Hamilton Dentist Accepting CDCP — Direct Billing at Red Rose Dentistry

The Canadian Dental Care Plan is a federal program providing dental coverage for millions of Canadians who do not have access to private dental insurance. Red Rose Dentistry at 135 James St S, Downtown Hamilton is enrolled in CDCP and provides direct billing to Sun Life on behalf of all eligible patients. This page explains exactly how CDCP works at our clinic — what to bring, what is covered, how billing is handled, and how to get started as a new CDCP patient.

For a broader discussion of how CDCP makes dental care accessible for lower-income Hamilton residents and what the program covers at each income tier, see our affordable dentist Hamilton guide. For CDCP renewal information, see our CDCP renewal guide for Hamilton.

How to Use Your CDCP at Red Rose Dentistry — Step by Step

Step 1: Confirm Your CDCP Enrolment

Before booking, confirm that you are enrolled in CDCP. You are enrolled if you received a welcome letter from Sun Life (or from CDCP/Service Canada) confirming your coverage. You can also check your enrolment status through your My Service Canada Account at canada.ca. If you are unsure whether you are enrolled, contact Service Canada — not your dentist — to verify your status, as eligibility is determined by the federal government based on your tax return income data.

Your CDCP member ID number appears on your welcome letter and in your online Sun Life account. You will need this number when booking at Red Rose Dentistry.

Step 2: Provide Your CDCP Member ID When Booking

When you call (905) 521-2221 or book online, provide your CDCP member ID (and your Sun Life plan member number if you have it). Our reception team verifies your CDCP coverage before your appointment — including which services are covered at your income tier and the specific fee schedule that applies. We confirm your expected out-of-pocket cost before you arrive.

Step 3: Attend Your Appointment — We Handle the Billing

At your appointment, your dentist or hygienist provides the covered service. After the appointment, Red Rose Dentistry submits the claim directly to Sun Life — you do not fill out any forms, mail anything, or manage any reimbursement process. Sun Life processes the claim and pays the clinic directly. You pay only the out-of-pocket portion that is not covered by your CDCP tier — confirmed before treatment begins.

Step 4: Pay Your Out-of-Pocket Portion (If Any)

Your out-of-pocket amount depends on your income tier:

• Adjusted family net income under $70,000: 100% coverage — no out-of-pocket payment for covered services
• $70,000–$79,999: 60% covered — you pay 40% of the CDCP fee
• $80,000–$89,999: 40% covered — you pay 60% of the CDCP fee
• $90,000 and above: not currently CDCP-eligible

The CDCP fee (the government’s fee schedule amount for each service code) is different from a clinic’s regular fee. We always apply the CDCP fee schedule for CDCP-enrolled patients, and your out-of-pocket is calculated as a percentage of that government-set fee, not the clinic’s standard fee. This distinction is confirmed at booking so there are no surprises.

What CDCP Covers at Red Rose Dentistry

The following services are covered under CDCP and available directly billed at Red Rose Dentistry. Coverage for each item is subject to frequency limits, clinical eligibility criteria, and the specific CDCP fee schedule at the time of the appointment:

Diagnostic and Preventive Services

• Comprehensive dental examination — covered (with frequency limits; typically once every 3 years for adults, annually for children)
• Recall examination — covered at each recall visit
• Bitewing X-rays — covered at each recall appointment
• Complete-mouth X-rays (full series or panoramic) — covered subject to frequency limits
• Professional scaling (cleaning) — covered; typically up to two units of scaling per year for most adults, more for patients with documented gum disease
• Fluoride treatment — covered for eligible patients (typically children and some adults)
• Fissure sealants — covered for children on eligible teeth

Restorative Services

• Composite (tooth-coloured) fillings — covered on posterior teeth subject to tooth-type and surface limitations
• Amalgam fillings — covered; CDCP may specify amalgam for some posterior tooth-surface combinations
• Stainless steel crowns for children — covered as an alternative to extraction for severely decayed primary teeth

Surgical and Emergency Services

• Routine extractions — covered
• Surgical extractions — covered (including some wisdom tooth extractions meeting clinical criteria)
• Emergency examination and radiographs — covered for acute dental pain or trauma
• Pulp therapy (baby tooth root canal) for children — covered

Periodontal Services

• Scaling and root planing (deep cleaning) — covered for patients with documented gum disease; per-quadrant billing
• Periodontal maintenance appointments — covered following active gum disease treatment

Prosthodontic Services

• Complete dentures — covered for eligible patients (frequency limits apply — typically not more than once every 5 years)
• Partial dentures — covered; framework and some tooth types subject to fee schedule
• Denture relines and repairs — covered subject to frequency limits

Endodontic Services

• Root canal treatment on anterior and premolar teeth — covered for most eligible tooth types
• Molar root canal coverage — limited; coverage depends on the specific tooth and current CDCP fee schedule

What CDCP Does NOT Cover at Red Rose Dentistry

The following services are not currently covered under CDCP and are provided on a self-pay basis at Red Rose Dentistry:

• Cosmetic treatments — teeth whitening, porcelain veneers, dental bonding for aesthetic purposes
• Orthodontic treatment — ClearCorrect aligners and traditional braces for adults
• Dental implants — implant placement and implant-supported crowns or bridges
• Dental crowns on adult posterior teeth (for restorative purposes) — limited; coverage may apply in specific clinical circumstances
• Dental bridges — not currently in the CDCP fee schedule for most cases

For services not covered by CDCP, Red Rose Dentistry provides a written cost estimate before any non-covered treatment begins. Patients make informed decisions about non-covered treatment with full cost information in hand.

