Personal Health Insurance Basic plan

Our lowest-cost plan

Personal Health Insurance Basic plan is our lowest-cost option. It helps you pay for basic medical and dental expenses. If you want more benefits with higher coverage limits, consider our Personal Health Insurance Standard or Enhanced plans.

  • You should consider this plan if:

  • You don't have health benefits through your employer
  • Your current coverage is not enough
  • You want catastrophic drug and emergency travel medical coverage
  • You're losing your group coverage. If you apply for Personal health insurance and are denied coverage, you won’t be eligible to apply for Health Coverage Choice

Learn more about eligibility requirements for this plan.

 

Get a quote for our Personal Health Insurance Basic plan

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Plan details:

Prescription drugs

  • Pay-direct drug card (except in Quebec)
  • 60% reimbursement
  • No deductible
  • $750 annual maximum of eligible expenses can be claimed
  • Up to $5 paid towards dispensing fee on prescriptions
  • Includes smoking cessation drugs ($250 lifetime maximum)
  • Excludes:
    • contraceptives
    • fertility drugs
    • dietary supplements, vitamins
    • over-the-counter medications, even if prescribed by a physician or nurse practitioner
    • drugs to treat obesity

Dental

  • 60% reimbursement
  • $500 annual maximum
  • Recall visits every 9 months
  • 3-month waiting period before coverage begins
  • Preventive dental coverage includes:
    • Examinations and diagnosis
    • Tests, x-rays and lab exams
    • White fillings
    • Space maintainers for children under 12 years of age
    • Scaling, minor extractions
    • Pit and fissure sealant for children under 19 years of age

  • No coverage. Coverage for restorative dental care is available on the Enhanced plan as part of the optional dental benefit.

  • No coverage. Orthodontics coverage is available on the Enhanced plan as part of the optional dental benefit.

Supplemental healthcare

  • 60% reimbursement
  • $400 maximum every 5 years

  • 60% reimbursement
  • $2,000 per fracture or injury

  • 60% reimbursement
  • Ground or air ambulance services

  • 60% reimbursement
  • $2,500 annual maximum combined with in-home nursing and home care
  • $20,000 lifetime maximum combined with in-home nursing and home care

The following items are covered to a maximum of $2,500 per year and $20,000 lifetime combined with in-home nursing and home care:

  • Artificial limbs or other prosthetic appliances
  • Orthopaedic shoes and orthotics, limited to a maximum $150 in a calendar year
  • Splints and crutches
  • Casts
  • Braces
  • Wigs and hairpieces, limited to a maximum $100 in a calendar year
  • Oxygen
  • Continuous glucose monitors
  • Diagnostic laboratory tests and x-ray examinations
  • Blood glucose monitor, limited to $150 per 5-year period
  • Rental, or purchase at our option, of durable equipment required for use in the patient's home and that we have approved. Eligible durable equipment includes, but is not limited to, items such as:
    • wheelchairs ($1,000 lifetime maximum)
    • walkers
    • hospital beds
    • traction kits
  • For Quebec residents only: medically necessary MRIs, ultrasounds, CAT and CT scans to a combined maximum of $750 in a calendar year

  • 60% reimbursement
  • $2,500 annual maximum combined with medical equipment and services
  • $20,000 lifetime maximum combined with medical equipment and services

*Private duty nursing includes services of registered nurses, registered practical nurses or registered nursing assistants.

Paramedical practitioners

  • 60% reimbursement
  • $25 maximum per visit
  • Up to $250 per year, per type of practitioner
  • Increased coverage for psychology and social worker services to a shared maximum of $500 per year, $35 maximum per visit
  • Paramedical practitioners include: acupuncturists, chiropractors, naturopaths, osteopaths, physiotherapists, podiatrists, chiropodists, psychologists, social workers, registered massage therapists, speech language pathologists

Vision care

Emergency travel medical

Semi-private hospital room

This is an optional benefit with this plan and includes:

  • 85% reimbursement
  • Coverage up to $200 daily and $5,000 annually
  • Convalescent hospital:* $20 per day up to 180 days per incident

If you are pregnant at the time your application, we will pay for up to 2 days of hospitalization due to pregnancy.

*Convalescent hospitals are facilities licensed to provide convalescent care and treatment for sick or injured patients on an in-patient basis.

Additional services

Age requirements

  • Coverage is available for new applicants age 69 and under and is renewable for customers over 70.
  • You and everyone included in your application must be age 69 or under on the date you apply.

Eligibility

You are eligible for coverage if:

  • You are in Canada when you complete and submit the application
  • You and your family members are residents of Canada and have provincial or territorial health and drug coverage
    • Quebec residents must also have and continue to have group drug coverage provided by an employer, through membership in an order or association or through the Régie de l'assurance maladie du Québec (RAMQ). A person not covered under a group benefit plan or through RAMQ is not eligible for coverage.
  • Your dependent children are under age 25 (dependent children aged 21 to 24 must be full-time students)

You are not eligible for coverage if:

  • You had or have any of these illnesses or conditions
  • You are currently awaiting doctor recommended tests or investigations
  • You have a pending surgery

More information

  • You must also apply to your provincial or territorial government health and drug plan first, then submit a claim to us for the unpaid portion.
  • All annual or lifetime maximums are per person and based on a calendar year (January 1 to December 31).
  • We may change rates each year. If we do change the rates, we'll send you written notice at least 30 days before the change.
  • Waiting periods begin on the date the policy becomes effective.
  • This page does not form part of your policy. If there are any inconsistencies between the content on this page and your policy, the terms of your policy will apply. Your policy includes exclusions and limitations of coverage.

Find more exclusions and limitations in the Basic plan with semi-private hospital room coverage sample policy.

Get Personal Health Insurance

Three ways to buy

  • Give us a call

    Our team of licensed financial services consultants (registered as financial security advisors in Quebec) can assess your coverage needs and recommend solutions.

    1-866-292-2517

    Monday - Friday: 8 a.m. - 8 p.m. ET

  • Work with a Sun Life Financial advisor

    Sun Life Financial advisors look carefully at your specific needs to help you develop a personalized plan. They'll work with you to understand your goals and what you want to achieve.

    Find an advisor