The Public Service Dental Care Plan is a valuable government benefit for federal employees. However, many are unsure about their entitlements and how to use them. This article explains the eligibility requirements, coverage details, and how to access your benefits. Whether you are newly hired, returning from leave, or simply trying to maximize your family’s dental benefits, you will find the details here to use your coverage effectively.
What is the Public Service Dental Care Plan?
The Public Service Dental Care Plan (PSDCP) is a dental benefits plan paid for by employers, managed by Canada Life, for eligible federal public service groups and their dependants. It covers specific dental services and supplies that are not included in provincial or territorial health or dental care plans.
The PSDCP is administered by The Canada Life Assurance Company on behalf of the Government of Canada. It has four boards of management, each representing its respective members and consisting of both employer and bargaining agent/member representatives, including those from the National Joint Council Component.
The PSDCP operates separately from the Public Service Health Care Plan (PSHCP), which covers medical expenses, and from the Pensioners’ Dental Services Plan (PDSP), which is exclusively for retirees.
Important note: Members of the PSDCP coverage and their eligible dependents are ineligible for the Canadian Dental Care Plan (CDCP), which is the federal public dental benefit program.
Who Qualifies for PSDCP Coverage?
You qualify for the Public Service Dental Care Plan if you are a full-time or part-time federal employee who has been appointed for more than six months, or if you have completed six months of continuous employment. Part-time employees must work more than one-third of the normal workweek for a full-time employee in the same occupational group to be eligible.
Here are the deep dive criteria for the eligibility of the PSDCP dental coverage:
Eligible Employees for Public Service Dental Care Plan
The following categories of employees are eligible for membership in the Public Service Dental Care Plan:
- Indeterminate employees (permanent)
- Seasonal employees
- Full-time term employees appointed for more than six months or who have completed six months of continuous employment.
- Part-time employees working more than one-third of the normal full-time hours
- Excluded or unrepresented employees
- Executives
- Employees of participating employers listed in Schedule I of the PSDCP Rules
- Civilian members of the RCMP
- Members of Parliament, Senators, and their staff
- The Governor General and Lieutenant Governors
A common mistake is that term employees under six months often assume they are covered immediately. However, keep in mind that you are not eligible until either your term exceeds six months or you complete six months of continuous service.
CAF Members, RCMP Members, Reservists
Regular members of the Canadian Armed Forces (CAF) and some CAF Reservists are included in the plan. However, CAF and Royal Canadian Mounted Police (RCMP) members receive dental coverage through their respective military or RCMP dental programs. Only their dependents are eligible to use the PSDCP for dental coverage through the Canadian Forces Dependants’ Dental Care Plan.
CAF Primary Reservists must submit paper claim forms that include their unit’s orderly room stamp. To confirm the specific eligibility requirements for different categories of reservists, it is advisable to contact your departmental compensation office or your unit’s orderly room.
Eligible Dependants for Public Service Dental Care Plan
Your eligible dependants who can be covered under your PSDCP membership include your spouse or common-law partner and dependent children.
Spouse or Common-Law Partner
A common-law partner is defined as someone you have lived with in a conjugal relationship for at least one calendar year (12 months). If you have both a legal spouse (who is separated) and a common-law partner, you can only cover one of them. The PSDCP dental coverage will only provide coverage for the individual you include in your positive enrolment. A divorced spouse cannot be covered, but a separated spouse may remain covered until the divorce is finalized.
Dependent children
Eligible children include unmarried natural children, adopted children, stepchildren, or children for whom you act in place of a parent. To qualify, a child must meet one of the following criteria:
- Be under 21 years of age, OR
- Be between 21 and 25 years of age and attend an accredited school, college, or university full-time, OR
- Be over 21 (or over 25 if they are a student) and unable to support themselves due to a mental or physical impairment that occurred before reaching those ages.
To apply for coverage for a dependent child with a disability, you must submit the PSDCP Application for Dependent with a Disability Coverage Form to Canada Life within 31 days of the child turning 21 (or 25 if they are a full-time student).
In addition, eligible dependent children aged 21 to 25 who are full-time students can have their coverage suspended during academic breaks. If dental services are provided during a break, please do not submit those claims until coverage is reinstated, which occurs after proof of re-enrollment is received. Remember to track the 15-month submission window from the date the expense is incurred.
