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Canada’s Provincial Health Plans – Quick Links Highlight What’s Covered Where You Are

Canada flag with stethoscope
Ever wonder just how “universal” the Canadian healthcare services are? In case you didn’t know, the covered healthcare services that you receive are determined from province to province. What is “free” where you live may not be so in another province.

It’s important to remember that all costs when travelling to another province are usually reimbursed at your home province’s fee guide rates.

Here is a handy list (October 2023) of what most provincial plans cover to give you an idea of what Canada has to offer from coast to coast. Benefits from all provinces are changed regularly; therefore, please click on the provincial page links for the most up-to-date information about coverage.

For healthcare services not covered by your provincial plan, you may purchase supplemental health insurance. For more information, click here.

ONTARIO: ONTARIO HEALTH INSURANCE PLAN (OHIP)

https://www.ontario.ca/page/what-ohip-covers

Covered services:

  • Doctor visits, including those at walk-in clinics and since January 1, 2023, pharmacies can provide prescriptions for 13 common ailments, such as rashes, pink eye, insect bites or urinary tract infections
  • Hospital visits, doctor and nursing services, services to diagnose what’s wrong (such as blood tests and x-rays), wardroom accommodation and meals if you stay (if you want semi-private or private you must pay fees), medications for in patients (once discharged, prescribed medications are not covered)
  • Dental surgery when performed in hospital if medically necessary
  • Optometry is covered only to an extent for those between the ages of 20 and 64 who have a specific medical condition, and an annual eye exam is covered for those 19 and under or every 18 months for those 65 and older. Glasses or lenses are not covered
  • Podiatry is covered for a small portion of the cost of each visit up to a determined maximum per person, per year. X-rays are also partially covered. Surgery is not covered
  • Ambulance services may be covered for medical emergencies, but often you will have to cover some of the cost
  • Prescription drugs: coverage is available for people up to age 25 who do not have private coverage. There is a senior drug program for seniors over age 64
  • Fees related to travel for health services are available if you live in Northern Ontario
  • Out-of-country emergency inpatient services will be paid up to $400 per day if provided in an operating room, coronary care, intensive care, neonatal or pediatric special care unit, or $200 (Canadian) per day for lower levels of care
  • Supplemental insurance is strongly recommended

MANITOBA: INSURED BENEFITS BRANCH OF MANITOBA

https://www.gov.mb.ca/health/mhsip/index.html

Covered services:

  • Physician services, surgery / anaesthesia, x-ray and laboratory services are covered
  • Vision care coverage includes one exam every two years for people under 19 and over 65. Certain tests are also covered
  • Chiropractic care is eligible up to seven visits per calendar year
  • Dental surgery is reimbursed when hospitalization is required
  • Hospital coverage includes standard level accommodation and meals; nursing services; laboratory, x-rays and diagnostics; surgery and related supplies; and dietetic counseling
  • Ambulance fees are not covered
  • Out-of-country coverage includes emergency medical services paid at the same rates as Manitoba, but the province may not cover the entire amount
  • Supplemental insurance is strongly recommended

Personal care home residents are eligible for:

  • Standard accommodation
  • Nursing care
  • Physiotherapy and occupational therapy
  • Medical and surgical supplies
  • Prescription drugs
  • Meals and laundry services

ALBERTA: ALBERTA HEALTH CARE INSURANCE PLAN

https://www.alberta.ca/ahcip-what-is-covered.aspx

Covered services:

  • Physician services, hospital services, surgery, including oral surgery in a hospital
  • Standard ward hospitalization and drugs administered in a hospital
  • Private nursing care and nursing services may be covered
  • Laboratory and diagnostic services
  • Psychiatric visits
  • Vision care coverage annually for eye exams and some treatment if younger than 18 or older than 65, and care for any age if caused by trauma, accident, or illness
  • Podiatry is eligible to an extent
  • Out-of-province / out-of-country coverage: Alberta Health Care coverage doesn’t pay for all medical costs when you travel outside the province, even within Canada. The AHCIP covers only limited physician and hospital costs outside of Canada. Patients are responsible for the remaining amount after AHCIP’s coverage
  • Supplemental insurance is strongly recommended

