Health & Dental

Personal health and dental insurance is a plan you buy on your own to cover the everyday medical costs that provincial health does not. It typically covers prescription drugs, dental work, glasses, physiotherapy, massage, and therapy. You pay a monthly premium, and the plan reimburses a share of those bills up to set limits. It is the same type of coverage many people know from a workplace benefits plan, except this one is yours to keep no matter where you work. Read the full guide →

Provincial health covers the major costs, but not the everyday ones, which is why many Canadians buy personal health insurance. Provincial plans pay for doctor visits, hospital stays, and most surgeries with your health card and no bill. What they generally do not cover is prescription drugs outside hospital, dental, vision, physiotherapy, massage, and private therapy, and those costs add up quickly. Personal health and dental insurance is built to fill exactly those gaps.

Provincial health plans, like OHIP in Ontario, cover medically necessary doctor and hospital care, most surgeries, and diagnostics. The gaps are where a personal plan comes in. Prescription drugs are generally not covered for working-age adults outside a hospital, routine dental is not covered in most provinces, and vision care past a certain age usually is not covered either. Paramedical care such as physiotherapy, chiropractic, and massage, plus a psychologist or counsellor, also falls outside provincial coverage. A personal plan is designed to sit on top and cover those costs. Read the full guide →

Personal health and dental insurance is typically bought by people who do not have coverage through an employer, or whose workplace plan has real gaps. That includes the self-employed, contractors and freelancers, small business owners, retirees who lost their group benefits, and anyone between jobs. Families with regular dental and prescription costs also buy it, because the plan can pay for itself over a year. Anyone who regularly faces out-of-pocket dental bills or drug receipts is a strong candidate for a plan.

Personal health insurance and extended health benefits are essentially the same type of coverage under different names. Extended health benefits, or extended health care, is the industry term for coverage that goes beyond what your provincial plan pays. Personal health and dental insurance is that same coverage bought as an individual policy rather than through an employer's group plan. Terms like extended health, extended benefits, and supplementary health insurance all point to the same idea.

A typical personal health plan covers a mix of the everyday costs provincial health does not. That usually means prescription drugs, dental treatment, vision care, and paramedical services such as physiotherapy, chiropractic, and massage. Many plans also include mental health support such as therapy or counselling, plus some medical equipment and emergency travel coverage. Each category has its own reimbursement percentage and annual maximum, so a higher plan tier pays back more. Read the full guide →

Yes, personal health and dental insurance covers prescription drugs, and drug coverage is one of the main reasons people buy a plan. A typical plan reimburses a share of your drug costs, often somewhere from 60 to 80 percent, up to an annual maximum. This covers the medications you fill at the pharmacy, which provincial health usually does not pay for if you are a working-age adult. For anyone taking regular medication, this part of the plan can add up to meaningful savings over a year.

Yes, dental is one of the most popular parts of a personal plan, and it is included in most mid-tier and enhanced plans, sometimes as an add-on you choose. Coverage usually starts with routine care such as cleanings, exams, and fillings, and higher tiers add major work like crowns and even orthodontics. Each category has its own reimbursement percentage and yearly limit. It is worth matching the plan to how much dental care your family actually uses. Read the full guide →

Yes, most mid-tier and enhanced plans cover vision, glasses, and eye exams. Vision coverage typically gives you a set dollar amount toward glasses or contacts every year or two, and it often covers an eye exam as well. The exact allowance and how often you can claim depend on the plan. Basic plans sometimes leave vision out, so confirm it is included before choosing a tier if new glasses are a priority. Read the full guide →

Yes, massage, physiotherapy, and chiropractic fall under paramedical coverage, one of the most used parts of a plan. Paramedical coverage usually includes physiotherapy, chiropractic, and massage therapy, and often acupuncture, naturopathy, and more. Each service comes with its own annual maximum, and some plans require a doctor's referral before they will pay. For anyone who sees a physiotherapist or massage therapist regularly, this is where a plan delivers real value. Read the full guide →

Yes, most personal health plans now cover therapy and mental health treatment. Sessions with a psychologist, social worker, or counsellor can be reimbursed under the paramedical part of your coverage. Provincial health covers a family doctor or psychiatrist, but not a private therapist, which is exactly the gap this fills. Coverage comes with an annual limit that varies widely between plans, so if therapy is a priority, look for a plan with a higher mental health maximum. Read the full guide →

Personal health insurance partly covers injuries from a car accident, and it usually works alongside your auto insurance. If you are hurt in a car accident, your vehicle insurance accident benefits are the first place to look, and they cover a certain amount of treatment. A personal health plan can top that up, for example paying for extra physiotherapy or massage sessions once your auto benefits run out. The two work together rather than one replacing the other, and an advisor can help you see where the coverage lines up.

