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Need A Quick Guide On Health Insurance in Canada?

Canada Compass
Canada’s provincial healthcare plans offer hospital and doctor visit coverage for most permanent residents of the country. However, not all health care costs are covered by these government plans, and an increasing number of Canadians need private health insurance to cover expenses they face to take care of their health and their families health.

If you are wondering who is most likely to be living without insurance, consider this: a massive number of retiring baby boomers and contract workers generally do not have access to insurance through their workplace. This creates a gap in coverage that, fortunately, can be addressed through private health insurance.

Learn what the rules are in your province, how changes to government coverage might affect you, and who you can turn to for more information.

As outlined in the Canada Health Act, each provincial and territorial health insurance plan covers medically necessary hospital and doctors’ services for its qualified residents. They are provided on a pre-paid basis, without direct charges at the point of service

Generally provincial coverage does not include prescription drugs, dental visits, vision care, medical equipment, hospital accommodations (other than wardroom), registered therapists and ambulance transportation.

This is by no means a full list of exclusions. For specific details, please consult the individual health ministry for your province or territory or for more information on your province or territory’s plan, click here.

What is the cost of provincial health insurance coverage?

The provincial and territorial governments fund healthcare services with assistance from federal cash and tax transfers.

Most provinces do not collect monthly or annual premiums for healthcare coverage, while others offer some additional services like prescription drugs and medical transport to only certain qualified residents like senior citizens or the chronically ill.

Most provinces and territories have special accommodations for prescription drug coverage for residents over the age of 65, though there is often a copayment amount that must be paid out of pocket. These fees range broadly by province.

British Columbia

British Columbia’s provincial plan is the Medical Services Plan (MSP). Residents are not charged to be in the MSP Plan, but enrolment is mandatory for all residents.

Alberta

It is often described as “free” because eligible individuals do not have to pay upfront fees at the point of service for medically necessary hospital and physician services. However, it’s essential to understand that the AHCIP is not entirely “free” in the sense that it is funded through taxes and valuable contributions from the government and residents. Alberta residents pay taxes, including income tax and other taxes, which contribute to funding the provincial health care system.

Saskatchewan

The Saskatchewan provincial health care plan will give you access to some medical and community health services free of charge, provided you hold a valid Saskatchewan Health Card.

Manitoba

To receive free provincial health care, you must have a Manitoba Health number. The Manitoba Health card takes approximately four–six weeks to arrive. There is no cost to apply for a Manitoba health card and no monthly fees. The Manitoba Health card is required when visiting a doctor, obtaining services from the hospital, or filling a prescription.

NWT

NWT healthcare coverage is available at no cost to any permanent resident of the Northwest Territories (NWT). There are no fees to apply for NWT health care.

Nunavut

The Department of Health offers insurance programs to help Nunavummiut pay the costs of insured medical treatment, prescription drugs, medical supplies and medical travel. Every Nunavut resident is covered under the Nunavut Health Care Plan when they meet the eligibility criteria.

Yukon

If you’re a Yukon resident, you can apply to the Yukon Health Care Insurance Plan to get health care in the territory. If you’re new to the Yukon, once you’ve been a resident for 3 months, you’re eligible to apply for insured health services.

Ontario

OHIP is the government-run health plan for Ontario. It is funded by money from taxes paid by Ontario residents and businesses.

Currently Ontario’s OHIP plan is the only provincial plan with premiums. Residents of Ontario with employment or pension income over $20,000 per year pay a premium that ranges from $0–$900 and is automatically deducted from your pay or pension. People who are self-employed or pay income tax instalments submit payment with their annual tax return. The premium is based on an individual’s taxable income regardless of whether someone is married, divorced, separated or single.

Quebec

Quebec’s Health Insurance Plan is a public plan that gives all Quebecers access to free health care. The plan is managed by the Régie de l’assurance maladie du Québec (health insurance board), also known as the “RAMQ.” The Health Insurance Plan isn’t the only public program that covers health care.

Newfoundland

In Newfoundland and Labrador, publicly funded healthcare for all legal residents is provided by Medical Care Plan Newfoundland, which is most frequently called MCP Newfoundland. There are no fees or charges for MCP registration.

PEI

Health PEI is responsible for the delivery of publicly funded health services in Prince Edward Island. If you (and members of your family) have recently moved to Prince Edward Island to live, work, or study, you may apply for a PEI Health Card to receive publicly funded health services.

Nova Scotia

The Hospital Insurance program is administered directly by the Department of Health and Wellness. The cost of providing these services to Nova Scotians is met through the general revenues of the province. You pay no premiums.

New Brunswick

As a new New Brunswicker, you are entitled to basic, universal, government-funded health care. Health care coverage, including most medically required services, is provided by the provincial government.

Health Insurance circle graphic

Planning for the future and your provincial health insurance

It is important to note that what is currently covered by provincial plans may be dropped from the program at any time, when there is a new provincial budget or a change in government leadership in the province or territory.

While provincial governments are making great strides in providing better, more affordable access to prescription drugs and dental care for their residents, many other vital services remain outside the plans. As budgets tighten and the delivery of healthcare becomes more expensive, government health officials will review their list of covered services and make changes accordingly.

SBIS is a good place to start your search for health insurance

At SBIS we work with top Canadian insurers who pay close and constant attention to the regulatory conditions in each province. They respond to changes in government coverage by adjusting their health and dental insurance policy features and coverage levels to meet changing needs. Experts agree that carrying private health insurance to bridge any gaps in government coverage is the safest way to protect yourself and your family from unexpected healthcare costs.

For information supplemental health coverage options by province check out the links below:

…or if you are thinking about purchasing your own supplemental insurance go to our information page here.

Speak with us at SBIS today to discuss the best coverage options for your specific needs. Our helpful customer service representatives are available to help you, live and in person, Monday to Friday from 8:45 a.m. to 4:45 p.m. Call us today!

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