What Dental Services Does PSDCP Cover?
PSDCP reimburses 90% of preventive and basic services, 65% of major restorative services, and 50% of orthodontic services, once the annual deductible is met. You are responsible for paying the remaining co-payment percentage and any charges your dentist imposes that exceed the previous year’s provincial fee guide.
Preventive Services
Here’s a summary of what preventive services are recommended for oral health and disease prevention, which are covered with a 90% reimbursement rate, along with their suggested frequency:
- Oral Exams: Full exam every 36 months; recall exam every 9 months (every 6 months for children).
- X-rays: Full series every 36 months; bitewings every 9 months (every 6 months for children); panoramic every 36 months.
- Cleaning and Polishing: Every 9 months (every 6 months for children).
- Fluoride Treatment: Every 9 months (every 6 months for children).
- Sealants: Available for all ages.
- Oral Hygiene Instruction: Once a year for children; once for adults in a lifetime.
During chemotherapy for cancer treatment, the frequency limits for polishing, fluoride applications, and scaling/root planing are temporarily lifted. Canada Life must be notified and may request supporting documentation. Eligibility will be reassessed 12 months after the initial approval.
Basic Services
The following 6 basic services are covered at 90% of the rate.
- Fillings: Replacement fillings for the same tooth and surface are covered once every 24 months (every 12 months for children).
- Root Canal and Endodontic Services: There are no frequency limitations.
- Scaling and Root Planing: Limited to 6 time units per calendar year. Up to 6 additional units may be pre-approved by Canada Life, subject to evidence of gum disease.
- Denture Repairs and Adjustments: No limitations on the frequency of repairs and adjustments.
- Rebasing and Relining of Dentures: Covered once every 36 months.
- Oral Surgery: Includes extractions, surgical removal of impacted teeth, and frenectomy.
If you have documented periodontitis (gum disease), your dental provider can submit a treatment plan requesting up to 6 additional scaling units. Pre-approvals are valid for 3 years from the approval date. When applying for reimbursement within 3 months after treatment, you may be reimbursed for up to 2 time units at a time.
Major Restorative Services
The reimbursement rate for major dental services will increase from 50% to 65%, effective January 1, 2025. The major services covered include:
- Crowns: These can be replaced every 60 months, unless the treating provider determines that an earlier replacement is necessary and obtains approval from Canada Life.
- Inlays and Onlays: Covered once every 60 months, subject to certain conditions.
- Complete and Partial Dentures: Replacement is only permitted under specific conditions.
- Fixed Bridges and Implants: There are limitations on replacements.
- Services for Congenitally Missing Teeth: Covered for individuals under 23 years of age (the age limit will increase from 21 in 2025).
Tip: The PSDCP dental coverage includes an Alternate Benefit Clause. If you choose a more expensive treatment when a less costly option would effectively address the same dental issue, the plan may reimburse you only up to the cost of the less expensive option. Always submit a treatment plan for any procedure expected to cost $300 or more to obtain a predetermination of benefits.
Orthodontic Services
Orthodontic services for crooked teeth are covered at 50%, up to a lifetime maximum. In contrast, orthodontic diagnostic services, such as examinations, X-rays, and diagnostic casts, are reimbursed at 90%.
Note that no orthodontic benefits will be paid if the initial appliance was installed before you were enrolled in the PSDCP. This policy applies to both members and their dependents.
Orthodontic coverage depends on whether the service is eligible and provided by a licensed dental provider in your area. If you are thinking about aligners or other orthodontic treatments, ask your provider for a treatment plan or estimate before starting. This will help you know how much you will be reimbursed by the PSDCP.
Note: Your PSDCP coverage does not begin right away. Typically, coverage starts exactly three months after you become an eligible employee, which means there is a three-month waiting period. If you require dental work shortly after starting your job, make sure to verify your coverage start date before receiving treatment.
What is Not Covered by the PSDCP?
While the PSDCP is comprehensive, certain services are ineligible for reimbursement. Understanding these exclusions can help you avoid unexpected costs.
Generally, the plan does not cover cosmetic treatments such as porcelain or composite facings on molars; experimental procedures; duplicate prosthodontic appliances; analysis of mixed dentition if a complete exam was conducted within the past 12 months; tooth isolation unless medically justified; and user fees exceeding amounts set by public plans.
