Updated: April 2025  |  bremo.io financial guides

Canada Private Health Insurance: What You Need Beyond Public Coverage

Canada's provincial health insurance systems cover medically necessary physician and hospital services. But there are significant gaps — prescription drugs, dental care, vision, physiotherapy, psychotherapy, and many other services are not covered by public plans. Private supplemental health insurance fills these gaps for millions of Canadians. This guide explains the landscape.

What Provincial Health Plans Cover

Each province administers its own public health insurance (OHIP in Ontario, MSP in BC, etc.) covering:

• Physician services (GP and specialist visits)
• Emergency and inpatient hospital care
• Medically necessary surgery
• Diagnostic tests (most)

Notably NOT covered by most provincial plans: prescription drugs for most adults, dental care, vision care, physiotherapy, massage therapy, mental health counselling, hearing aids, ambulance services (partial in some provinces), and private hospital rooms.

What Private Health Insurance Covers

Supplemental or extended health insurance policies cover:

• Prescription drugs — With a formulary and co-insurance structure
• Dental — Preventive, basic, and sometimes major restorative work
• Vision — Eye exams, glasses, and contact lenses
• Paramedical services — Physiotherapy, massage, chiropractic, naturopathy, psychotherapy
• Semi-private or private hospital room upgrade
• Out-of-country emergency medical — If not otherwise covered

Group vs. Individual Health Insurance

Group health insurance through an employer or association is typically the best value — premiums are often subsidized, and group underwriting means no medical exclusions for pre-existing conditions. Individual health insurance is available for self-employed, retired, or uninsured workers, but premiums are higher and underwriting may exclude pre-existing conditions.

Federal Dental Care Plan

The federal government launched the Canadian Dental Care Plan (CDCP) beginning in 2023-2024, providing dental coverage for eligible uninsured Canadians (based on income). This significantly expands dental access for lower-income Canadians who previously had no coverage, though the plan has limitations on covered services and income thresholds.

Private Health Insurance Providers in Canada

Major providers of individual and group supplemental health insurance include: Manulife, Sun Life, Great-West Life (Canada Life), Blue Cross (various provincial plans), iA Financial, and Desjardins. Self-employed Canadians can access group rates through professional associations and chambers of commerce.