family, or a community health centre for recommendations, and then verify participation yourself — a recommendation is not proof. When you call a new clinic, have your member card details ready, and confirm three things before booking: participation, direct billing to Sun Life, and the fee policy. Also ask whether the clinic is accepting new CDCP patients, since some participating clinics limit new patient intake.
Questions to ask before treatment
- Do you participate in the CDCP, and will you bill Sun Life directly?
- Is this treatment covered, and does it need preauthorization?
- What is the CDCP established fee for this treatment, and what is your fee?
- What will I owe after the CDCP pays, in total, in writing?
- If preauthorization is needed, has it been approved?
- When does my coverage start, and is this appointment after that date?
Types of provider
The CDCP works with dentists, denturists, dental hygienists, and dental specialists, but not every provider offers every service. A denturist, for example, is the usual provider for dentures, while a hygienist may provide scaling and preventive care. If your usual provider does not offer a service you need, ask them who they refer CDCP patients to, and verify the new provider's participation the same way.
Do not book before your coverage start date
Your welcome package from Sun Life includes a coverage start date. Treatment before that date is not covered, even if you have already been approved. If you are in pain or have an urgent problem before your start date, call the clinic and explain the situation — but do not expect the plan to pay for treatment delivered before coverage begins.
Rural and remote areas
Provider availability varies. In smaller communities there may be only one participating clinic, or none nearby, and you may need to travel. If distance is a problem, ask Service Canada about providers in your region, and ask clinics about wait times for new patients. Planning ahead matters more here than in a large city: a routine cleaning booked months ahead is easier to arrange than urgent treatment at short notice.
Photo credits: de16.jpg — Montreal skyline (CC BY 3.0); de17.jpg — Vancouver skyline (CC BY 4.0); de18.jpg — Canada Post mailbox, Markham (CC0) All photos via Wikimedia Commons under the licences noted.