Canada’s healthcare system is regarded as one of the best in the world, providing all citizens and permanent residents free access to emergency care and regular doctor visits. However, there are still certain services that Medicare – the country’s universal health coverage – does not cover – including eye and dental care, outpatient prescription drugs, rehabilitation services, and private hospital rooms – which Canadians need to pay for.
So, it is not surprising that, although not required, nearly 70% of Canadians have taken out supplemental private health coverage, according to the latest figures from the Canadian Life and Health Insurance Association (CLHIA). Of these, 90% were purchased through group plans.
Overall, the nation’s health and life insurance providers paid out $30.4 billion in supplementary health benefits, $8.8 billion in disability claims, and $1.6 billion for accidental death and dismemberment, critical illness, and long-term care coverage last year, the association’s data also revealed. These numbers indicate a thriving private health insurance market in a country where the public health system already provides a good level of support for acute and accident care.
Read more: Health insurance – what do Canadians want?
Canada has a “decentralized, universal, publicly funded health system,” according to the Commonwealth Fund, a private nonprofit group that supports independent research on health care issues and provides grants aimed at improving the country’s health system.
“Health care is funded and administered primarily by the country’s 13 provinces and territories,” the organization explained. “Each has its own insurance plan, and each receives cash assistance from the federal government on a per-capita basis.”
The group added that while benefits and delivery approaches vary, all Canadian citizens and permanent residents receive “medically necessary hospital and physician services free at the point of use.”
However, not everything is covered by Medicare. According to the personal finance website moneyGenius, the public health system provides universal access to about 70% of a Canadian’s medical needs. The rest must be paid out of pocket or covered by supplemental private insurance.
The country’s public healthcare system covers many of the “basics.” These include:
Each province and territory implement their own rules when it comes to health coverage, so the exclusions may vary. For the following items and services, private health insurance may be necessary to obtain cover, depending on where a person resides.
Long-term care insurance has long been lacking in the country, another thing to be aware of.
Read more about the benefits and drawbacks of long-term care insurance in Canada in this guide.
The latest available figures from the Canadian Institute for Health Information (CIHI) estimated the cost of private health insurance at $756 per year, which is equivalent to $63 monthly. The institute’s data also showed that the average Canadian paid out $902 in out-of-pocket health expenses, or slightly over $75 each month.
These numbers, however, were taken before COVID-19 shook not just Canada’s healthcare system but also that of the world’s, so the values might actually be higher at present. In addition, the figures above are mere estimates and the best way to get an accurate amount is to contact the health insurance companies directly.
The country is home to 128 private health insurance providers, which served a total of 27 million Canadians in 2021, according to CLHIA’s latest industry fact book. These companies paid out around $30.4 billion in claims, $13.4 billion of which were for prescription drugs – the top reason for filing a claim. This was followed by dental coverage at $9.5 billion and private hospital accommodations at $1.6 billion. Vision care and massage therapy, which were valued at $1.3 billion and $1.1 billion, respectively, rounded up the top five causes of supplementary health insurance claims.
To find out which insurance providers in Canada offer the best health coverage, moneyGenius compared several policies from different insurers, “breaking each product or service into its component features” and comparing them to similar offerings in the market. The personal finance firm gave every feature a score between zero and five stars, then calculated the average to come up with a rating for each provider. These are the best health insurers in Canada based on the website’s rankings.
moneyGenius rating: 4.8 stars
Availability: Nationwide
Eligibility: Canadian citizen/age of majority
Customization: Yes
Features & benefits: Dental and vision care, paramedical services, prescription medication, travel coverage, private hospital accommodation, accidental death and dismemberment, short- and long-term disability
Other inclusions: Virtual health care (for certain regions), hearing aids, medical equipment
Optional extras: Critical illness coverage, hospital cash, assured access
moneyGenius rating: 4.4 stars
Availability: Nationwide
Eligibility: Canadian citizen/age of majority
Customization: Yes
Features & benefits: Vision and dental coverage, prescription medication,
Optional extras: Travel coverage, private hospital accommodation, accidental death and dismemberment, short- and long-term disability
moneyGenius rating: 4.2 stars
Availability: Nationwide
Eligibility: Canadian citizen/age of majority
Customization: Yes
Features & benefits: Vision and dental care, prescription medication, paramedical services
Optional extras: Travel coverage, semi-private hospital accommodation, orthodontics, preventative and restorative dental coverage
moneyGenius rating: 3.8 stars
Availability: Nationwide
Eligibility: Canadian citizen/age of majority
Customization: Yes
Features & benefits: Vision and dental coverage, prescription medication, ambulance services, in-home nursing, medical supplies, and hearing aids
Optional extras: Accidental death and dismemberment, emergency travel medical coverage, hospital accommodation, hospital cash, major dental care
moneyGenius rating: Undisclosed
Availability: Nationwide
Eligibility: Canadian citizen/age of majority
Customization: Yes
Features & benefits: Vision and dental coverage, prescription medication, travel insurance
moneyGenius rating: Undisclosed
Availability: Nationwide
Eligibility: Canadian citizen/age of majority
Customization: Yes
Features & benefits: Vision and dental coverage, prescription medication
Optional extras: Speech therapists, hearing aids, orthotics
