Understanding healthcare in Canada
There are 3 types of healthcare coverage in Canada:
Universal healthcare (provincial/territorial)
Provincial and territorial healthcare is funded by taxpayers and most basic healthcare and medical services are covered.
Workplace benefits
Workplace benefits are provided by many employers or associations to help employees cover the cost of things provincial/territorial health care plans may not pay for including certain prescription drugs, dental, hospital, vision, paramedical and ambulance services.
Personal health and dental insurance
This insurance is most often used by people who are retired, who are self-employed or not eligible for workplace benefits, or who are losing their previous workplace benefits coverage.
What are some of the gaps in public healthcare?
Prescription medications
Many necessary drugs aren’t covered by the public system, leaving you to bear the financial burden yourself.
Dental care
Routine dental care, including cleanings, fillings, and other preventive measures, isn’t covered under public healthcare. This can be a considerable expense for you and your family.
Vision care
Eye exams and corrective lenses, such as glasses or contact lenses, aren’t covered under the public system. If you require vision correction, the costs can add up quickly.
Paramedical services
Services provided by paramedical professionals, such as physiotherapists, chiropractors, and massage therapists, aren’t covered by public healthcare. These services can be crucial if you have a chronic condition or injury, and treatment sessions can be expensive.
Mental health services
While mental health services are included in public healthcare to some extent, there are limitations. Access to psychologists or therapists may be restricted, and the coverage for certain mental health treatments may not be comprehensive.
Workplace health insurance plans offered through employers or associations can fill some of these gaps. These plans often provide more comprehensive coverage, including access to services not covered by public healthcare.
When is it worth it to have personal health insurance?
Personal insurance plans like Freedom to Choose™ health and dental insurance can bridge the gaps left by public healthcare systems and can be worth it for people who are self-employed, retired or who don’t have access to a workplace insurance plan.
Health and dental coverage can include:
- Routine dental services
- Eye exams, glasses, contact lenses and laser surgery
- Prescriptions drugs
- Physiotherapy, chiropractor visits and massage therapy
- Social workers and psychologists
- Naturopaths, dieticians, acupuncturists, no referral needed like all our paramedical services
Personal insurance plans like this allow you to obtain comprehensive coverage that’s customizable, portable, and can provide quicker access to services with fewer wait times and out of pocket costs.
Personal insurance could be with it if you are:
- Self-employed
- Retired
- Leaving a workplace plan
- Don’t qualify for coverage under a workplace plan
- Need coverage in addition to a workplace plan
Let’s look at an example. Sarah is a self-employed graphic designer in Toronto who needs a dental cleaning but isn’t covered by a workplace insurance plan. A cleaning costs $220. Sarah purchases a Freedom to Choose Select plus plan that covers 80% of routine dental services. Now instead of paying the entire $220 out of pocket, she’ll only pay $44 with her personal insurance plan.
The above example is for illustrative purposes only. Situations will vary according to specific circumstances.
Considerations when choosing personal health insurance
Picking personal health insurance is a big choice. Consider these things to make sure the plan fits your needs:
Whether you have a family
If you have a family, choose a plan to which you can add your spouse and children as dependents. If your spouse has coverage through a workplace plan, you may be able to coordinate benefits.
Costs
Understand the financial aspects of the insurance plan, including monthly premiums, deductibles, co-payments, and any additional out-of-pocket expenses. Evaluate the overall cost against your budget to ensure affordability.
Coverage for pre-existing conditions
Ask about the coverage for pre-existing conditions. Some personal health insurance plans may impose waiting periods or exclusions for certain pre-existing medical conditions. With our guaranteed acceptance plans at Canada Life, you can still be covered if you have a pre-existing condition.
Portability
Consider the portability of the insurance plan, especially if you move between provinces or travel frequently. Some plans offer flexibility, allowing you to maintain coverage regardless of your location.
Flexibility and customization
Look for insurance plans that offer flexibility and customization options.