Canada’s universal healthcare system provides vital medical services to eligible residents. However, coverage gaps often necessitate additional private insurance.
This is where private health insurance from companies such as PolicyMe, Canada Life, and Blue Cross come into play. They offer plans with varying coverage options that complement the public healthcare system.
Health Insurance Coverage and Plans
Canada offers three types of healthcare coverage:
- Universal healthcare (provincial/territorial) – Canada’s public insurance that covers most basic healthcare and medical needs, including doctor visits and hospital stays; options vary depending on your province or territory
- Workplace healthcare plan – Offers coverage not available in public insurance; may include dental care, vision care, and prescription drugs; more affordable than a personal health and a dental plan
- Personal health and dental insurance – Often used by retirees, self-employed individuals, and other people not qualified for group benefits; coverage includes protection not covered by provincial/territorial plans
This is Why You Should Have Health Insurance
Canada’s publicly funded single-payer healthcare system offers citizens and permanent residents crucial medical coverage. Eligible people get access to necessary medical services without paying for anything. However, universal healthcare does not cover services vital to Canadians’ overall health.
With private insurance, extended healthcare services can be more easily accessible and less expensive. If you’re a traveller to Canada, additional insurance provides better protection if you run into health issues while in another country.
Typical Costs of Health Insurance
The cost of health insurance in Canada often depends on age, preferred coverage, and medical history. On average, an individual plan can cost from $75-$150 per month. Family plans can cost between $100 and $300 monthly. Plans with more comprehensive coverage and added services cost more.
With private health insurance, your premium and deductible can also impact the cost. At times, you may be required to pay additional out-of-pocket expenses if your protection does not cover the entire cost of the service or procedure.
Pros and Cons of Health Insurance
Eligible Canadians enjoy the following benefits:
- Access to universal healthcare coverage with the use of a health card
- Reduced out-of-pocket expenses for individuals and families
- Social equity through access to significant medical services, regardless of age, income, or health status
- A fair healthcare system that ensures the health and well-being of all citizens, without taking their financial status into account
Below are some of the cons of this healthcare system:
- Long wait time for medical procedures
- Shortage of healthcare providers
- Lack of sophisticated medical technology and treatments
Best Health Insurance in Canada
Choosing the best health insurance in Canada can take time due to the many available options. Below are some of the top insurance offerings to find the coverage that best suits your needs.
PolicyMe
PolicyMe is an insurance provider offering streamlined, technology-driven insurance solutions for eligible Canadians. Founded in 2018, the company has sold $6 billion in coverage and has helped almost 10,000 Canadians get insurance.
PolicyMe’s approach focuses on making the insurance process simple and fast through online applications, instant decisions and efficient customer service. Backed by Securian Canada, a subsidiary of Fortune 500 company Securian Financial, the company has secured $18 million in Series A funding.
Plans and Coverage
- Term Life Insurance – Provides coverage and financial protection for a specified term.
- Critical Illness Insurance – Provides coverage for early-stage conditions, offering financial protection for medical expenses and recovery time.
- Health and Dental Insurance – Provides coverage for prescription drugs, health services, vision care, dental care, mental health services, and professional services; comes in two options, namely Guaranteed Issue Plans and Protect Plans.
Pricing
PolicyMe insurance rates are generally 5-10% lower than its competitors, which it can offer due to reduced operational costs as an online company.
Additionally, PolicyMe offers a 10% discount in the first year to couples who apply for a life insurance policy together. Each child also gets free coverage worth $10,000. The rates for Health and Dental insurance planholders are also locked in for one year, with annual renewal.
Pros
- Does not require a medical questionnaire
- No obligation quote
- Application process of 5 minutes or less
- Coverage approval in minutes
- Option to access benefits on a preferred date
- Transparent pricing
- Flexible insurance plans
- Added perks (such as free child coverage)
- Availability of licensed advisors
- Dedicated claims concierge services
- Plan cancellation at any time
Cons
- Limited products compared to those offered by traditional insurers
- Products offered include only term life, critical illness, and health/dental insurance
- Does not offer specialized products
- A primarily digital insurance company
- A relatively new company that does not hold a long track record in the industry
Canada Life
Canada Life offers a wide range of insurance products for individuals, families, and business owners across Canada. Founded in 1847, Canada Life is one of the country’s oldest and largest insurance providers noted for its financial stability and numerous insurance offerings.
Plans and Coverage
Canada Life offers two health insurance options: Guaranteed Health Insurance and Select Health Insurance. Its guaranteed package features the Freedom to Choose health and dental insurance, which comes in three types:
- Select – A base plan designed for people who do not have health and dental insurance.
- Select plus – Suitable for those who don’t already have coverage and for anyone who’s leaving a group plan or doesn’t want to pay for more coverage they don’t need.
- Select elite – Ideal for those looking for coverage with higher maximums and co-insurance.
All the plans cover dental, prescription drugs, paramedical services, and vision.
Pricing
The cost depends on several factors, with the premium being based on individual circumstances. The factors include age, gender, health history, optional extras, the number of people on your plan, smoking status, and lifestyle. Coverage options available and your location can also affect pricing.
Pros
- 100% vision coverage
- Lower average premium compared to a group plan with an employer
- Policy cancellation can be done anytime
- Children up to age 21 are covered
- Coverage starts the first day of the month following receipt of your application
- Exclusive savings for Rexall customers
Cons
- Pricing is less than competitive
- Replacement plans are costly
Blue Cross
The Canadian Association of Blue Cross Plans represents several independent non-profit insurance providers operating across Canada since 1938. Collectively known as “Blue Cross,” these providers have insured over 7 million Canadians.
