Paul Sanchez
Canada's public healthcare system provides essential services to citizens and permanent residents with no direct costs at the point of care. However, it is not entirely free, as it is funded by taxpayers. While the Canadian government provides universal healthcare to its citizens and permanent residents, visitors, temporary workers, and expats are not automatically covered. Even eligible residents may need to pay for certain services, such as prescriptions, dental care, and some mental health treatments, as these are not fully covered by the public system. This is where private insurance comes in, as it can cover additional services and fill in the gaps left by public healthcare.
| Characteristics | Values |
|---|---|
| Type of coverage | Universal healthcare (provincial/territorial), workplace benefits, and personal health and dental insurance |
| Who is covered? | Canadian citizens, permanent residents, some temporary residents (e.g. workers with valid permits, international students), refugees |
| Who is not covered? | Short-term visitors (tourists), non-citizen employees |
| What does it cover? | Medical essentials like doctors' visits, hospital services (surgeries, both in-patient and out-patient), immunisations |
| What is not covered? | Prescription drugs, dental care, vision care, ambulance fees, long-term care, emergency medical treatment outside of Canada, psychological counselling/therapy, massage therapy, chiropractic services, etc. |
| Additional coverage | Private insurance can be purchased to cover additional services like prescription drugs, dental care, vision care, and emergency medical treatment outside of Canada |
| Cost | There is no direct cost at the point of care, but it is funded by taxes. Some services require out-of-pocket payments or supplemental coverage. |
| Travel insurance | Visitors to Canada should purchase travel insurance to cover healthcare costs during their stay |
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What You'll Learn
Eligibility for public healthcare
Canada has a universal healthcare system, funded by taxes, that provides essential services with no direct costs at the point of care for citizens and permanent residents. This system is called Canadian Medicare. It was established through federal legislation passed in 1957 and 1966, and the Canada Health Act of 1984, which sets national standards for medically necessary hospital, diagnostic, and physician services.
To be eligible for public healthcare in Canada, you must be a Canadian citizen or permanent resident. Some work permit holders, refugees, and temporary residents, such as workers with valid permits or international students, are also eligible for provincial or territorial healthcare coverage (Medicare), depending on the province. Non-citizen employees may be eligible for private health plans provided by their employers.
To access healthcare in Canada, you need to apply for a health card from your province or territory, which acts as proof of eligibility for healthcare services. Each province and territory has a different health plan that covers different services and products, so it is important to know what your plan covers. Once you have a health card, you must show it at hospitals or medical clinics to receive non-emergency services. In an emergency, you can go to the nearest hospital even without a health card.
It is important to note that while Canada's public healthcare system is universal, it does not cover all services. For example, prescription drugs, dental care, vision care, medical devices, gender care, psychotherapy, and some mental health treatments are not fully covered by the public system, and individuals may need to pay out-of-pocket or rely on private insurance to cover these additional costs. Provinces and territories may offer programs to help certain populations, such as seniors, children, and those on social assistance, with the cost of prescription medications and other services.
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Private health insurance
Canada's public healthcare system provides essential services with no direct costs at the point of care for citizens and permanent residents. However, it is not entirely free, as it is funded by taxes. Additionally, some services are not covered by public healthcare, and some residents may not be eligible for it. This is where private health insurance comes in.
There are different types of private health insurance plans available in Canada. Basic plans offer reimbursement for eligible drug expenses, usually up to a maximum amount per year. Standard plans offer a higher percentage reimbursement for a higher maximum amount. Enhanced plans cover a wider range of services, such as medical, dental, vision, and emergency travel expenses.
When considering private health insurance, it is important to check what is already covered by your workplace health care plan or any existing insurance, so you don't purchase duplicate coverage. It is also essential to carefully read the policy to understand what is and isn't covered, as some pre-existing medical conditions may be excluded.
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Travel insurance
If you are a Canadian resident travelling outside Canada, it is recommended that you purchase travel insurance to cover any medical treatment you may need while abroad. The Canadian public healthcare system does not cover visitors, temporary workers, or expats, and even eligible residents may need to pay for certain services, such as prescriptions, dental care, and some mental health treatments.
There are several types of travel insurance plans available for Canadians, including single-trip and multi-trip medical plans, as well as trip cancellation and interruption plans. Some providers offer family coverage for you, your spouse, and unmarried dependent children under the age of 22 (or 26 if they are full-time students). It is important to carefully review the terms, conditions, limitations, and exclusions of your travel insurance policy before purchasing, as many policies will not cover travel to regions where the Government of Canada has issued a travel advisory.
Additionally, if you have any pre-existing medical conditions, be sure to ask the insurance provider about any limitations or restrictions on coverage and get a written agreement that your insurance covers these conditions. Your plan should also include provisions to help your loved ones if you die outside of Canada due to an accident or sudden illness. By considering your specific needs and choosing a comprehensive travel insurance plan, you can travel with peace of mind and focus on enjoying your trip.
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Workplace benefits
Canada's public healthcare system provides essential services to citizens and permanent residents, funded by taxes. However, some services are not covered by public healthcare, and many Canadians rely on private insurance to cover these additional services, such as prescription drugs and dental care.
Many employers also offer supplemental medical and retirement benefits, which are not required by law but help attract and retain talent. These can include medical, optical, dental, life, accident death and dismemberment (AD&D), and disability insurance. The cost of such a package is around 5,000-7,000 Canadian Dollars per year.
Some employers also offer wellness programs, such as virtual care, mental health training, and digital health and fitness platforms. These can include health coaching, health risk assessments, and health screening. Other initiatives include providing healthy snacks, rearranging cafeterias to promote healthy food options, and making physical changes to the workplace to encourage healthy behaviours.
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Dental and vision care
The Canadian Dental Care Plan (CDCP) is a public option that helps eligible Canadian residents pay for a portion of their oral health care costs. The CDCP covers a wide range of services, including dental exams, treatments for cavities and broken teeth, and services to prevent gum disease and detect mouth conditions like cancer early on. Applications for the CDCP are currently open for the coverage period ending June 30, 2025, for eligible Canadians aged 18 to 64. Starting in 2025, orthodontic services will also be added to the CDCP, but only in cases of medical need and with a maximum spending limit.
For vision care, there are two main sources of coverage: publicly-funded provincial healthcare plans and private health insurance. Private plans often cover vision care expenses that are not included in provincial healthcare, such as eye examinations, prescription glasses, and contact lenses. For example, the Blue Vision Global plan covers ophthalmologists, while optometrists are always covered. Additionally, children from low-income families may be eligible for programs like "Healthy Smiles, Clear Vision" or the Children's Drug and Optical Program, which provide financial assistance for vision care expenses.
Private health insurance plans can be tailored to meet specific needs and budgets. For instance, Manulife offers Flexcare® combination plans that bundle drug, dental, vision, and travel coverage, while their FollowMe™ plans provide drug, vision, and hospital coverage. Freedom to Choose™ health and dental insurance is another option that bridges the gap between provincial plans and out-of-pocket expenses. These plans can be personalized to include a range of healthcare needs, such as dental and vision care, and they do not require medical exams or complicated pricing structures.
It is important to note that coverage for dental and vision care in Canada may vary depending on age, income, and medical history. Some plans may have eligibility requirements, such as being over the age of 18 and a resident of Canada. Additionally, pre-existing conditions may impact the cost of monthly premiums and plan eligibility.
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