CDCP Eligibility and Income Tiers 2026

CDCP income tiers: the four bands

The CDCP uses your adjusted net family income — the figure on line 23600 of your CRA Notice of Assessment — to determine how much of the CDCP Dental Benefit Grid fee the plan will reimburse. There are four bands:

Source: canada.ca/en/services/benefits/dental/dental-care-plan/coverage.html, effective 2026.

The income thresholds are fixed annually. For 2025 coverage, the CRA used your 2023 Notice of Assessment. Going forward, each benefit year is linked to the most recently filed return, so your tier can shift year to year if your family income changes significantly.

What "CDCP fee" means — and why balance billing matters

The most important nuance on this page is this: the CDCP does not reimburse your dentist's actual charge. It reimburses based on the CDCP Dental Benefit Grids, published by Sun Life Financial (effective April 1, 2026). These grids list the maximum amount the plan will pay per procedure code, and they are typically lower than the provincial suggested-fee guides dentists use when setting their own fees.

This gap creates what is called balance billing: the difference between what your dentist charges and what the CDCP grid allows. Even at the 100% income tier — where the plan covers 100% of the CDCP grid fee — you can still owe money if your dentist bills above that grid amount.

Dentists participating in the CDCP are not required to limit their fees to the grid. They may bill their standard provincial-guide fee and simply let the CDCP reimburse its portion. Whether a dentist accepts the CDCP fee as payment in full (called assignment billing) is a practice-by-practice decision. Before scheduling covered work, ask your dentist directly whether they bill above the CDCP Dental Benefit Grid.

Worked examples

The CDCP Dental Benefit Grid amounts are not publicly available in per-procedure dollar form — the Sun Life PDF grids require practitioner login. The examples below use the provincial suggested-fee guide as a conservative lower-bound proxy. Your actual CDCP grid fee may be lower, which would increase your out-of-pocket balance.

Example 1 — Recall exam, under $70,000 tier: Dentist fee: $82 (Ontario). CDCP grid fee (proxy): $55. CDCP pays 100% of $55 = $55. You owe: $82 minus $55 = $27 (balance billing).

Example 2 — Ceramic crown, $70,000–$79,999 tier: Dentist fee: $1,350 (Ontario). CDCP grid fee (proxy): $900. CDCP pays 60% of $900 = $540. You owe: 40% of $900 + ($1,350 minus $900) = $360 + $450 = $810.

Example 3 — Complete denture (per arch), $80,000–$89,999 tier: Dentist fee: $1,140 (national average). CDCP grid fee (proxy): $800. CDCP pays 40% of $800 = $320. You owe: 60% of $800 + ($1,140 minus $800) = $480 + $340 = $820.

These examples illustrate that even covered procedures can leave significant out-of-pocket amounts — especially in the 40% and 60% co-pay tiers, and whenever there is a gap between the dentist's actual fee and the CDCP grid.

CDCP out-of-pocket calculator

Use the calculator below to estimate your co-pay across all four income bands for common procedures. Figures use the provincial suggested-fee guide as a proxy for the CDCP grid.

Who qualifies — other eligibility criteria

Income is only one part of CDCP eligibility. To qualify, you must also meet all of the following conditions:

• Canadian resident with a valid Social Insurance Number and an active CRA My Account (or applied through Service Canada).
• No private dental insurance that fully covers the service in question. If your employer plan or individual policy covers the procedure, the CDCP will not duplicate that coverage. Partial coverage by a private plan may allow the CDCP to cover the remainder — this is called coordination of benefits.
• Children under 18 are eligible regardless of family income (they are covered at 100%).
• Seniors 65 and over were the first group enrolled (November 2024). Adults 18 to 64 with no private coverage enrolled from 2025 onward.
• People with disabilities receiving the Disability Tax Credit are also eligible regardless of income tier, following the same co-pay structure.

If your private dental plan covers some but not all of a procedure, check with Sun Life to confirm how coordination of benefits applies. For a full walkthrough of the application process and how to check your status, see CDCP application and status.

Adjusted net family income: which tax year?

The income used to determine your CDCP tier is the adjusted net family income from your most recently filed Notice of Assessment, as reported to the CRA. "Family" here means you and your spouse or common-law partner — both incomes are combined, and the total is compared against the four thresholds.

For the 2024 benefit year, the CRA used the 2023 Notice of Assessment. For 2025, the 2024 return determines eligibility. If your income has dropped since your last assessment — for example, due to job loss, retirement, or a change in household — you may qualify for a higher tier than you received in a prior year. Your eligibility is re-assessed automatically each benefit year based on the return on file.

If you believe your tier is wrong, you can request a review through Service Canada or contact the CDCP information line.

Explore related CDCP topics

Frequently asked questions

This page provides pricing and market research information, NOT medical or dental advice. Real Dental Costs is an independent data publisher and is not affiliated with the Government of Canada or Sun Life Financial.