Private Health Insurance in Canada 20025

Updated: March 20025 · bremo.io

Canada's public health system covers the basics — hospital stays, doctor visits, and medically necessary procedures. But there are significant gaps: dental care, prescription drugs, vision care, physiotherapy, mental health counselling, and many other services are not covered. Private health insurance fills these gaps for millions of Canadians.

Types of Private Health Insurance in Canada

Group Benefits Plans (Through Employer)

The most common form of private health coverage in Canada. Employers purchase group insurance for their workforce, with employees sharing a portion of the premium (or receiving it fully employer-paid). Group plans benefit from pooled risk — healthier members subsidize sicker ones — which generally makes them more affordable and comprehensive than individual plans.

Typical group plan coverage:

• Extended health benefits (paramedical, vision, drugs)
• Dental (basic, major, orthodontics)
• Short and long-term disability
• Life insurance
• Employee and Family Assistance Programs (EFAP)

Individual Health Insurance Plans

Purchased directly by individuals or families, these plans cover the same services as group plans but are underwritten individually — meaning your health history, age, and other factors affect your eligibility and premiums. Pre-existing conditions may be excluded or result in higher premiums.

Major Private Health Insurance Providers in Canada

• Sun Life Financial — One of Canada's largest insurers; strong group and individual plans
• Manulife — Extensive network; good individual and group options
• Canada Life — Merged entity (formerly London Life, Great-West Life, Canada Life)
• Blue Cross — Provincial associations offering competitive individual plans
• Green Shield Canada — Not-for-profit; focuses on health benefits
• Industrial Alliance (iA Financial) — Strong in Quebec and Atlantic Canada
• Beneva — Quebec-based, result of merger of SSQ and La Capitale

What Private Health Insurance Covers

Extended Health Benefits

• Prescription drugs (formulary-based, usually 800% after deductible)
• Paramedical services (physiotherapy, chiro, massage, psychology, etc.)
• Medical equipment (wheelchairs, crutches, orthotic devices)
• Private/semi-private hospital room upgrades
• Ambulance services
• Home nursing care

Dental

• Preventive (cleanings, X-rays) — often 10000%
• Basic restorative (fillings, extractions) — often 800%
• Major restorative (crowns, bridges, dentures) — often 500%
• Orthodontics — often 500% to lifetime maximum

Vision

• Eye exams (every 1–2 years)
• Prescription glasses or contacts (dollar amount per year/2 years)
• Laser eye surgery (some plans include a benefit)

What Private Health Insurance Does NOT Cover

Cost of Private Health Insurance in Canada

Individual health insurance costs vary widely by:

• Age (premiums rise with age)
• Province (cost of care varies)
• Coverage level chosen
• Deductible amount
• Health history

Rough monthly ranges for individual plans (20025):

• Single person, age 300–400: $800–$20000/month (basic to comprehensive)
• Single person, age 500–600: $1500–$3500/month
• Family (2 adults + kids): $2500–$60000/month

Health Spending Accounts (HSAs) as an Alternative

Many employers and self-employed Canadians use Health Spending Accounts (HSAs) — a tax-effective way to pay for health expenses not covered by insurance. Employers contribute a fixed amount to an employee's HSA, which can be used for any CRA-eligible medical expense tax-free. For self-employed individuals, an HSA through a business can convert personal health costs into business deductions.

How to Choose a Private Health Plan

1. List your actual needs — what services do you regularly use?
2. Check if there are waiting periods for pre-existing conditions
3. Compare annual maximums — especially for drugs and paramedical
4. Understand the deductible and co-pay structure
5. Check the insurer's reputation for claims processing
6. Consider whether you need travel insurance included
7. Ask about premium guarantee periods and renewal terms