Dental Insurance, CDCP Coverage, Benefits & Direct Billing - Everything you need to know
Dental Insurance, Benefits & Direct Billing
Dental insurance helps reduce the cost of care, but every plan is different.
A dental benefit plan is a financial benefit, not a treatment plan. Your dentist recommends care based on your oral health, while your insurance provider decides what is covered.
Plans may include deductibles, annual limits, co-payments, and coverage differences between procedures. Because of this, treatment may be fully covered, partially covered, or not covered at all.
For larger treatments, a predetermination (pre-treatment estimate) can be sent to your insurer to help estimate coverage before treatment begins.
“Direct billing” usually refers to an assignment of benefits, where your insurance pays the dental office directly.
You are still responsible for any portion not covered by your plan, including deductibles and co-payments. Not all insurance plans allow this option.
Canadian Dental Care Plan (CDCP)
Morgan Heights Dental Centre is pleased to accept the Canadian Dental Care Plan (CDCP), the federal government dental program designed to help eligible Canadians access essential dental care.
Who is eligible for CDCP?
Eligibility is determined by the Government of Canada and is based on factors such as:
Household income (generally under $90,000)
Lack of access to private dental insurance
Canadian residency and tax filing status
Important information about CDCP fees
The CDCP fee guide differs from the Canadian Dental Association (CDA) fee guide used by many dental offices. Because of this difference, there will be a patient portion (co-payment) for certain treatments.
This means:
CDCP will not cover the full cost of treatment
Patients are responsible for paying the difference between the CDCP fee schedule and the dental office fee
Our team will always explain any estimated out-of-pocket costs before treatment begins.
Preauthorization and treatment estimates
For many procedures, we can submit a preauthorization (predetermination) directly to the CDCP before starting treatment.
This allows us to:
Confirm what is covered under your plan
Estimate the portion covered by CDCP
Provide you with a clear estimate of your out-of-pocket cost before treatment begins
This helps ensure there are no surprises and allows you to make informed decisions about your dental care.
How Morgan Heights Dental Centre Helps
Our team helps patients understand insurance and CDCP coverage so the financial process is easier to navigate.
Provide your insurance information
Call ahead with your insurance or CDCP details so we can review your coverage and estimate benefits.
Treatment comes first
Your dentist focuses on your oral health needs first. Insurance or CDCP coverage does not determine what treatment is recommended.
We will explain your diagnosis, options, and expected costs before you decide how to proceed.
Understanding your costs
We can help estimate your insurance or CDCP coverage, but final decisions are made by your provider or the government program.
Frequently Asked Questions
Do you accept dental insurance and CDCP?
Yes. We accept both private insurance and the Canadian Dental Care Plan (CDCP).
Do you offer direct billing?
This depends on your insurance plan and whether assignment of benefits is allowed.
Can you tell me exactly what will be covered?
We can provide estimates, but final coverage is determined by your insurance provider or CDCP.
Why do I still have to pay?
Most plans and CDCP coverage do not pay 100% of all fees.
Should I wait for approval before treatment?
Your dentist will advise whether treatment can safely wait or should be done sooner.
