CDCP vs Private Dental Insurance (2026)

Side-by-side comparison

The table below compares the CDCP against a typical employer-sponsored group plan. Individual private plans differ substantially — always check your own Schedule of Benefits.

Can you have both?

In most cases, no. The CDCP requires that you do not have qualifying private dental coverage for the service being claimed. If your employer-sponsored group plan covers basic dental — exams, fillings, extractions — you are typically not eligible for the CDCP for those same services. The eligibility test is service-specific, not plan-wide: if your private plan explicitly excludes orthodontics, for example, you may still claim that service through the CDCP if you otherwise qualify on income.

The critical word is "qualifying." A private plan that covers dental services relevant to your claim disqualifies you from CDCP reimbursement for that claim. Plans that only cover vision, drugs or paramedical services and contain no dental component do not disqualify you. If you are unsure whether your group benefits count as qualifying dental coverage, check with Service Canada or the CRA before your appointment — a retroactive denial after treatment is much harder to resolve.

The exclusions gap: where CDCP falls short vs private coverage

The CDCP's absolute exclusions are its most significant limitation compared to many private plans. Implants, bridges, implant-supported crowns, and precision-attachment partial dentures are all excluded with no possibility of reconsideration, regardless of income tier or clinical circumstances. A single full implant in Canada costs roughly $3,000–$6,100 CAD out of pocket — zero of which the CDCP reimburses.

Many employer group plans offer a major restorative tier that includes at least partial reimbursement for these procedures. Coverage is typically subject to an annual maximum (often $1,500–$2,500 per year), waiting periods of 6–12 months, and may still carry a patient co-pay of 50% or more. Even so, a private plan that pays $1,500 toward a $5,000 implant represents meaningful savings the CDCP cannot match. For patients whose primary dental need involves implants or bridgework, private insurance — or paying out of pocket — are the only options under the current CDCP structure. See our detailed breakdown on whether the CDCP covers implants.

The exclusion list also includes orthodontics, which the CDCP has deferred to a future implementation phase with no confirmed date. Many private group plans cover orthodontics for both children and adults up to a lifetime maximum, making them materially more comprehensive for families with alignment needs.

Balance billing: it can happen with both

Balance billing — the gap between what a plan pays and what a dentist charges — is a risk under both the CDCP and some private plans. The CDCP pays based on its own Dental Benefit Grids (administered by Sun Life, effective April 2026), which are often below provincial suggested-fee guides. Dentists are not required to accept these grid fees as payment in full, and there is no mechanism in the CDCP framework that caps the gap.

Private plans that reimburse on a fee-for-service (non-assignment) basis expose patients to the same dynamic: the plan pays its schedule rate, and the patient owes the difference. The key distinction is that some private group plans — particularly large employer plans — negotiate preferred-provider agreements with dental networks. Within those networks, participating dentists agree to limit their charges to the plan's reimbursement rate, eliminating or reducing balance billing. The CDCP has no equivalent network of participating dentists who commit to zero-balance billing. When booking a CDCP appointment, it is worth asking your dentist directly whether they bill above the CDCP fee or accept it as payment in full. This question matters even at the 100% income tier.

CDCP Out-of-Pocket Calculator

Use the calculator below to estimate what the CDCP covers by income tier and procedure — helpful when comparing your expected out-of-pocket costs against a private plan's deductible and co-insurance structure.

When private insurance is clearly better

• You need dental implants or bridges — the CDCP provides no reimbursement for either.
• You need orthodontics for yourself or your children — the CDCP has not yet implemented orthodontic coverage.
• Your net family income is at or above $90,000 — you are not eligible for the CDCP at that income level.
• You prefer to avoid mandatory pre-authorization for crowns and complex restorative work.
• You want predictable annual dollar maximums rather than procedure-specific frequency limits.
• You anticipate needing major restorative work within the next few years and can afford monthly premiums now.

When the CDCP is your best option

• You have no employer dental plan and are purchasing private coverage would cost more than your expected annual dental spend.
• Your net family income is under $70,000 — at this tier, the CDCP covers 100% of its fee schedule with no premium.
• Your dental needs are primarily preventive and basic restorative: exams, cleanings, fillings, extractions and root canals.
• You need complete dentures — covered without pre-authorization, one arch every 8 years, at no cost to qualifying lower-income patients.
• You had private coverage that recently lapsed and have not yet found an affordable replacement plan.

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.