Yes, in most cases you can get personal health insurance with a pre-existing condition. A pre-existing condition affects which plan fits, not whether you can get covered at all. If you are healthy enough, a medically underwritten plan may cover you fully, though it can exclude a specific condition. If not, a guaranteed acceptance plan takes everyone with no health questions, so your condition is generally covered rather than left out. The right route depends on your health, and an advisor can walk you through both options. Read the full guide →

The difference between guaranteed acceptance and medically underwritten health plans comes down to whether you answer health questions. A medically underwritten plan asks about your health history, and based on your answers it may offer full coverage, exclude a condition, or adjust the price, but it usually provides broader benefits and better value if you qualify. A guaranteed acceptance plan asks no health questions and takes everyone, which makes it suited to serious conditions, though coverage is more limited and the price is higher for what you get. Healthy applicants usually do better with underwriting.

Often yes, you can convert from a group plan to a personal plan without a medical review if you act quickly. Many insurers let you convert without answering health questions if you apply within a set window after your coverage ends, commonly around 90 days. That means a pre-existing condition can be carried over rather than excluded. Missing that window may mean facing medical underwriting, so if your work benefits are ending, it pays to line up a plan sooner rather than later.

Sometimes there are waiting periods before health and dental coverage starts, depending on the plan and the benefit. Guaranteed acceptance plans often have a waiting period before certain benefits, such as major dental, pay out in full, which is the trade-off for asking no health questions. Medically underwritten plans may have shorter waits, or none, for basic benefits. This is one of the fine-print details worth checking up front, and an advisor can point out where the waiting periods sit before you commit.

A single adult often pays around 50 to 150 dollars a month for a basic to mid-range personal health and dental plan. Enhanced plans with strong drug, dental, and paramedical benefits can run 200 dollars or more, and families and older applicants pay more. Your price depends on your age, province, plan tier, and health. The only way to see your real number is to compare a few quotes. Read the full guide →

Several factors affect the price of a health and dental plan. Age is a major one, since premiums climb as you get older, and your province matters because costs and rules differ across Canada. The plan tier is the other main lever, as higher reimbursement percentages, bigger annual maximums, and more benefits all push the price up. On a medically underwritten plan, your health history can factor in as well. Matching the coverage to what you will actually use is the key to good value.

Most health and dental insurance claims are submitted through an online portal or mobile app, where you photograph your receipt and file the claim in a couple of minutes, and some insurers still accept paper forms by mail. Many dentists, pharmacies, and clinics also offer direct billing, where they bill the insurer for you and you pay only your portion at the counter. Once a claim is approved, reimbursement usually lands in your bank account within a few days. Read the full guide →

Sometimes you pay out of pocket first, but not always. With many providers you pay for the service up front, submit the receipt, and get reimbursed for your covered share within a few days. However, many pharmacies, dental offices, and clinics offer direct billing, which means they bill the insurer directly and you pay only the portion your plan does not cover, right at the counter. Direct billing is common enough that you often will not front the full cost at all.

Personal health insurance and critical illness insurance solve very different problems. Personal health insurance covers ongoing, everyday costs such as prescriptions, dental, and physiotherapy, reimbursing a share of each bill. Critical illness insurance instead pays a single tax-free lump sum if you are diagnosed with a covered serious illness such as cancer, a heart attack, or a stroke, and you can spend that money however you need. One handles the small, frequent bills, and the other cushions a major diagnosis.

You may not need your own health plan if you already have workplace benefits, but it is worth a closer look. Group benefits are valuable, but they are tied to your job, so if you leave, get laid off, or go freelance, the coverage usually ends with your employment. A workplace plan can also have gaps, such as a low paramedical limit or no coverage for a partner. A personal plan is yours to keep, and some people use a small one to top up where their group plan falls short.

Whether health and dental insurance is worth it when you are young and healthy depends on how you use healthcare. If you rarely see a dentist, take no medications, and never book physiotherapy, you might spend more on premiums than you claim back. But if you get regular cleanings, wear glasses, take a prescription, or see a therapist, the numbers often work in your favour. Adding up a year of your own out-of-pocket health costs and comparing that to the premium is the clearest test.

Yes, self-employed Canadians can often deduct health costs through a health spending account. A health spending account, also called a private health services plan or PHSP, lets you turn eligible medical and dental costs into a tax-deductible business expense rather than paying them with after-tax money. The rules differ depending on whether you are incorporated or a sole proprietor, and there are conditions and limits, so it is wise to confirm the details with an accountant. It can be a genuinely tax-efficient way to cover your family's health costs. Read the full guide →

To choose the right health and dental plan, start with how you actually use healthcare. List what you spend in a normal year on prescriptions, dental visits, glasses, physiotherapy or massage, and therapy, and let that point you to the benefits that matter most. Then weigh the reimbursement percentages and annual maximums against the monthly premium. Because plans and prices vary widely between insurers, comparing a few side by side is the surest way to find good value, and a licensed advisor can do that work with you at no cost. Read the full guide →