CDCP and Private Dental Insurance at Red Rose Dentistry

If you have both CDCP and a private dental insurance plan, both can apply to your dental costs. The standard approach: your private plan is billed first, CDCP then covers a portion of any eligible remaining balance. This coordination can eliminate out-of-pocket costs for many covered services. Red Rose Dentistry manages this coordination on your behalf — you provide both insurance details at booking and we handle the claims. For a detailed explanation, see our CDCP and insurance coordination guide.

What to Bring to Your CDCP Appointment at Red Rose Dentistry

• Your CDCP member ID — on your welcome letter or in your Sun Life online account
• Your Sun Life plan/member number — if available; the same as your CDCP member ID in most cases
• Your date of birth — required for CDCP claim verification
• Any private insurance details — if you have both CDCP and private insurance, bring that information too so we can coordinate billing
• A list of your current medications — for patients attending their first appointment

You do not need to bring a physical CDCP card. The member ID number is all that is required for our billing system to verify your coverage and submit the claim.

CDCP at Red Rose Dentistry — Serving All Hamilton Communities

Red Rose Dentistry accepts CDCP patients from all Hamilton communities and surrounding areas. Whether you are in the downtown core, on Hamilton Mountain, in Stoney Creek, Ancaster, Burlington, Dundas, Waterdown, or even as far as Caledonia — we are a CDCP-enrolled provider that direct-bills Sun Life regardless of where you live in Ontario. New CDCP patients are accepted without referral. Free parking at 135 James St S. Saturday appointments available.

Frequently Asked Questions — CDCP at Red Rose Dentistry Hamilton

Is Red Rose Dentistry a CDCP dentist in Hamilton?

Yes. Red Rose Dentistry at 135 James St S, Downtown Hamilton is enrolled in the Canadian Dental Care Plan. We accept CDCP patients and directly bill Sun Life on their behalf — no upfront payment required for covered services, no reimbursement process for patients to manage. We verify your CDCP coverage before each appointment and confirm your out-of-pocket amount in writing before treatment begins. New CDCP patients are accepted from Hamilton and all surrounding communities without a referral.

How do I find out if I am eligible for CDCP in Hamilton?

CDCP eligibility is determined by the federal government based on your adjusted family net income from your most recent tax return. If your household income is below $90,000, you do not have access to private dental insurance, and you are a Canadian resident, you may be eligible. Eligibility confirmation comes from Service Canada — you can check your status through My Service Canada Account at canada.ca, or by calling Service Canada. Red Rose Dentistry can also check your coverage at booking if you have your CDCP member ID available.

Do I pay anything at a CDCP appointment at Red Rose Dentistry?

For patients at the 100% tier (adjusted family net income under $70,000), eligible services are covered entirely — no out-of-pocket payment at the time of service. For patients at 60% and 40% tiers, you pay 40% and 60% of the CDCP fee respectively for covered services. We confirm the exact out-of-pocket amount before any treatment begins so you are never surprised at checkout. Non-covered services (cosmetic, orthodontic, implants) are billed separately and are self-pay, with costs disclosed before any such treatment is proposed or performed.

Can I get a CDCP cleaning and checkup at Red Rose Dentistry?

Yes. Professional cleaning (scaling and polishing) and examination are core CDCP-covered services at Red Rose Dentistry. For 100% tier patients, your routine cleaning and examination appointment involves no out-of-pocket payment. We submit the CDCP claim directly to Sun Life after your appointment and you pay only your tier’s share, if any. We recommend booking your cleaning and examination together — both are covered and the combined appointment takes approximately one hour for most patients.

What if my CDCP claim is declined?

If a CDCP claim is declined for a covered service, Red Rose Dentistry handles the resolution process on your behalf. This may involve providing clinical documentation to support the claim, resubmitting with additional information, or appealing the decision through Sun Life’s review process. We do not bill patients for covered services whose claims were declined due to administrative or documentation issues — we resolve those claims on your side. If a service is determined to be outside CDCP coverage based on the fee schedule, we discuss the outcome and your options before any self-pay billing applies.

Book Your CDCP Dental Appointment at Red Rose Dentistry

Red Rose Dentistry at 135 James St S, Unit 114, Downtown Hamilton accepts CDCP patients and directly bills Sun Life for all covered services. Book your cleaning, examination, or restorative dental appointment today. Bring your CDCP member ID — we handle everything else. No referral needed. Free parking on site. Saturday appointments available.

Call (905) 521-2221, email info@redrosedentistry.ca, or book online at redrosedentistry.ca.

Red Rose Dentistry
135 James St S, Unit 114
Hamilton, ON L8P 2Z6
Phone: (905) 521-2221
Email: info@redrosedentistry.ca
redrosedentistry.ca