Why seniors need health insurance in Canada
Health insurance is important at any age but becomes significantly more prevalent when Canadians age and their healthcare needs tend to increase. While provincial health plans provide some coverage, they don’t pay for everything. This is where having additional health insurance can come in handy.
What provincial plans typically don't cover
- Prescription medications (or only partial coverage)
- Dental care and cleanings
- Vision care and eye exams
- Paramedical services (physio, massage, chiropractic)
- Medical equipment and mobility aids
- Emergency travel medical
For seniors especially, these uncovered costs can add up quickly and place a significant strain on a fixed or retirement income. Health insurance for seniors can help fill the gaps left by provincial health plans, offering more predictable healthcare costs, and greater access to services that support overall well-being.
Sun Life health insurance solutions for seniors
Sun Life offers several types of insurance plans suited for seniors:
| Basic | Standard | Enhanced |
|---|---|---|
| Essential medical and dental needs | Increased prescription drug coverage | Highest prescription drug coverage |
| Budget-friendly premiums | Emergency travel medical included | Comprehensive dental options |
| Core paramedical services | Enhanced paramedical limits | Restorative and orthodontic dental |
| Best for: Healthy seniors with minimal healthcare needs | Best for: Seniors with regular prescriptions who travel | Best for: Seniors requiring extensive dental work and maximum coverage |
Critical Illness Insurance (CII)
CII provides a one-time payment if you’re diagnosed with a covered serious illness, such as cancer, heart attack or stroke.
This is a popular option for seniors because:
- You can use funds for any purpose (treatment, home modifications, travelling for treatment)
- There are no restrictions on how you spend the benefit
- It can supplement other health coverage
Long-Term Care Insurance
Long-term care insurance provides a benefit if you become dependent on someone for your care.
Key advantages include:
- The protection of retirement savings
- You can maintain your independence longer
- It can reduce family caregiver burden
What provincial healthcare changes can you expect at age 65?
The core healthcare services covered by provincial health plans remain largely the same before and after age 65, however, there are changes to how certain services are covered:
Enhanced coverage
- Access to provincial drug programs (varies by province and income)
- Some provinces offer senior-specific health benefits
Potential coverage gaps
- Loss of employer group benefits at retirement
- Income-tested programs may not cover all costs
- Deductibles and copayments may still apply - Many medications not on provincial formularies
For more a more detailed look at what each province covers and doesn’t cover, please visit our provincial health coverage page.
How to choose the right health insurance for seniors
Choosing the right type of health insurance depends on a variety of different factors and your current situation. Speaking to an advisor is a good first step, as they can tailor solutions to your unique needs. In the meantime, here are some valuable insights on how to choose the right health insurance after you turn 65:
Current and expected healthcare needs
Seniors who take prescription drugs regularly, require ongoing paramedical services or anticipate dental or vision expenses may benefit from coverage that prioritizes these services. Reviewing your past healthcare usage can help identify which benefits are most valuable to you.
Budget
This is a particularly important consideration for seniors living on a fixed income. While premiums may vary, having health insurance can make health related expenses more predictable by reducing unexpected costs. It’s helpful to compare monthly premiums against potential out-of-pocket expenses without coverage to determine overall value.
Coverage limits and deductibles
Some plans have annual maximums on services such as dental care or prescription drugs. Understanding these limits can help you avoid surprises when making claims.
Eligibility and medical underwriting
Some health insurance plans require medical underwriting or have waiting periods before certain benefits become available. Seniors with pre-existing conditions should review plan terms carefully to understand how coverage applies to ongoing health needs.
Lifestyle
It’s also important to consider your own personal lifestyle, such as the need for home care support or your travel frequency. Seniors who travel often may want to ensure their plan includes travel medical coverage, while others may prioritize access to medical supplies or mobility aids.
When to purchase health insurance
Timing matters when it comes to health insurance for seniors. Ideally, you should secure coverage before you retire and while you're still in good health. Some plans require medical underwriting, which means pre-existing conditions may limit your coverage options or result in exclusions. Additionally, some plans have waiting periods before certain benefits become active, particularly for dental and vision care.
If you're transitioning from employer-sponsored coverage, ask your benefits administrator about conversion options. Many group plans allow you to convert to individual coverage within a specific timeframe without medical underwriting, helping you maintain continuous protection.
Need more help? Reach out to a Sun Life advisor
If you’re not sure how much personal health insurance you need, speak to a Sun Life advisor. An advisor can help you figure it out and get you a customized quote.
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This information is meant for educational and illustrative purposes only. Some conditions, exclusions and restrictions apply.