According to Statistics Canada, Canadians spend over $300 million annually on health care, averaging $9,000 per person. This poses a significant financial challenge for nearly 3 million self-employed professionals without employer benefits.
While universal healthcare covers basic and emergency care, personal insurance from companies like PolicyMe, Sun Life, Canada Life, or Blue Cross can help manage additional health and dental expenses.
Types of Health and Dental Insurance in Canada
Public Health Insurance
Public health insurance in Canada, or universal healthcare, is a publicly-funded healthcare system that provides Canadian citizens and permanent residents coverage for medically required hospital and doctor services without incurring out-of-pocket expenses.
Referred to as Medicare, this system delivers basic medical services to eligible residents mostly at no cost to the patient. These include doctor visits, hospital stays in regular rooms, maternity care, specialist referrals, and end-of-life care.
However, public health insurance only covers basic and emergency medical care for Canadians. For self-employed individuals, this results in a significant gap in insurance coverage and anxiety over unexpected medical bills and out-of-pocket costs that can hurt their finances.
Workplace Benefits
Employers in Canada typically offer health and dental insurance as part of their employee benefits package. They often sponsor group life insurance, accidental death and dismemberment insurance, and disability benefits.
Companies usually offer supplemental insurance plans that provide more comprehensive and robust coverage than universal healthcare. These plans often include dental care plans that cover preventive and diagnostic treatments.
Additionally, employers typically offer extended healthcare coverage not provided by public insurance, such as vision care, prescription drugs, medical services and equipment, hospital care, and paramedical assistance and services like physiotherapy and chiropractic care.
Private Health Insurance
Private health insurance in Canada complements the universal healthcare system by offering coverage for services not included in public healthcare. These plans are designed for families and individuals who prefer additional protection beyond what public insurance provides.
The health services covered by private insurance include mental health services, diagnostic tests, dental and vision care, physiotherapy, and prescription drugs, among others. Self-employed individuals often purchase private insurance as a supplement to Medicare.
With the best health insurance for self-employed individuals in Canada, they can better protect themselves from unexpected medical and dental costs and customize their plans to suit their unique needs. This ensures they receive timely and comprehensive care without financial strain.
Health and Dental Insurance Costs
According to PolicyAdvisor, the average cost of health and dental insurance plans for a self-employed individual in Canada is approximately $80 per month. The site also provides average monthly costs of different plan types from three top providers:
Best Health and Dental Insurance Options for Self-Employed Individuals
With only public insurance to rely on, self-employed individuals seeking more extensive coverage can turn to private insurance providers to fill the gaps left by universal healthcare. Below are the top providers offering comprehensive plans that cover a broader array of services.
PolicyMe
PolicyMe is a digital life insurance provider that aims to make insurance simpler and more affordable for Canadians. Since its inception in 2018, the company has issued more than $10 billion in insurance coverage and provided coverage to more than 18,000 Canadians.
Founded in 2018, the Toronto-based fintech company offers health and dental insurance, term life insurance, and critical illness insurance designed to make protection for families and individuals easier to access and less expensive.
Health Insurance
PolicyMe offers health insurance coverage for various medical and dental expenses not covered by Medicare. Coverage varies from basic preventative care to more comprehensive healthcare services and specialized care. Key features include:
- Prescription Drugs – Up to $2,800 annually for prescription drugs.
- Dental Care – Up to $1,200 annually for routine and unexpected dental costs.
- Mental Health Services – Up to $1,300 annually for therapists and psychologists.
- Professional Services – Coverage for massage therapy, chiropractic care, and more.
- Vision Care – Annual eye exams and eyewear coverage.
Dental Insurance
Dental insurance plans from PolicyMe include the following:
- Preventive Dental Services – Coverage for exams, cleanings, fillings, and extractions.
- Basic Dental Services – Up to 80% coverage for endodontic and periodontal treatments.
- Major Dental Services – Up to 60% coverage for braces and major restorative surgeries.
- Prescription Drugs – Up to $2,800 annually for prescription drugs
PolicyMe offers affordable insurance plans with premiums that can be customized to specific needs. The cost varies based on several factors, including age, health status, coverage level, location, provider, plan type, and family size.
Sun Life
Sun Life is one of Canada’s leading financial services companies offering a range of insurance, wealth, and asset management products and services. For self-employed individuals, Sun Life offers personal health insurance that helps cover the cost of preventive care or medical bills due to illness.
Personal health insurance plans from Sun Life include:
- Basic – Sun Life’s low-cost plan that covers basic medical and dental needs
- Standard – Offers more coverage for prescription drugs, includes emergency medical coverage for travel, and optional preventive dental coverage
- Enhanced – Most comprehensive plan that offers the highest amount of prescription drug coverage, and comes with optional dental coverage that includes restorative and orthodontic services
The cost of a Sun Life insurance plan for self-employed individuals depends on personal needs, level of coverage, and your chosen insurance plan, which comes with different coverage options and costs.
Canada Life
Canada Life is the country’s first domestic life insurance company. Founded in 1847, it offers various insurance and wealth management products for individuals, families, and small businesses. Its Freedom to Choose program offers comprehensive health and dental insurance plans that include a variety of services:
- Prescription drugs – Up to $250,000 in prescription drug coverage
- Vision care – Coverage for eye examinations, glasses, contact lenses, and laser eye surgery
- Paramedical services – Includes services like physiotherapy and massage therapy
- Dental services
- Covers 70-80% of costs for dental checkups, cleanings, fillings, and oral surgeries
- Includes dental routine checkups, with the option to add major dental services
- Covers major dental services like orthodontics, crows, and root canals
Below are some common dental expenses and the associated costs with and without coverage under Canada Life’s Select Plus plan:
- Routine dental services
- Without coverage – $117
- With Select Plus plan – $23.40 (80% reimbursement)
- Major dental (i.e. crowns, dentures, bridges, etc.)