Plans and Coverage
Blue Cross offers Complete Health plans that come in three Health Benefits modules: Entry, Essential and Enhanced. Blue Cross plans are specific to regions and have different features depending on location. A Blue Cross insurance plan typically covers prescription medication, paramedical expenses, mental health services, dental, vision, and travel.
Pricing
The cost of a Blue Cross health insurance plan depends on various factors, including age, gender, health history, lifestyle, and location.
Pros
- Self-service options
- Unlimited drugs
- Capped out-of-pocket prescription medication costs
- Unlimited dental services (minor only)
- Assured access coverage
- Customizable plans
Cons
- Major dental services are available for Enhanced plans only
- No replacement plan
- Less than competitive unlimited drug pricing
- Travel plans are available only for Enhanced plans
Manulife
Manulife is a leading insurance provider and the second-largest insurance company in Canada. As of 2021, it holds $1.3 trillion in assets under management and administration.
Plans and Coverage
Manulife offers four options: Flexcare, Health & Dental Guaranteed Issue Enhanced Insurance, FollowMe Health & Dental Insurance, and Manulife Vitality. Coverage includes prescription drugs, dental services, vision care, medical equipment, homecare and nursing, ambulance services, hearing aids, accidental dental, and emergency medical travel.
Pricing
The cost of Manulife health insurance depends on factors like age, gender, optional benefits, and individual circumstances. A sample cost for a 30-year-old woman residing in Toronto who opts for a basic plan without dental can expect to pay around $100 monthly.
Pros
- Guaranteed plans and combo plans are available
- Comprehensive paramedical coverage
- Option to choose what coverage to include
- 24/7 access to health professionals online
- A trained operator for emergency assistance anytime
- Home security and home monitoring from your phone
- Health insurance support for some plans
Cons
- The comprehensive coverage can make it expensive
- Hospital benefits not included
Sunlife
Founded in 1865 and headquartered in Toronto, Sunlife is a leading Canadian financial services company. One of Canada’s largest insurers, it has maintained a strong presence in the country while expanding globally. The company is recognized for its financial stability, innovative products, and noteworthy customer service.
Plans and Coverage
Sunlife offers three plans. Basic, the low-cost option, covers basic medical and dental needs. The most popular plan, Standard, includes more coverage for prescription drugs, optional preventive dental care, and emergency medical coverage for travel. Enhanced is the most comprehensive, offering the highest prescription drug coverage, restorative and orthodontic services, and optional dental coverage.
Pricing
The cost depends on factors like age, location, and the number of people you add to your plan. For example, a 40-year-old single woman residing in Ontario who doesn’t smoke can expect to make a monthly payment of around $125.
Pros
- Comprehensive prescription coverage
- Competitive prices
- Travel coverage for Standard and Enhanced plans
Cons
- The Basic plan does not include emergency travel medical and vision coverage
- Coverage for counselling services is limited
CAA
CAA (Canadian Automobile Associate) is a not-for-profit automobile association in Canada established over 115 years ago. In partnership with Manulife, it offers comprehensive health and dental insurance to Canadians through Securian Canada.
Plans and Coverage
CAA health and dental plans include Fully Underwritten Plans, Guaranteed Issue Plans, and Next Plans. Depending on the plan, options include Essential, Standard, Enhanced and Dental Secure. Coverage includes extended and mental health care, prescription drugs, dental, vision, and hospital stays. CAA’s guaranteed issue health insurance provides coverage without answering medical questionnaires.
Pricing
The cost of a CAA health insurance plan depends on your age, gender, health, location, lifestyle, and your chosen coverage. A CAA Basic Extended Healthcare plan with prescription drugs and dental care coverage can cost around $100+ monthly for a 30-year-old, non-smoker male.
Pros
- Customizable plans
- Option to extend coverage to family members
- Offers discounted rates if you bundle multiple policies
- Extended health care
- CAA members save 5% off their rates
- Simple, online application
- 24/7 access to Telehealth
Cons
- Complaints of long wait times for dental services
How to Get a Health Insurance Quote
Start by researching private insurance providers offering supplemental coverage not available in the public healthcare system. Use online comparison tools to request quotes based on your needs and circumstances. You can also choose among the top providers and fill out an online form to receive a customized quote.
How to Choose the Best Health Insurance Provider
Consider factors like the range of coverage offered, deductibles, premium costs, and the provider’s reputation for claim processing and customer service. Obtain multiple quotes from different providers and compare their plans to find one offering the ideal coverage at an affordable price.
What Is Not Covered By Health Insurance?
Health insurance does not cover services that are not medically necessary, such as cosmetic or elective procedures, experimental treatments, and alternative therapies like acupuncture or chiropractic treatments. Pre-existing conditions are also not covered for a specific period following enrollment.
FAQs:
Is it worth getting health insurance in Canada?
Getting health insurance in Canada can be worthwhile to obtain coverage for procedures or services the public healthcare system does not usually cover. These include prescription drugs, dental care, and private hospital stays. Also, health insurance can shorten wait times and provide faster access to healthcare professionals and certain treatments.
How long do you have to live in Canada to get free healthcare?
You must be a permanent resident or citizen in Canada to qualify for free healthcare in Canada. A waiting period of up to three months after establishing residency may also be necessary before you can access public health insurance.
Is healthcare free in Canada without insurance?
All Canadian citizens and permanent residents are entitled to access medically necessary services provided by a doctor or a hospital. This universal health care system, known as Medicare, is funded through taxes, which means citizens or permanent residents can apply for public health insurance.