Therefore, if the cost of dental work exceeds $300, it is recommended that you or your provider submit a treatment plan or estimate to Canada Life first. This will provide you with a predetermination indicating what expenses are eligible and how much you may need to pay out of pocket.
How to Enroll in the Public Service Dental Care Plan Claim
PSDCP positive enrollment is the required process through which you provide Canada Life with information about yourself and your eligible dependents. This includes giving consent for the use of your personal information to process claims. Claims cannot be paid until you complete positive enrolment, even if you technically have coverage.
To enroll in the PSDCP, follow these three steps:
Step 1: Gather Required Information
To access your benefits, you will need to gather your certificate number (from your pay system or departmental compensation office), your plan number, and your personal information for yourself and any dependents.
Your plan number is based on your birth month as follows:
- January to March: 72111
- April to June: 72112
- July to September: 72113
- October to December: 72114
Step 2: Complete PSDCP Positive Enrollment
You can complete this step either online or by mail.
For the online method, visit the PSDCP positive enrolment page at welcome.canadalife.com/psdcp/positive-enrolment. Then, enter your last name, date of birth, and certificate number. After completing all steps and providing consent, you will receive a confirmation immediately and can download your benefit card.
If you are enrolling by mail, download the Positive Enrolment Form from the PSDCP Member Services website or contact Canada Life to request a paper form. Fill out the double-sided form, sign it, and mail it to the address indicated on the form. Please allow approximately three weeks for processing.
If your paper form is incomplete or illegible, it will be returned, and you will need to resubmit it. Any claims submitted before positive enrolment is completed will not be processed and must be resubmitted afterward.
Step 3: Create Your PSDCP Member Services Account
Once you have completed the positive enrolment, create your account at canadalife.com/psdcp. If you already possess a Public Service Health Care Plan account with Canada Life, please use the same email address and password.
How to Submit a Public Service Dental Care Plan Claim
You can submit claims in three ways: by having your dental provider submit electronically on your behalf, by submitting online through your PSDCP Member Services account, or by mailing a completed claim form to Canada Life.
Option 1: Electronic Submission by Your Dentist
The fastest way to submit your dental claims is through electronic submission by your dentist. Make sure to provide your plan number and certificate number; most dental offices can submit claims directly at the time of service.
Canada Life must receive your claim within 15 months from the date the expense was incurred. If you can demonstrate that it was impossible to submit the claim within this timeframe, the plan may consider claims up to 24 months in limited circumstances, such as legal incapacity or other unavoidable situations.
Option 2: Online Submission
You can also submit claims online via your PSDCP Member Services account. This option allows you to upload receipts and track the status of your claims, which is particularly useful for services received outside of Canada, where providers cannot submit claims electronically.
Option 3: Mail Submission
If you prefer mail submission, you need to complete a paper claim form and send it to the address provided on your PSDCP claim form. This form directs mailed claims to Winnipeg Benefit Payments at the following address: PO Box 6025, Station Main, Winnipeg, MB R3C 3C7.
If you require correspondence in French, please follow the instructions from Canada Life/NJC to find the appropriate French mailing address, rather than using an address based on your province.
Be sure to keep copies of all claims, receipts, and supporting documents, as Canada Life does not return original receipts after processing.
What are the Annual and Lifetime PSDCP Maximums?
For dental services in Canada, PSDCP covers eligible expenses based on last year’s dental fee guide for your province or territory, along with any deductibles or co-payments. For services outside Canada, reimbursement is based on standard charges for that location. If your dentist charges more than the fee guide amount, you will be responsible for the difference, in addition to your co-payment percentage.
From January 1, 2025, to December 31, 2026, the maximum amount covered for combined preventive, basic, and major services is $3,000 per person. According to the plan’s schedule of improvements, this annual limit will increase to $3,250 starting January 1, 2027.
If your coverage begins on or after July 1, the maximum reimbursement for that calendar year is limited to 50% of the annual maximum, which is $1,500 in 2025.
The annual deductible is $25 for individuals and $50 for families each calendar year. If your first dental expense occurs between October and December, the deductible will carry over to the following year.