- Without coverage – $642
- With Select Plus plan – $321 (50% reimbursement if you add on optional major dental coverage)
Blue Cross
Blue Cross is a network of health insurance providers that has been offering a range of healthcare services to 8 million Canadians each year since 1938. Available through regional organizations, these plans ensure access to essential healthcare services that include the following:
- Prescriptions – Discounted medications
- Dental services – Includes routine visits, examinations, cleaning, and polishing, among others
- Vision care – Coverage for eye examinations, eyeglasses, or contact lenses
- Hospital services – Access coverage for ambulance service and post-hospital care
- Massage – Treatment by registered specialists and professional therapists
The cost of Blue Cross insurance plans depends on individual needs, the chosen health and dental insurance plan, and the level of coverage. Other factors that influence costs include age, gender, optional extras, lifestyle, smoker status, and the number of people on the plan.
Pros and Cons of Health and Dental Insurance
Pros
- Financial protection. Health and dental insurance protects self-employed individuals from unexpected medical and dental costs and reduces out-of-pocket costs.
- Access to care. Insurance plans provide a network of healthcare professionals, making it easy for the self-employed to access needed healthcare services.
- Preventive care. Many health insurance plans offer coverage for preventive care services, such as checkups and screenings, that help to detect health issues early.
- Peace of mind. If you’re a self-employed individual, having health and dental insurance gives you peace of mind knowing you have financial protection from unforeseen medical and dental costs.
Cons
- Cost. Premiums, deductibles, and copays can add up, resulting in more expensive insurance, particularly if you don’t use it often.
- Coverage. Some insurance plans have limited coverage, such as exclusions for specific conditions or treatments.
- Lengthy procedures. Filing claims and getting approvals can be a long process that requires multiple steps.
- Paperwork. For some, dealing with insurance companies can be challenging due to claim disputes or denials, extensive documentation, communication barriers, and complex terminology.
How to Get Affordable Health Insurance for Self-Employed Individuals
In Canada, health and dental insurance costs can range from $50 to $150 per month for an individual, and between $100 and $300 per month for family plans. Additional coverage, such as vision care and extended health services, may result in higher costs.
For self-employed individuals looking for affordable private health insurance, there are steps they can take:
- Compare insurance plans. Use online comparison tools to review various plans from reputable providers like Blue Cross, Sun Life, and PolicyMe. Identify your insurance needs and provide the necessary information to get personalized quotes.
- Review coverage details. Evaluate the details of each plan, including coverage limits, deductibles, and premiums.
- Find flexible plans. Choose plans that offer customizable coverage and select only the health services you need, such as dental care, prescription drugs, and mental health services.
- Check for tax deductions. Self-employed individuals may be qualified for tax deductions on their premiums, reducing their overall cost. Under the Medical Expense Tax Credit, sole proprietors can deduct their health insurance on their annual income tax return.
What to Avoid When Seeking Medical Insurance for Self-Employed
When seeking medical insurance as a self-employed individual, it’s crucial to be mindful of potential pitfalls that can affect your insurance coverage and costs. Below are some key things to avoid:
- Not comparing insurance plans. Comparing multiple plans ensures you’re getting the best coverage for your needs and value for your money. Review your options based on your budget and needs using websites and comparison tools.
- Not considering your unique needs. Find an insurance plan that fits your specific needs as a self-employed individual. Tailor your plan accordingly to ensure you have the ideal coverage.
- Overlooking deductibles and copayments. Check if your premiums come with higher out-of-pocket costs when you need care. Evaluate the costs to see if they fit into your healthcare needs and budget.
- Ignoring coverage details. Read and understand what is covered and what isn’t, exclusions, waiting periods, and limitations. This is to avoid unexpected expenses and to ensure the plan meets your requirements.
How to Get a Health Insurance Quote
Getting a health insurance quote is a straightforward process that can be completed in minutes. Various sources are available to obtain a quote. PolicyMe offers a quick, tech-driven process with personalized recommendations in less than a minute.
Traditional providers like Sun Life and Canada Life also provide detailed quotes, allowing you to learn more about their offerings. Insurance brokers can also provide quotes from multiple companies, saving you time and effort.
To obtain a quote online, first identify your health and dental insurance coverage needs and other services you require. Research reputable providers and compare plans based on monthly premiums, deductibles, services included, and coverage limits.
For a quicker process, you can also use a comparison website like PolicyAdvisor to view quotes from several companies simultaneously. These sites help you find quotes tailored to your requirements and budget.
FAQs:
Who is PolicyMe health and dental insurance best suited for?
The health and dental insurance from PolicyMe is ideal for self-employed individuals, including freelancers and gig workers. The plan is also suitable for people with dependents and those nearing or in retirement.
How does the PolicyMe activation process compare to other providers?
PolicyMe’s activation process is designed to be faster than other providers, offering coverage activation in as little as one business day. With other providers, activation can take several days or weeks.
How can I reduce the cost of my health and dental insurance premiums?
Reduce the cost of your insurance premiums by shopping for the best rates, choosing a higher deductible that lowers your monthly premiums, practicing preventive care, and enrolling in wellness programs that reward healthy choices.
Conclusion
In conclusion, choosing the best health and dental insurance for self-employed individuals requires thorough consideration of factors, which include cost, coverage option, flexibility, and provider reputation.
With the best health insurance for the self-employed in Canada, individuals can focus on growing their businesses while maintaining their well-being without worrying about unexpected medical and dental expenses.