Do you need individual health insurance?

Freedom 55 Financial - 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.