Health Insurance

Personal health insurance

The everyday gaps. Provincial health coverage pays for doctors and hospitals; it does not pay for the dentist, the physiotherapist, most prescriptions outside hospital, or a new pair of glasses. For a household with children in braces or anyone on ongoing medication, those add up to a real annual figure.

What It Covers

The usual components

A personal health plan reimburses a proportion of eligible expenses, usually up to annual maximums per category. You choose the level of each rather than taking a fixed package, which is what makes these plans worth comparing properly.

Dental

Routine cleaning and check-ups, fillings, and at higher levels major work — crowns, bridges, implants — and orthodontics. Dentistry in Canada is paid out of pocket beyond emergency treatment, and it is the single largest reason most people buy one of these plans.

Prescription drugs

Medication dispensed outside hospital. If anyone in the household is on ongoing medication, price this component carefully — the difference between coverage levels can exceed the difference in premium within a year.

Paramedical services

Physiotherapy, chiropractic, massage therapy, psychology, naturopathy and similar, usually with a per-practitioner annual cap. Psychology coverage in particular has improved across most plans and is worth checking rather than assuming.

Vision and the rest

Eye examinations, glasses and contact lenses on a cycle of a year or two. Most plans also include medical equipment, ambulance, and some travel medical cover — though for a real trip abroad you should still arrange proper travel insurance rather than relying on it.

Is It Worth It

How to decide

This is the one product on the site where the arithmetic is genuinely simple, and where the answer is sometimes no.

Add up a year

What did the household actually spend last year on dental, prescriptions, glasses and physiotherapy? For a healthy single person with good teeth, that number is often small enough that a plan does not pay for itself. For a family of four with a child in braces and someone on regular medication, it usually does, comfortably.

Remember these plans reimburse a percentage

Cover is rarely a hundred percent, and each category has an annual maximum. Compare the maximums against your actual spending, not against the premium — a cheap plan that caps dental below what you spend has not saved you anything.

Leaving a job is the common trigger

Group benefits usually end with employment, often within a month. Most insurers offer conversion plans without medical underwriting if you apply within a short window of losing group cover — typically sixty days. Missing that window means answering health questions instead, so it is worth acting quickly.

If you are self-employed

Premiums may be deductible as a business expense within CRA limits, which materially changes the real cost. Raise it with your accountant — the structure of your business affects the answer.

Apply before the group plan ends, not after. Conversion from an employer plan to an individual one is normally available without medical questions if you apply within a short window — commonly sixty days of the group cover ending. After that you are underwritten like any new applicant, and anything diagnosed in the meantime may be excluded. Diarise the date the day you leave.

No obligation

Bring last year's numbers.

What the household actually spent on dental, prescriptions and therapy over twelve months is all an advisor needs to tell you whether a plan is worth buying — and which level of each component to take. Sometimes the honest answer is that you do not need one.

Talk to an advisor

Personal health insurance questions

At the higher levels, usually — these fall under major dental rather than basic, and are often subject to a waiting period after the plan starts and a percentage co-payment. Basic plans typically cover cleaning, examinations and fillings only.

It depends on how you join. Plans that ask health questions may exclude existing conditions; guaranteed-issue plans and conversions from group cover generally do not underwrite, which is why the conversion window matters so much.

Usually, for major dental and sometimes for other categories — commonly three to twelve months from the start of the policy. It exists to stop people buying a plan the week before expensive treatment, so plan ahead of the work rather than after the quote.

Yes, and it is nearly always cheaper than individual plans. Children can normally stay on a family plan into their early twenties while in full-time education.

No, and it is not meant to. It sits on top, paying for what the provincial plan excludes. You need to be enrolled in your provincial plan to hold one.

Paying for dental and prescriptions yourself?

Call 437-428-2828 and talk it through with a licensed advisor. Mon–Sat, 9am–8pm ET. No obligation, and nobody will push you to buy on the call.

Call 437-428-2828