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How do I get the right personal health insurance?
July 24, 2025
By Paul Moser
Help protect your health and your wallet with personal health insurance. Discover how to choose the right coverage for dental, vision, and extended care. Speak with a Sun Life advisor to tailor a plan that fits your unique needs and budget. Your well-being is worth the investment.
Why would you need personal health insurance (PHI)? If your province or territory doesn’t cover costs such as dental care, eye care, prescriptions, and paramedical services (like physiotherapy), then you’ll want to think about PHI. Also consider PHI if you don’t have workplace benefits, often called group benefits.
This kind of health insurance can help contribute to your well-being and financial stability. That's why it's important for you to understand what it is, and how it works.
Knowing about PHI will help you make informed decisions about an important piece of your overall health coverage.
Also, by choosing PHI, you're investing in your future, ensuring that you and your loved ones are protected, and giving yourself the freedom to focus on what matters most – your health and happiness.
What is personal health insurance (PHI)?
PHI is coverage that helps you pay for your medical expenses. It's a contract between you and an insurance company. If you buy PHI, you'll pay regular premiums in exchange for financial protection against unexpected, preventative, and ongoing health-care costs.
PHI typically covers a range of medical services: dental care, vision-care needs, prescription medications, and paramedical services like massage or physiotherapy. The specific benefits and costs can vary widely depending on the policy chosen. PHI provides peace of mind by reducing the financial burden of health care and ensuring access to certain health services when you need them.
Dental coverage
Dental care is a crucial component of overall health and well-being, making it an essential consideration when selecting a PHI plan. Regular dental check-ups and preventive care can help detect early signs of oral health issues, preventing more serious and costly health problems down the line.
A comprehensive dental coverage plan typically includes routine cleanings, X-rays, and basic procedures. They help people maintain good oral hygiene habits. Moreover, dental health is closely linked to various systemic health conditions, including heart disease and diabetes, underscoring its importance in overall wellness.
By including dental care in your health insurance plan, you not only protect your oral health, but also potentially reduce the risk of other health complications. Additionally, having dental coverage can significantly reduce out-of-pocket expenses for both routine care and unexpected dental emergencies. Prioritizing dental care in your PHI can be a wise investment in your long-term health and financial well-being.
Eye-care coverage
Regular eye exams and vision care are essential for maintaining overall health and well-being. They can detect not only vision problems, but also early signs of other serious health conditions, such as diabetes and hypertension.
Including eye care coverage can help you pay for routine check-ups, prescription eyewear, and treatment for eye-related issues, helping to manage out-of-pocket expenses.
By prioritizing eye health through a dedicated plan, you're investing in preventive care that can help preserve your vision and catch potential problems early. That can potentially save you from more costly and serious health issues in the long run.
Extended health care coveage
Extended health care, also known as supplemental health insurance, is a type of coverage that goes beyond basic health insurance plans to provide additional benefits and services. It typically includes coverage for medical expenses not fully covered by standard health insurance or government programs, such as prescription drugs, vision care, paramedical services, and medical devices.
Extended health care is important for PHI, because it helps fill the gaps in coverage, reducing out-of-pocket expenses for you and your family. This comprehensive approach to health coverage ensures that you can have access to a wider range of medical services and treatments, promoting better overall health and well-being.
Additionally, extended health care can provide peace of mind by offering financial protection against unexpected medical costs. By including extended health care in a personal insurance plan, you can create a more robust and tailored health coverage strategy.
How do I get personal health insurance in Canada?
Many employers offer group health insurance plans or workplace benefit plans, so check if this is an option through your workplace. Then make sure these adequately cover you. Be sure to consider factors like prescription drug coverage, dental care, vision care, and other basic health-care services not fully covered by government programs.
If there are gaps and you need to top up coverage, you can also purchase personal health insurance directly from Sun Life.
Understand your personal health-care needs
Before purchasing health insurance, think about your current health status, family medical history, and potential future needs. Consider factors such as age, lifestyle, any existing medical conditions, gaps in coverage, and cost to determine the level of coverage you require.
Don't wait to buy health insurance until you need it
Procrastination can be costly when it comes to health insurance. Waiting until you have a health issue may result in higher premiums or even denial of coverage. It's best to secure insurance while you're healthy to ensure comprehensive protection.
Employer benefits may not be enough to cover your needs
While many employers offer health benefits, these plans may have limitations. Review your employer-provided coverage carefully and consider supplementing it with personal insurance to address any gaps in coverage.
Provincial health plans are different and may not cover all health issues
Each Canadian province has its own health insurance plan, but coverage can vary significantly. Familiarize yourself with your provincial plan's limitations and consider additional insurance to cover services not included.
How much does personal health insurance cost in Canada?
PHI costs in Canada can vary widely depending on several factors, including:
- your province or territory of residence,
- the type and level of coverage you want, and
- your age, health status, and lifestyle habits.
While Canada has a universal public health-care system that covers many essential medical services, some Canadians choose insurance to cover expenses not included in the public system, such as dental care, prescription drugs, vision care, and paramedical services.
On average, individual health insurance plans in Canada can range from approximately $50 to $300 per month. However, it's important to note that these figures are rough estimates, and actual costs can be higher or lower based on specific circumstances and the chosen insurance provider.
Some employers also offer group health insurance plans to their employees, which can be more cost-effective than individual plans.
Base your policy purchase on more than only cost
While affordability is important, don't let it be the sole determining factor. Consider the scope of coverage, claim process, and reputation of the insurance provider when making your decision.
If you need help looking at your finances and how much you could afford for PHI, Sun Life's Budget Calculator is a good place to start.
Which personal health insurance is best in Canada?
There is no single "best" PHI in Canada that applies to everyone, as the ideal coverage depends on individual needs and circumstances.
The best options for you depend on factors such as age, health status, lifestyle, budget, and specific health-care needs. It's advisable to compare different plans, considering coverage options, premiums, deductibles, and any limitations or exclusions. Consulting with an advisor can help in selecting the most suitable PHI tailored to your specific needs.
Also keep in mind these recommendations:
Coverage may not be automatic upon policy purchase
Some insurance policies have waiting periods before certain benefits become active. Understand these timelines to ensure you're not caught off guard when you need to use your coverage.
Make sure you disclose your full medical history
Honesty is crucial when applying for health insurance. Failing to disclose relevant medical information can result in claim denials or policy cancellations. Provide a complete and accurate medical history and answer all medical questions so that you make sure you're getting valid coverage.
Read the fine print of the policy and ask an advisor for help
Insurance policies can be complex. Take the time to thoroughly read and understand your policy, and don't hesitate to seek clarification from your insurance advisor on any unclear terms or conditions.
Get a professional opinion about your personal health insurance
When you’re reviewing your finances with an advisor, you can look at your health protection, too. An advisor can:
- give you more information about PHI,
- overall health insurance, and
- help you figure out which type fits your financial situation best.
An advisor can help you build a comprehensive health plan that also includes:
You could also consider Health Coverage Choice - Extended Health Care and Dental Plans, if your workplace or retiree group coverage ends and you need to replace your group health insurance and dental insurance.
By carefully considering these factors and tailoring your PHI to your specific needs, you can ensure that you and your loved ones are well-protected against potential health challenges and financial burdens associated with medical care in Canada.
This article is meant to provide general information only. It’s not professional medical advice, or a substitute for that advice.
Sun Life Assurance Company of Canada does not provide legal, accounting, taxation, or other professional advice. Please seek advice from a qualified professional, including a thorough examination of your specific legal, accounting and tax situation.
