The Basics of Health Insurance

Talk to anyone about Canada, and chances are the phrase ‘universal health care’ will be thrown around within a few minutes of talking about the country’s virtues. While it’s true that Canada is certainly ahead of the curve when it comes to providing health care services to its citizens, that doesn’t mean that absolutely every ailment or malady is covered by the government. So what’s actually covered by the government and what’s reliant on a private health insurance company?

For those who aren’t covered by a private insurance company, it can be a shock to realize that you still have to pay for a lot of services and medications out of pocket. Whether you’re a student straight out of school (and no longer covered by your parent’s insurance) or a freelancer/independent contractor, you may find yourself considering opting into buying additional coverage.

What’s Usually Covered by the Government?

Every province and territory differs in what they offer and how their coverage functions. For the specifics of where you live, you can look up your province of territory on this list or here.

The broad definition of what’s covered according to Health Canada is: “Hospital services provided to in-patients or out-patients, if the services are medically necessary for the purpose of maintaining health, preventing disease or diagnosing or treating an injury, illness, or disability; and medically required physician services rendered by medical practitioners.”

There are also additional benefits that certain provinces and territories may offer (this varies greatly depending on where you live). Some examples of additional benefits could include prescription drugs, and some degree of dental, optometric, chiropractic and ambulatory services. Keep in mind that these additional benefits are rarely applicable to the entire population but rather just a targeted section (for example, children or seniors might receive more coverage).

What’s Not Covered and Requires Health Insurance?

Aside from those who might be eligible for additional benefits through their government funded health care, most Canadians must have extended health plans/private insurance in order to qualify for coverage when it comes to prescription medication, chiropractic services, dental or orthodontic appointments and services, and optometric appointments and services.

This means that, without private insurance, you will have to pay for both the actual appointment and any other products or services out of pocket. If you’re a glasses or contact lens wearer, you’ll have to pay the full price for both. The same goes for braces, dentures, fillings, and any other major dental procedures or surgeries. Typically, ambulance services are not covered by government health care either.

Where Should I Look For Health Insurance?

Take a look at this list for all of the health and life insurance companies in Canada. Spend some time researching the most popular ones and make sure you find a plan that suits your needs and lifestyle. Ask your friends and family for recommendations, request quotes from multiple companies, and don’t feel obligated to agree to anything on the spot. Ultimately, it’s a personal decision, and if you feel like the costs for coverage outweigh the benefits in your case, then at least you know where you stand.