If you claimed the previous $2,500 orthodontic lifetime maximum before January 1, 2025, you may be eligible to claim the remaining balance up to the new $3,000 maximum for services incurred after that date.
How does Coordination of Benefits Work with the PSDCP?
If you or your dependents have coverage under another dental plan, including your spouse’s membership in the PSDCP, you can coordinate benefits to receive up to 100% reimbursement of actual eligible expenses.
To submit claims for yourself, first submit them to your own PSDCP, especially if you are also covered as a dependent under your spouse’s plan.
For your spouse’s claims, they should submit them to their own plan first, and any remaining eligible amounts can then be submitted to your PSDCP.
When submitting claims for your children, use the birthday rule: the parent whose birthday falls earlier in the calendar year (considering month and day, not year) should claim first under their plan. For example, if your birthday is May 1 and your spouse’s is June 5, you would claim your children’s expenses under your PSDCP first.
In addition, if you are enrolled in both the PSDCP and the PSHCP, follow the guidelines below for submitting claims:
- For accidental dental injuries, submit your claim to the PSHCP first.
- For oral surgery, submit your claim to the PSDCP first.
The total reimbursement you receive from all plans cannot exceed either the actual expense incurred or the relevant fee guide amount, whichever is lower.
If your dental coverage lapses and you are over 65 in Ontario with low income, consider the Ontario Seniors Dental Care Program (OSDCP) while you re-establish the PSDCP.
How does Coverage Work During Leave Without Pay?
Leave Without Pay (LWOP) is not a one-size-fits-all situation. If you plan to take LWOP, be sure to contact your departmental compensation office or Pay Centre before your leave begins. In many cases, employer-paid coverage continues for the first three consecutive calendar months.
However, starting from the fourth month, you will need to pay contributions if you wish to maintain your PSDCP coverage. If you do not inform your compensation office or Pay Centre, your coverage may be suspended during your leave.
To continue your coverage, you must inform your compensation office. Additionally, you may have the option to repay any contributions owed upon your return to work.
Members need to inform their departmental compensation office or the Public Service Pay Centre if they want to keep their PSDCP coverage during LWOP. If they do not, coverage will be suspended starting the first of the month after the LWOP begins.
If you choose to retain your PSDCP coverage while on LWOP, you have the option to repay any owed contributions when you return to work. If you are required to pay PSDCP contributions during LWOP, follow the payment instructions provided by your compensation office or Pay Centre, as the timing and method can vary. Do not assume you can postpone payment until you return to work.
If your household includes a CAF member, check how their military dental coverage applies during LWOP scenarios in the Canadian Forces Dental Services.
The bottom line
To summarize, here are 4 key takeaways about the Public Service Dental Care Plan:
- 90% reimbursement for preventive and basic services
- Major restorative now covered at 65% (up from 50%)
- Annual maximum is $3,000 per person for 2025 to 2026
- Positive enrolment is required before claims can be paid
By highlighting these key aspects of the PSDCP and clarifying expectations for coverage and financial responsibility, you can make informed decisions regarding your dental care.
Disclaimer: The information in this article is intended for informational purposes only and is based on data available as of early 2026. Please note that the rules for the Public Service Dental Care Plan (PSDCP) may change. For the most up-to-date and authoritative information, always refer to the official PSDCP Rules on Canada.ca and the Canada Life PSDCP member portal.
FAQs about the Public Service Dental Care Plan
When are the PSDCP claim deadlines?
Canada Life requires claims to be submitted within 15 months from the date the expenses were incurred. Claims submitted after these 15 months will not be paid unless you can prove it was impossible to submit them on time. Additionally, claims submitted more than 24 months after the expense date will not be paid, except in cases of legal incapacity.
For orthodontic claims, it’s essential to submit them monthly according to the payment schedule outlined in your treatment plan, rather than as a lump sum at the end of the treatment.
What changed in the PSDCP as of January 1, 2025?
The January 2025 enhancements represent the most significant PSDCP upgrades in recent years, featuring increased maximum benefits, improved major restorative coverage, and new covered services.
Among the new services are tomography (including CBCT), anesthesia for oral surgery or any eligible service when there is documented mental health illness or a developmental disorder for the safety of the patient or provider, as well as TMJ injections, appliances, and assessments.
