Regarding the Canadian Dental Care Plan (CDCP)
Dear Patients,
As you know, as of May 1st, 2024, the Canadian Government dental plan, the “CDCP”, will begin to provide coverage for patients who meet the financial criteria. Many of you have already received your dental benefit card and are excited to start treatment. We are also sure that you are wondering whether our clinic will be participating in the program.
Currently, there are still many ongoing issues surrounding the program that need to be addressed to ensure this program has a positive impact on patient care and practice sustainability.
We believe that this program can be very successful and provide necessary benefits to many people who have not previously been eligible for provincial programs and require dental treatment.
One of the biggest hurdles for many dentists is the “required enrolment”. After much negotiation between the Federal Government and the Ontario Dental Association, this obstacle has been removed. Unfortunately, practices that do not enroll will be penalized and will not be able to start treating patients under the CDCP program until the month of July. We have chosen not to enroll; therefore, we will not be able to treat patients under the CDCP program until July.
One of the biggest obstacles, as I am sure you have heard about, but may not understand, is regarding “Balance Billing”.
We would like to take a little time to help patients understand this process. Dentists are governed by The Royal College of Dental Surgeons (RSDSO) and supported by the Ontario Dental Association (ODA). One of the many responsibilities of the ODA is at the beginning of each year they provide dentists with a fee guide. This fee guide “price list” is constructed with consideration of the cost of running a dental practice each year. Staff wages, costs of dental supplies, and lab fees are just a few of the factors. Each January, all dental supply companies, labs, and suppliers raise their fees. Rising costs result in yearly increases in the fee guide.
Contrary to Health Minister, Mark Holland’s comment during his Breakfast Television interview, dentists do not choose their own fees. The ODA sets the fees for that year. They have this down to an exact amount of how much it costs to run a dental practice by the hour.
We would also like to provide clarification on Health Minister Mark Holland’s comment, “yes, dentists are allowed to balance bill, but we really want them not to and to consider the individual.”
This comment, with no disrespect to Health Minister Mark Holland, is completely unethical. According to the RCDSO and it’s code of ethics, this is unethical and it is a punishable act. It is unethical to say to one demographic you do not need to pay your co-pay (balance billing) but, then to another demographic you must pay a co-pay. Exceptions can’t be made; fees must be the same for everyone. As mentioned above, the cost involved in running a private dental clinic is astronomical, especially since covid. Fees increase yearly to offset rising costs. To ensure clinic survival, waving balance billing would be very detrimental.
The CDCP Fee Guide is not the same as the ODA Fee Guide. Remember, as mentioned above the fee guide is designed to reflect the overall cost of running a dental practice. The difference between the fee guides may seem small and insignificant on a less expensive service, but a much larger discrepancies can be seen in the higher end services. On average, we see approximately 1000 patients a month and under this circumstance the difference is quite significant. As mentioned above, if Dental Offices were to waive the balance billing for patients under the CDCP program, they would be required to waive this for all patients, even with insurance coverage. A discount would have to be provided for those who do not qualify and do not have insurance. How would this even be assessed? The need for balanced billing is important for the sustainability of the clinic.
Example of Balance Billing for a service in the amount of $285.00:
1) Annual household net income Less than $70,00.00 with 100% CDCP coverage:
ODA Fee Guide $285.00
CDCP Fee Guide $237.38 meaning the CDCP pays $237.38
The difference between the two Fee Guides is $47.62
The total patient out of pocket cost is $47.62
Patient’s % of ODA Fee Guide is 16.7%
2)Annual household net income between $70,000 & $79,999 with 60% CDCP coverage:
ODA Fee Guide $285.00
CDCP Fee Guide $237.38 meaning the CDCP pays $142.43
The difference between the two Fee Guides is $47.62 + Patient CDCP co-pay $94.95
The total patient out of pocket cost is $142.57
Patient’s % of ODA Fee Guide is 50%
3) Annual household net income between $80,000 and $89,999 with 40% CDCP coverage:
ODA Fee Guide $285.00
CDCP Fee Guide $237.38 meaning the CDCP pays $94.95
The difference between the two Fee Guides is $47.62 + Patient CDCP co-pay $142.43
The total patient out of pocket cost is $190.05
Patient’s % of ODA Fee Guide is 66.7%.
The Ontario Dental Association has been diligently working alongside the Federal Government to help structure the CDCP Dental Plan. Even though the plan is essentially beginning, the ODA is still fighting with the Government to restructure the CDCP Fee Guide to match that of ODA Fee guide, putting less financial responsibility on the patient.
There are many outstanding issues of concern for the success of the program. The dental community recognizes the importance of this program in the community and the impact it can have, but there is still a lot of work to be done.
The ODA still represents you and your right to visit any clinic of your choice and receive your treatment sooner than later. Unfortunately, as of today, we are still not able to see patients under the CDCP program until July. We will continue to update our website as information becomes available to us.
Thank you for your patience while we navigate this new program.
Smolen Dentistry