SASKATCHEWAN: GOVERNMENT OF SASKATCHEWAN

https://www.saskatchewan.ca/residents/health/prescription-drug-plans-and-health-coverage/health-benefits-coverage/fully-covered-services

Covered services:

  • Medically necessary physician and public hospital services received in Canada including visits to physicians’ offices, x-ray and laboratory services, diagnostic and surgical procedures and other inpatient or outpatient hospital care
  • Ambulance services are not covered
  • Physiotherapy and occupational therapy (not in private clinics) and mammography for women ages 50 to 69; vaccines; HIV testing; services to treat substance abuse; mental health services and addiction services
  • Select additional services for lower income working families
  • Prescription drugs: family coverage is available for children aged 14 and under. There is a senior drug plan available for low-income seniors over age 64
  • Out-of-country coverage: Emergency medical or hospital care while outside Canada are partially covered up to $100 CAD per day for inpatient services/Up to $50 CAD for outpatient
  • Supplemental Insurance is strongly recommended

BRITISH COLUMBIA: MEDICAL SERVICES PLAN

http://www2.gov.bc.ca/gov/content/health/health-drug-coverage/msp/bc-residents/benefits/services-covered-by-msp

Covered services:

  • Physician services
  • Midwife services
  • Oral surgery if performed in a hospital
  • Medically necessary eye exams
  • Some orthodontic services
  • Some supplementary services: Acupuncture, chiropractic, massage therapy, naturopathy, physical therapy, and non-surgical podiatry (only for eligible individuals – low income)
  • Out-of-province / out-of-country coverage: some coverage for emergency hospital care when you travel outside Canada, limited to a maximum daily payment of $75.00, in Canadian funds
  • Supplemental insurance is strongly recommended

PRINCE EDWARD ISLAND: HEALTH PEI

https://www.princeedwardisland.ca/en/topic/health-care-coverage

Covered services:

  • Physician, including virtual care, and hospital services
  • Drug plans, depending on your income
  • A portion up to the full amount could be paid for home care, palliative care, long-term care, addiction and mental health services, and drug programs
  • Dental public health services for those with low income
  • Chronic disease prevention and management
  • Public health nursing
  • Diabetes program, community nutrition, cancer screening programs, speech language pathology services, etc.
  • Ambulance services are not generally covered unless for age 65+ emergency care
  • Out-of-country coverage: Travel coverage includes emergency or sudden illness coverage. Fees are reimbursed at PEI rates
  • Supplemental insurance is strongly recommended

NEWFOUNDLAND AND LABRADOR: NEWFOUNDLAND AND LABRADOR MEDICAL CARE PLAN

https://www.gov.nl.ca/hcs/mcp/hospitalplan/

Covered services:

  • Visits to a physician’s office, hospital or beneficiary’s residence
  • Surgical, diagnostic and therapeutic procedures, including anaesthesia, pre- and post-operative care
  • Certain surgical-dental procedures which are medically necessary, to be performed in hospital by a dentist or oral surgeon
  • Hospital accommodation and meals at the standard ward rate, nursing services, diagnostic procedures, medications, and therapy while in hospital
  • Out-of-province / out-of-country coverage: does not cover all hospital-related charges, treatment received in a clinic, or ambulance / air ambulance services. MCP strongly recommends that additional travel/health insurance be purchased from a private insurer before you leave the province – even if only for one day
  • Supplemental Insurance is strongly recommended

QUEBEC: QUEBEC HEALTH INSURANCE PLAN (RAMQ)

https://www.ramq.gouv.qc.ca/en/citizens/health-insurance/medical-services

Covered services:

  • General practitioner and specialist physician services only by those who have not withdrawn from RAMQ
  • Medical examinations, consultations, diagnostic procedures, therapeutic procedures
  • Medical procedures (e.g. surgery) and anesthetics, including oral surgery
  • Outside-of-province / out-of-country: The Régie reimburses up to the applicable Québec rates, even if you paid more. Hospital services outside-of-country are covered only following a sudden illness or accident. Reimbursements are issued up to a maximum of $100 per day of hospitalization or $50 per day for healthcare received at a hospital outpatient clinic
  • Supplemental Insurance is strongly recommended

