Do you need individual health insurance?
Canada Life - Apr 01, 2021
Many Canadians have group health insurance through their employer. But if you’re retired, self-employed, employed on contract or are between jobs, you may want to explore individual health insurance.
Because Canadians have health coverage through their provincial and territorial governments, you’d be forgiven for thinking that all your health expenses are covered. A provincial health plan covers many health expenses, but it doesn’t cover everything.
Many Canadians have group health insurance through their employer. But if you’re retired, self-employed, employed on contract or are between jobs, you may want to explore individual health insurance.
What’s covered
Individual health insurance and provincial or territorial health insurance cover different health expenses. This chart is a general overview of what’s covered by each style of plan.
| Service | Covered by private health insurance? | Covered by provincial/territorial health insurance? |
|---|---|---|
| Doctor visits | No, covered by provincial/territorial plan | Yes |
| Diagnostic services (for example, blood tests, x-rays) | Yes (exact coverage depends on plan) | Yes (with limits) |
| Prescription drugs | Yes (exact coverage depends on plan) | In some provinces, but limited |
| Hospital visits and stays | Yes (exact coverage depends on plan) | Yes, but ward stays only |
| Dental care | Yes (exact coverage depends on plan) | Only if eligible (for example, dental surgery in hospital) |
| Eye health (optometry) | Yes (exact coverage depends on plan) | Only if eligible (for example, based on age or if you have a medical condition) |
| Glasses or contact lenses | Yes (exact coverage depends on plan) | No |
| Ambulance | Yes (exact coverage depends on plan) | Yes (with limits) |
| Services such as chiropractic, massage therapy and physiotherapy | Yes (exact coverage depends on plan) | In some provinces, but limited |
| Out-of-province, out-of-country | Yes (exact coverage depends on plan) | Yes, but very limited and only for emergencies |
For specific details of what your province or territory includes in its health insurance, visit Canada Health Act – Links to Provincial and Territorial Health Care Web Resources.
How can you insure yourself?
One option you could consider is PlanDirectTM, individual health insurance available through Canada Life which can help you cover expenses like prescription drug, dental, hospital, vision, paramedical or ambulance services. With PlanDirect, you’ll also get Consult+ virtual health care, which gives you access to qualified doctors, nurses and other healthcare professionals by phone, text or video chat.
Questions?
If you’re not covered through an employer, or you’re retired or close to retiring, contact me today to start exploring your options.
The information provided is based on current laws, regulations and other rules applicable to Canadian residents. It is accurate to the best of our knowledge as of the date of publication. Rules and their interpretation may change, affecting the accuracy of the information. The information provided is general in nature, and should not be relied upon as a substitute for advice in any specific situation. For specific situations, advice should be obtained from the appropriate legal, accounting, tax or other professional advisors.
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