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Canadian Dental Care Plan working but costing more than expected, AG says

WeMaple AI by WeMaple AI
October 21, 2025
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Canadian Dental Care Plan working but costing more than expected, AG says
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While the Canadian Dental Care Plan has improved access to affordable dental care, the cost of the program exceeded projections by more than $1 billion in its first two years and will do so by another $2.4 billion by 2032, according to a new report by Auditor General Karen Hogan.

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The report also found that confusion over how the program works persists, with call centres and government resources failing to provide useful information.

“We found that across the 2024-25 and 2025-26 fiscal years, payments for dental benefits to oral health providers exceeded the initial budget commitments by a total of $1.1 billion, resulting in funds moved between years to compensate,” the report found.

The cost overruns were explained by what the reports said were “higher than anticipated claim payments” for each member of the program.

While moving the money from later years forward helped plug the immediate financial hole, to get a better sense of the cost for services under the plan, Health Canada asked the Office of the Chief Actuary to provide a more accurate forecast of what claim payments would look like going forward on a quarterly basis.

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The audit said the forecasting “improved the credibility of the forecasts for claim payments … under the plan as the use of actuarial expertise to forecast payments for dental benefits is an accepted practice in the insurance industry.”

Hogan’s report found that when comparing the actuary forecasts for the annual cost of providing oral care from 2026-27 to 2031-32, there will be a further shortfall of about $2.4 billion in total. 

The report said that while Health Canada could address this gap by moving funding from later years, as it did for the earlier $1.1 billion gap, doing so “would reduce funds available for future years when demand is forecasted to be higher than the amounts currently allocated each year.”

To remedy this, the audit said Health Canada could make changes to the program to lower the costs by modifying the services it funds, changing eligibility criteria, requesting more funds from the treasury or some combination of all three.

Under the plan, Canadians with an adjusted net family income under $70,000 pay no fees for eligible services, members with an income from $70,000 to $79,999 pay about 40 per cent of the cost of services, while families with an income between $80,000 and $89,999 pay 60 per cent. 

The report, which looked at how efficiently the program is managed from Dec. 1, 2023, to May 31, 2026, found that Canadians using the plan paid an average of $264 in out-of-pocket expenses, compared to the $536 households paid in 2023. 

About 560,000 plan members, or 16 per cent of the plan members that accessed services in 2025, had their procedures fully covered. 

The report received survey results from almost 5,000 dental care providers and found that a third of them said information about the plan was hard to find and access. 

“For example, enrolment confirmation letters prominently displayed the percentage of eligible fees covered by the Plan — most often 100% — but did not clearly explain that members may still have to pay some costs themselves,” the Auditor General’s Office said in a statement. 

A key complaint was that the information was spread across too many sources, requiring dental providers to spend an average of about an hour a day explaining the plan to members. 

The audit said that Health Canada received almost 800,000 calls between March 2025 and February 2026 asking how the program works. A Health Canada survey analyzed 180 of those calls and said only two-thirds managed to meet required metrics. 

The audit said that when it looked at the 180 calls examined by Health Canada, it challenged that finding, saying it found it “difficult to come to a conclusion on the quality of the answers provided.”

The Auditor General’s report found that scripts and frequently asked questions approved by the department did not cover key questions. 

The report concluded by saying that while “Health Canada efficiently managed the Canadian Dental Care Plan to provide affordable dental care for eligible Canadian residents” it needs to do a better job of assessing claims, providing clear information and monitoring the impact on Canadians’ oral health.

The report said that, across most of the country, take up of the program was strong with 6.9 million of the 10.5 million Canadians eligible having registered, and 4.2 million having submitted claims for procedures as of March 31, 2026.

The report also found that uptake was much better in the provinces than it was in the territories. It said that 65 per cent of the people enrolled in the plan in Ontario had submitted claims, the highest utilization rate, while the lowest provincial rate was found in Saskatchewan at 52 per cent. 

In Nunavut the rate was just nine per cent, in Northwest Territories 25 per cent and in Yukon it was 45 per cent, “reflecting regional gaps in the availability” of care.  

The audit says that, to improve access in the territories, Health Canada should work to “remove barriers to access, including for children in provincial and territorial care.”

In her press conference, Hogan said 61,000 children in care across the country currently cannot access the program.

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