NEW BRUNSWICK: NEW BRUNSWICK MEDICARE

http://www2.gnb.ca/content/gnb/en/departments/health/MedicarePrescriptionDrugPlan/content/medicare/CoverageandClaimsInsideNewBrunswick.html

Covered services:

  • Drug coverage is available under the New Brunswick Drug Plan, which is intended for those without drug insurance
  • Physician and hospital fees and most medically required services provided in a physician’s office or hospital
  • Some dental services performed in a hospital
  • Hospital standard accommodation and meals, nursing service, drugs administered while in the hospital, diagnostic services, and therapies
  • Out-of-country coverage: Out-of-country costs are not covered, except for emergencies, at a maximum cost of $100 per day for in-patient, $50 for out-patient services.
  • Supplemental Insurance is strongly recommended

NORTHWEST TERRITORIES:  NWT HEALTH CARE PLAN

https://www.hss.gov.nt.ca/en/services/nwt-health-care-plan/general-information-residents#what-does-your-health-care-card-cover-

Covered services:

  • Physician diagnosis and treatment of illness and injury
  • Surgery, including anaesthetic services and surgical assistance where necessary
  • Hospital care and accommodation and meals at the standard ward care
  • Nursing services, when provided by the hospital and laboratory, X-ray and diagnostic procedures, and interpretation and drugs administered in the hospital
  • Radiotherapy treatment, occupational therapy, and physiotherapy when provided by an insured facility
  • Out-of-province / out-of-country coverage: The cost of medically necessary services needed for an emergency or sudden illness outside of Canada will be provided at NWT rates only, although charged costs may be considerably higher
  • Supplemental insurance is strongly recommended

NOVA SCOTIA: NOVA SCOTIA HEALTH

https://novascotia.ca/dhw/msi/

Covered services:

  • Physician and hospital services, including dental surgery
  • Optometry services every 2 years (under nine years of age and over 65)
  • Ambulance fees
  • Infection prevention
  • Mental health services
  • Out-of-country coverage: Inpatient hospitalization as the result of an accident or sudden illness is covered up to $525 CAD per day plus 50% of ancillary fees. It is strongly recommended that any resident travelling out of province purchase a supplemental Travel Health Plan for the period of absence to cover these balances and other uninsured services
  • Supplemental insurance is strongly recommended

NUNAVUT: NUNAVUT HEALTH CARE PLAN

https://gov.nu.ca/health/information/nunavut-health-care-plan

Covered services:

  • Physician diagnosis and treatment of illness and injury
  • Surgery, including anaesthetic services and surgical assistance, where necessary
  • Obstetrical care, including prenatal and postnatal care
  • Eye examinations, treatment and operations provided by an ophthalmologist
  • Hospital accommodation in a ward, use of the hospital facilities, nursing services, laboratory, x-ray and diagnostic procedures, and interpretation, and drugs prescribed by a physician and administered in the hospital
  • Radiotherapy treatment, occupational therapy, and physiotherapy when provided by an insured facility
  • Medical travel if a doctor, nurse, dentist or other health care professional advises a resident must leave a home community for medical treatment. The Nunavut Health Care Plan will pay airfare less a $250 round trip deductible (co-payment) from your home community to the nearest centre where treatment is available
  • Out-of-country coverage: The Nunavut Health Care Plan covers limited costs for emergency health services based on the Nunavut physician fee schedule and approved Nunavut hospital reciprocal rates. Residents are advised to consider purchasing supplemental travel insurance prior to leaving Canada for vacation or extended periods
  • Supplemental Insurance is strongly recommended

YUKON: HEALTH CARE INSURANCE PLAN (YHCIP)

http://www.hss.gov.yk.ca/yhcip-benefits.php

Covered services:

