Health Insurance In Canada: 8 Things You Should Know

So, you’ve finally decided enough is enough, concluded that the UK is a busted flush, and decided to move across the pond to Canada? 

You’re not alone; every year, upwards of 10’000 Brits move to Canada, attracted by the country’s job prospects, inclusive atmosphere, and fascinating geography. 

The fact that Canada has one of the world’s most extensive health care systems, and unlike its neighbor in the South, is universal, certainly helps to seal the deal, too. 

However, while this is typically funded by taxation, Canadians can opt to pay for health insurance if they wish to receive private care. Nonetheless, each province and territory have its own laws and regulations surrounding the process. This post will cover 8 things that you need to know about health insurance in Canada.

There Are Different Types Of Plans Available

Health insurance is a complicated subject, but just like in other countries, the Canadian health insurance system provides different services for different purposes. According to GMS Insurance, this can range from basic coverage to student travel insurance. Therefore, you must select the correct type of insurance for your needs. Some factors to consider include:

  • What risks are covered by your insurance policy
  • What is covered
  • If you need individual or family coverage
  • The insurance premiums
  • Your age, gender, and social status
  • Your current medical situation

Every Province & Territory Has Different Regulations

The healthcare system in Canada is complex and diverse, and first time visitors to the country will quickly learn that each province has its own healthcare requirements for residents. This can be a confusing process for patients and their families. In order to help with the confusion, some provinces have created online portals to help people find the right health care provider for them. These portals can also provide general information about the healthcare system, including the services covered by each province’s health plan. 

Therefore, when searching for medical insurance, you should check what is covered at the federal level and what will be covered by the province or territory. Once you know these things, you will be better positioned to devise a plan that suits your circumstances and location.

Public Health Insurance Doesn’t Usually Cover Dental Care

Most dental services are not covered by Canadian public health insurance. However, if you are in doubt, you can always check with:

  • Your public health authority should be able to inform you about what is and isn’t available depending on your financial status.
  • Your private health care provider will provide you with a range of plans that can cover private dental care.

However, dental care seems to be an issue throughout the country as approximately one in three Canadians aren’t covered for dental care. In practice, this means that many Canadians forgo routine care because they cannot afford it. 

According to some reports, this puts an undue strain on emergency departments because people go to their local hospitals when in pain. Nonetheless, the government has no real appetite to change the status quo, making private insurance the only viable option.

Private Insurance Might Be A Better Choice In Some Instances

According to some studies, around 60% of Canadians pay for private healthcare insurance for various reasons. In some cases, this is because universal health care doesn’t cover medication costs (see the next point), which in other cases is partially provided by private employers. In fact, this number has doubled over the past two decades, indicating that many Canadians are unsatisfied with the current state of affairs. 

Nevertheless, it should be noted that being unsatisfied doesn’t mean being unappreciative, as almost 90% are firmly in favour of it. Moreover, as with many other countries that have some form of universal care, private insurance tends to cover more (like drugs) and provide access to prompt treatment.

Universal Health Care Doesn’t Cover Medication

It is not free to get medications from a pharmacy. You may be required to pay for medications yourself if your public health insurance does not cover them. Other insurance plans or drug programs may be able to provide coverage. 

This is true not only for minor ailments that require over-the-counter drugs but also for prescription drugs. If you require prescription medication for more severe health issues, you need to get a note from your doctor. Once you have received this note, you can present it to a pharmacy that will provide you with the medications. If you are unable to afford such medication, you have two options:

  1. Apply for provincial and territorial medication programs (each with different eligibility requirements).
  2. Use private (or employer-provided) insurance plans that cover medication.

Almost Two-Thirds Of Canadians Pay For Private Insurance

As you might have already gleaned from the previous points, regardless of how valuable and loved the universal system is in Canada, almost two-thirds of the population have some form of private insurance coverage. As previously stated, this is due to several factors, and the number is somewhat influenced by employer-provided coverage. Furthermore, this is often to gain access to long-term medications if they aren’t eligible for provincial subsidies and to obtain dental treatment. 

Read: A tourist’s guide to enjoying Toronto to the full

Fortunately, the insurance market in Canada is vibrant, and there is lots of competition. You can often find providers willing to negotiate and who offer a broad range of plans that cover almost any issues you might have. Additionally, Canadian insurers are banned from accessing genetic testing results in order to manipulate pricing. In theory, this means that you should be able to get insured regardless of your medical situation (however, you should speak with your insurance provider for clarification).

There Have Been Reviewed Signs Of A Pan-Canadian System Of Drug Coverage

As already covered, Canada’s health care system does not offer coverage for drugs and medications, regardless of whether the situation is chronic or acute. However, over the past few years, there has been an increased discussion regarding a national drug plan. In 2018 an advisory panel was established to discuss how it could work, and a preliminary report was released in 2019. While nothing has come of this report yet, Canada may increase funding to include medication if public opinion moves in this direction.

To Access Healthcare, You Need A Health Card

Finally, as all Canadians know, you need a public health card to access healthcare, regardless of location. However, you must apply in your province or territory to receive one, and they are not transferable between them. If you move, you must reapply for a new card in your new jurisdiction.

The Bottom Line

Although Canadians have sensibly opted for a universal healthcare system (and overwhelmingly support it), healthcare is more nuanced than it first appears. Hopefully, this post has provided you with some interesting facts about the system that will enable you to make informed choices regarding your health as a newcomer to the country.

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