Personal health insurance

How much coverage do I get for prescription drugs?

It depends on the plan:

• Basic plan: Offers 60% reimbursement of eligible expenses, up to a yearly maximum of $750.
• Standard plan: Offers 70% reimbursement for first $7,000 and 100% for the next $93,000 of yearly eligible expenses.
• Enhanced plan: Offers 80% for first $5,000 and 100% of next $245,000 of yearly eligible expenses.

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Does personal health insurance cover dental care?

Dental coverage is included with a Basic personal health insurance plan. It includes 60% reimbursement for preventive dental care with a $500 annual maximum. (A 3-month waiting period applies before you can get this coverage.) Learn more about dental insurance.

You can also opt in to have dental coverage in a Standard or Enhanced personal health insurance plan.

A Standard plan comes with 70% reimbursement for preventive dental care with a $750 annual maximum. (A 3-month waiting period applies before you can get this coverage.)

An Enhanced plan comes with:

• 80% reimbursement for preventive dental care with a $750 annual maximum. (A 3-month waiting period applies before you can get this coverage.)
• 50% reimbursement for major restorative dental care with a $500 annual maximum. (A one-year waiting period applies before you can get this coverage.)
• 60% reimbursement for orthodontic services, up to a lifetime maximum of $1,500. (A two-year waiting period applies before you can get this coverage.)

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Does personal health insurance cover vision care?

Only our Standard and Enhanced plans include coverage for vision care.

A Standard plan offers 100% reimbursement for vision care, up to $250 maximum every 2 calendar years. (A one-year waiting period applies before you can get this coverage.)

An Enhanced plan offers 100% reimbursement for vision care up to $300 maximum every 2 calendar years. (A one-year waiting period applies before you can get this coverage.)

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How much coverage do I get for supplemental health care?

Supplemental health care includes coverage for medical equipment and nursing.

• A Basic plan includes 60% reimbursement.
• A Standard plan includes 100% reimbursement.
• An Enhanced plan includes 100% reimbursement. 

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Does personal health insurance cover paramedical expenses?

Yes. All our personal health insurance plans include paramedical expenses.

A Basic plan includes:

• 60% reimbursement.
• Paramedical practitioner services: $25/visit, up to $250 per year for each type of practitioner.
• Psychology/Social worker services: $35/visit up to a shared maximum of $500 per year.

A Standard plan includes:

• 100% reimbursement.
• Paramedical practitioner services: up to $300 per year for each type of practitioner.
• Psychology/Social worker services: up to a shared maximum of $1000 per year.

An Enhanced plan includes:

• 100% reimbursement.
• Paramedical practitioner services: up to $400 per year for each type of practitioner.
• Psychology/Social worker services: up to a shared maximum of $1500 per year.

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Does personal health insurance cover medical expenses while travelling outside of Canada?

Only our Standard and Enhanced plans offer Emergency Travel Medical care.

Both a Standard plan and an Enhanced plan offer coverage for the first 60 days of a trip with a $1 million lifetime maximum on emergency travel medical claims.

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How do I know if I need personal health insurance?

Personal health insurance can help anyone get the coverage they need to pay for various health-care expenses. It’s helpful as a layer of financial protection, especially if you don’t have health insurance or benefits through an employer.

For example, perhaps you’re self-employed or a contract worker. Or maybe you’re about to retire, in which case you might lose your employee health benefits. In these situations, it helps to have your own health coverage. That way, if you do get sick or injured, you won’t get stuck paying out-of-pocket for all your medical expenses. 

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Are there any other types of health insurance I may need?

Apart from personal health insurance, there are three other types of health insurance to consider:

• Disability insurance, which replaces part of your income if you can’t work.
• Critical illness insurance, which covers eligible expenses related to a covered critical illness.
• Long-term care insurance, which covers the cost of your care when you can’t perform two or more activities of daily living. Or, when you need ongoing supervision because your mental abilities have weakened.

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