  • Physicians’ services in their office, clinic, at the hospital, scene of an accident or in a patient’s home
  • Care and treatment by a physician before, during and after an operation, including anesthesia
  • Physicians’ care during pregnancy
  • Certain dental-surgical procedures that have to be performed in an approved hospital
  • Hospital accommodation and meals at standard ward rates
  • Necessary nursing services, laboratory, radiological and other diagnostic procedures
  • Drugs, biologicals, and related preparations when administered in a hospital
  • Use of operating room, case room and anesthetic facilities including equipment and supplies
  • Radiotherapy and physiotherapy services where available
  • Emergency and non-emergency out-patient services
  • Medical travel subsidy for costs such as accommodation, meals and taxis while receiving outpatient medical services outside of Yukon. Subsidy is $75/day starting on Day 2 of outpatient services to a maximum of 90 days
  • Out-of-country coverage: YHCIP covers limited costs for emergency health services outside-of-territory. Residents are advised medevacs and ambulance fees are not covered in the case of a health emergency
  • Supplemental Insurance is strongly recommended

9 Responses

  1. My daughter and her husband and 3 children moved to Ontario from BC in December of 2017. He recently enlisted in the Armed Services and has very low income. She has not been able to find employment due to the fact that when the employer finds out she is a ‘service wife’ they will not hire her because they know she will not stay due to frequent transfers. They have not registered for OHIP because they do not have the money to get registered. Their children are going without medical care. I thought that we in BC were the only province that have to pay for medical ie MSP premiums? I am concerned for my grandchildren – my grandson had to go for medical attention recently due to ear infections and now they have a $300.00 medical bill they cannot pay. How can this situation happen in Canada?

    1. I am sorry that your daughter has had to go through some financial hardships including medical expenses after moving to Ontario. That being said, to register and be enrolled in OHIP costs nothing, so I am not sure why your daughter believes it will be too expensive. It is a free program for those who fall under these qualifications.

      1. Your main residence in in Ontario
      2. During the first six months that you lived in Ontario, were you away less than 30 days?
      3. Are you in Ontario for at least 153 days in any 12-month period?

      If their main residence is in Ontario and for the first 6 months they were not away more than 30 days and they are living in Ontario for 153 days within a 12 month period, they automatically qualify for the OHIP. With OHIP most of their medical expenses (seeing doctors, hospitalization, prescription drugs for those under 25, eye exams for children, etc) would be covered.

      Please ask your daughter to enroll immediately to save her from any further medical expenses that the province would cover like her son’s ear infection.

    2. Gerri,

      That’s B.C. for you. We moved to B.C. from Alberta and we all went without healthcare for the first year and a half. We just couldn’t afford the costs. The reason we moved was because there was no work and my husband got a job in B.C. What we have discovered is that the government here has high costs and taxes on everything! The hydro is ridiculous with their step 2 residential billing, the extreme carbon taxes and provincial taxes, gas prices are out of this world, insurance is a joke. We pay 3 times more for insurance than we did in Alberta. Pying for healthcare wasn’t even negotiable for us. We had to pay out of pocket per visit. My kids have eye problems too, my one son needed surgery and to see an opthamologist. The qualifications to get free healthcare are so restrictive. The cost of living is here is high and the standard of living is relatively low compared to how we lived in Alberta.

      1. Hi Rhonda, thank you for your comment. I believe you misunderstood the article. You are correct you do not have to pay for OHIP or any other provincial healthcare (that is funded by your taxes). What we were saying is that when you reside in a province where the cost of medical services are less expensive than the province you are visiting and an illness or injury occurs, you will be responsible for the differences in pricing from what your home province would pay for the same service and what the actual cost in the province you received care in.

  2. I’m a technology worker who moves a lot and after having some out of province issues with OHIP, I’m wondering what my options are? My main residence is in Nova Scotia but my last position was in Ontario. I have thought about moving my residence to another province (e.g. New Brunswick) or even buying a place in the Yukon but I’m concerned about coverage especially if I’m not too sure where my next contract will be. Any thoughts?

    1. There are a lot of variables and moving parts in your specific situation, it would be best to give us a call at 1-800-667-0429 and speak to Rhonda, who understands your situation, for some guidance.

  3. Our son is about to go off of our benefits plan and we have been looking for a private carrier. We are unsure whether to get it all , Dental, Drugs, etc or just pick what is prudent to keep him safe. I would be interested to know your thought? Thanks Bruce

    1. I will contact you directly via your email address to discuss a few options that will best suit your sons needs. Thank you

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