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Personal health and dental insurance cover medical equipment and care beyond the basic coverage provided by universal health care. While government health plans typically cover essential medical services such as doctor visits, hospital stays, and surgery, extended health insurance expands the scope of coverage to include a broader range of services and treatments.
Extended health insurance coverage often includes benefits such as coverage for prescription drugs, vision care, dental care, paramedical services (such as physiotherapy, chiropractic care, or massage therapy), mental health services, medical equipment and supplies, and alternative therapies. These additional benefits can vary depending on the specific insurance plan and provider.
Antibiotics, narcotics, creams, etc.
Physiotherapy, massage, chiropractic, etc
Crutches, nebulizers, CPAP machines, etc.
Teeth cleaning, braces, crowns, etc.
Glasses, contact lenses, eye exams, etc.
Emergency medical expenses
Extended health insurance provides comprehensive coverage for prescription drugs, dental coverage, vision care, travel medical coverage, and more. There can be annual maximums placed on each coverage type in the form of dollar amounts as well as percentages of the cost covered. For example, a plan might cover.
The cost of extended health insurance in Canada is dependent on your personal health history and your plan's coverage details. Plans usually come tiered from basic health benefits to comprehensive coverage that includes dental, vision, and high coverage amounts.
The price you pay will differ from the price your neighbour pays—the plan and the cost are unique to you. But let's give you an example quote as a baseline.
*Quote for a 35-year-old male, non-smoker, with no health risk or pre-existing conditions, who lives in Ontario.
Without insurance, your medical costs can start to rack up! On top of dealing with your health recovery, you wouldn’t want to worry about these costs:
Even for routine checkups like vision care or orthodontics (especially if you have kids) things start to add up! When you buy medical insurance, you can budget your premiums and rest assured that if something happens to your family, you don’t have to worry about whether you can afford care.
Sometimes you have extended health care coverage through your work or group plan. But that's not always the case. You need extended health and dental if you are…
if you have your own business or are a self-employed side hustler, you won't have employer benefits and will need personal health insurance
Your emoloyee benefits plan may have covered you in your working years, but now that you're a retired sunsetter off the payroll, you will need your own extended health plan.
Families with dependents
Every family has their own unique needs--some have more complicated medical needs than others. If your family has dependents, costs add up(like when every kid needs braces)
Universal health care in Canada provides coverage for basic medical care like doctor's visits, hospital stays, and surgery. It may also cover some medications/treatments administered in the hospital. However, thousands of other out-of-pocket expenses come with medical, dental, and vision care that are not covered by the government health insurance plan.\n\n
Universal Health Care
Private Health Care
|Emergency travel medical|
|Emergency travel medical|
We work with Canada's best health and dental insurance providers. Each provider has different plans and different prices--out expert advisors at PolicyAdvisor can find the best health plan option for you!
To apply for health and dental insurance, start with our online quoting tool! We will ask you simple questions about your health and what coverage amounts you're looking for. Then we'll shop the health insurance market to find the best prices for your health and dental insurances!
Do I need personal medical insurance if I'm covered through work?
If you already have employee health benefits, you may not need additional health insurance. However, be sure to check your policy details. Sometimes there are heavy coverage restrictions on group plans. With your own personal health insurance, you get to decide your coverage plans and how much you pay.
Can I get health insurance if I have an existing health condition?
Yes, you can get health insurance if you have an existing health condition. When you apply for coverage, you'll be asked about any pre-existing conditions. These are health conditions that you have been diagnosed with prior to applying for health insurance. If you apply for coverage within 90 days of losing your employee benefits coverage, pre-existing conditions are commonly covered, but the plan may be more expensive. There are also guaranteed acceptance plans with no medical questionnaire, but these are more expensive than standard plans as well.
What does Canada's universal dental plan cover?
Canada's dental benefit was introduced in 2022, to help lower dental costs for eligible families earning less than $90,000 annually. A tax-free payment of $260, $390, or $650 is available for each eligible child, only if they do not have any other dental coverage elsewhere. It is different from private dental insurance in that it is a free social program based on family income.
What's the difference between medical insurance and critical illness insurance?
Medical insurance covers out-of-pocket expenses for standard injuries and illnesses. It will pay a portion of these expenses (usually 70-90%). Critical illness insurance on the other hand is a one-time payment to you if you are diagnosed with a critical or terminal illness. For example, if you are diagnosed with cancer, critical illness insurance will give you a one-time payment to cover things like travel costs to specialized treatment facilities or an extra special family vacation - extended medical will cover your cancer surgery and a portion of your cancer treatment.
What's the difference between extended medical coverage and medical travel coverage?
Extended health insurance covers out-of-pocket medical expenses that occur in your day-to-day life in Canada. This may include prescription drug coverage, coverage for vision care, and more. Travel medical insurance covers you for any unexpected medical expense you incur while traveling outside of your home province or country. For example, if you need ambulance services during your trip to the US.
Does extended medical insurance cover therapy?
Extended benefits usually cover paramedical expenses such as physiotherapy, chiropractic, and psychological services, including therapy. Always check your policy wordings to see how much coverage you get each year, if the coverage is capped at a maximum percentage or dollar amount per year, and if your coverage includes psychologists and/or psychotherapists. Some providers may require a doctor's recommendation for paramedical claims.
Does health insurance cover car accident injuries?
In many provinces, your vehicle insurance has accident benefits that cover the cost of therapies and medical treatments associated with the accident. However, that coverage is very limited. For example, the accident benefits may only provide 3 sessions of physiotherapy, but the whiplash sustained in the accident requires you to have more sessions to regain mobility. This is where your extended health benefits would come in—they could cover the cost (up to policy maximums) for the remaining sessions.
How do I submit a health and dental claim?
To submit a health or dental claim, go to your provider's website. Most insurance providers have online submission forms you can fill out or printable forms you send off in the mail. You will need the receipt as proof of the medical bills you paid, although some only require you to hold onto the receipt in case there is any claim dispute. Some providers also do direct billing, meaning that you don't have to pay upfront. The insurance company is directly billed at the point of the transaction.
What if my health insurance claim is denied?
Most insurance companies have an appeal process if your claim was denied. Sometimes claims can be denied due to a lack of documentation or because the policy does not cover that specific type of medical bill. Many insurance companies will also have a guide of what they believe is reasonable to charge for a service and will only cover a percentage of that fair price. For example, if the going rate for a massage is $100/hr in your province, they may not cover the full 80% of your fancy spa massage that cost $500/hr or they may deny the claim outright. If you cannot come to an agreement with the insurance company and your appeal was denied, you also have the option to file a legal dispute.