Health insurance protects your well-being by providing financial coverage for medical expenses.
These expenses can include the cost of doctor and emergency room visits, daily prescription medications taken for chronic or long-term conditions, one-time expenses like surgeries or, depending on the insurance plan, paramedical expenses like massage therapy and chiropractic expenses.
1. Provincial and Territorial Health Plans
Each of Canada’s provinces and territories offer government-funded health insurance plans to residents living in that area.
While each provincial and territorial plan is different, there are certain basic health care expenses that are almost always covered.
- Visits with a doctor, including walk-in clinic and emergency room visits
- Hospital stays if needed, medications provided while in hospital
- Dental surgeries performed in the hospital
- Most of the costs associated with ambulance services (some provinces require patients to pay a nominal fee)
Did You Know?
If you are travelling within Canada and need medical care outside of your own province, the costs associated with that care are usually reimbursed at the rates set by your home province.
2. Employee Supported Health Insurance
While all employers are different, most full-time, permanent employees are eligible for some sort of medical coverage that supplements the benefits provided by the government in the province or territory where you live.
Companies will usually consider multiple health insurance providers and compare the plans that they offer, and select a provider like Manulife, Canada Life, Green Shield or Blue Cross for the plan they provide to their employees as part of their total benefits package.
Most of these plans cover not only the employee, but also their spouse, partner, or children under the age of 19.
Children who are over the age of 19 can oftentimes also be covered.
This can differ based on your plan, so be sure to ask your insurance provider for details on who is covered.
Employees can access these plans at very competitive rates to have medical expenses covered that are not paid for by their government-provided health insurance plan.
These expenses typically include physiotherapy, mental health care, extended vision and dental benefits, orthodontics, massage therapy, chiropractic care, semi-private rooms if hospitalization is needed, home-based post-operative healthcare, medical equipment like wheelchairs and more.
Many plans also cover out-of-country health insurance to protect you if you get sick or injured while you’re travelling.
Some employers cover the cost of these health insurance plans as part of their employee benefits package, while others subsidize the cost and have their employees contribute, deducting the employee portion of the cost from employee pay cheques.
Some of these plans are optional, while others are a mandatory part of employment.
Did You Know?
Some companies offer a healthcare spending account (HCSA) as part of their health insurance offering. A HCSA gives you a certain amount of money you can use over the course of a year to cover a wide range of medical services. Here is a list of the medical expenses covered by employee healthcare spending accounts.
3. Purchasing Your Own Health Insurance
For the many Canadians who are self-employed, employed part-time, or not eligible for an employee-sponsored health insurance plan, finding health insurance that tops up the expenses covered by government-funded plans can be a major area of concern.
Luckily, there are many options to choose from that vary widely in terms of cost and breadth of coverage.
Many of the same health insurance providers employers use to provide benefits to their employees also offer health insurance plans for individuals.
These plans cover many of the same expenses as the employer-provided plans but are paid for by the individual.
Before choosing a plan, research the different providers available, the various plans that they offer, and the cost of their insurance plans.
Many of the healthcare expenses that you end up paying out-of-pocket for are tax-deductible.
In some cases, the premiums you pay for your health insurance may create a tax credit for you at the end of the year.
Be sure to speak with an accountant or other tax expert for details.
Frequently Asked Questions
- What is the main purpose of health insurance?
The main purpose of health insurance is to ensure you have access to the medical care you need and protect you from having to pay for medical expenses out-of-pocket. These expenses can include regular medical care like doctor’s visits, or emergency care to treat an acute injury, illness or infection. The Canadian provincial and territorial governments provide basic health insurance coverage that ensures each person has access to necessary and emergency care when needed. Additional health insurance can be purchased by either an employer or an individual to cover expenses not included in the government-funded plans.
- Can you get health insurance if you’re self-employed?
Yes. You are not limited to the health insurance coverage provided by the government in the province or territory where you live. People who are self-employed still have many options when it comes to choosing and purchasing additional health insurance to cover expenses not included in government-funded insurance plans. There are many private companies that provide health insurance coverage to individuals. The plans available can vary widely in terms of the cost of premium and depth of coverage, so it’s important to do your research and ask questions before selecting a health insurance plan.