.png)
Canadian citizens and permanent residents are fortunate to have a universal healthcare system that covers many medical essentials. But how much do you really know about Canada’s universal healthcare? Are there important medical and dental needs that aren’t covered? And is it enough to rely solely on government-funded healthcare?
While Canada’s universal healthcare system is a significant advantage, it does not address every health and wellness need. Approximately two-thirds of Canadians rely on personal health insurance to bridge the gap between universal healthcare and their actual needs.
The more you understand about the universal healthcare system, the clearer it becomes that health and dental insurance is just as important in Canada as it is in countries without government-funded healthcare systems.
There’s a lot to consider when it comes to health and dental insurance plans—what’s covered, who they’re designed for, and whether an individual plan is right for you. If you’re still deciding whether a health and dental insurance plan is necessary for you and your family, this guide will provide essential information to help you make a confident choice.
Taking a closer look at Canada’s universal healthcare
The federal government oversees the government health insurance plan, but each province or territory is responsible for administering care. Provinces and territories receive funding from the federal government to help cover healthcare costs.
This approach works well given Canada’s diverse and geographically dispersed population. Delivering public healthcare in remote and rural communities like Foam Lake, Spiritwood, and Hudson Bay comes with different challenges than providing care in larger centres like Regina or Saskatoon.
The good news is that if you are a Canadian citizen or permanent resident, you’re covered by the Canadian universal healthcare plan, which addresses many of your basic healthcare needs. The government-funded plan typically includes:
● Doctor’s visits
● Some specific tests such as blood work, pap smears, EKGs
● Emergency room visits
● Same-day and overnight surgeries
● Immunizations
● Prescription drugs provided in hospital
Because of differences in funding and administration, there are inconsistencies in what services and products are covered in each province and territory. You can find more information on the specifics of what’s offered in Saskatchewan here.
Additional support for those in need
The Canadian government also provides additional support programs for certain groups. Seniors, children, youth, and individuals receiving social assistance may qualify for dental care, mental health services, vision care, prescription drugs, home care, hospice care, and medical equipment coverage.
These programs vary across the country and have eligibility requirements you must meet to apply. When you qualify, they can provide much-needed support to those who need it most.
What’s missing from universal healthcare in Canada?
Universal healthcare in Canada covers a lot. As a Canadian citizen or permanent resident, you are less likely to face overwhelming medical bills to have a child or set a broken bone, for example.
However, public healthcare does not cover all your health needs. For many Canadians, the following services and products are not covered:
● Most prescription drugs
● Dental care
● Vision care
● Long-term care
● Ambulance fees for non-medical emergencies
● Psychological counselling/therapy
● Registered specialists such as massage therapy, physiotherapy, chiropractic care, etc.
So, while Canadians benefit from strong public healthcare, many important services—especially for those between 18 and 65—are not fully funded.
How does health and dental insurance work in Canada?
Universal healthcare helps ensure you can access essential medical care when needed. But some expenses can still come as a surprise if you’re not prepared or don’t have additional coverage.
Being prepared for these potential costs is extremely important for your financial well-being. Your physical health and well-being are just as important—delaying dental surgery or necessary prescriptions due to unexpected costs isn’t a choice anyone wants to make.
There are three main ways to help cover some or all of the costs for services not included in your government healthcare plan.
A robust savings plan
If you plan to pay out of pocket for prescriptions, therapy, dental care, and eye care, it’s essential to have savings earmarked for that purpose. Some expenses are predictable—like annual dental appointments, monthly prescriptions, and regular therapy sessions.
However, emergencies can arise unexpectedly, such as urgent dental work or sudden medical equipment needs. Without sufficient savings, paying out of pocket for these types of procedures can quickly become a significant financial burden.
Group insurance through your employer
Group insurance covers all members of a defined group and is often used by employers to provide employees with extended health and dental benefits. Many workplaces in Canada offer group insurance as part of their total compensation package.
Depending on the plan, you may be required to pay part of the monthly premiums through payroll deductions. Every group insurance plan is different, but most will at least partially cover:
● Prescription drugs
● Dental care
● Vision care
● Potentially the services of other registered specialists
All group health and dental insurance plans have their own terms and coverage levels, so it’s important to read the details carefully. For example, some plans cover 100% of eligible prescriptions, while others cover only a percentage. Many also have annual maximums per service per year.
Group benefits can significantly reduce your out-of-pocket costs for health and dental services, but they may not fully cover larger or ongoing needs, such as orthodontics for a child or extended physiotherapy after an accident.
These are key factors that may lead you to seek additional coverage through a personal health and dental plan. Knowing exactly how much your group benefits provide can help you make informed decisions about whether you need supplementary insurance.
Personal health and dental insurance
Health and dental insurance can help you access the medical care and treatment you need without draining your savings or relying on credit.
Every health and dental insurance plan has its own annual maximums, covered services, premiums, and reimbursement percentages for prescriptions and treatments. Here’s what you can typically expect to be covered by personal health and dental insurance plans, such as CAA Health and Dental Insurance plans:
● Prescription drug benefits
● Dental benefits
● Vision benefits
● Hospital accommodation benefits
● Telehealth benefits
● Extended health benefits, which may include:
○ Accidental dental benefits
○ Ambulance transportation benefits
○ Hearing aid benefits
○ Home support service benefits
○ Medical items and equipment benefits
○ Diagnostic services benefits
○ Professional services and registered therapists’ benefits
It’s important to look for a plan that suits both your needs and those of any dependents. For example, a plan with a high deductible for vision care may not be ideal if you wear contact lenses. Similarly, a yearly prescription maximum of $500 may not be sufficient if you take regular daily medications.
Take the time to research your options or speak with a professional so you can feel confident you’re getting coverage that fits your lifestyle and budget.
CAA Health and Dental plans, provided by Securian Canada, are designed to offer comprehensive coverage for a wide range of health needs. With a variety of plans and coverage tiers available, a CAA Health and Dental plan, provided by Securian Canada, can help protect your health and support your wellness while staying within your budget.
Who should get additional health and dental insurance in Canada?
After learning about Canadian universal healthcare and the advantages of employer group benefits, you might wonder why anyone would need to supplement their coverage. Publicly funded healthcare and workplace benefits do a lot of the heavy lifting.
However, as we’ve seen, there are gaps in government-funded healthcare, and not everyone has access to group benefits. For those who don’t, personal health and dental insurance can help manage the cost of various healthcare expenses like prescription drugs, vision care, and dental care.
So, who can benefit most from health and dental insurance? Four main groups often see significant value:
You’re a gig worker, freelancer, part-time worker, or self-employed
If you work in a role that doesn’t provide benefits, a personal health and dental insurance plan can give you peace of mind, knowing that you and your loved ones have coverage in case of unexpected health expenses. Personal health and dental insurance can help reduce out-of-pocket costs and protect your savings.
With CAA Guaranteed Issue Health and Dental Insurance, provided by Securian Canada, even the base-level plan offers meaningful coverage. With three coverage tiers, you can choose an option that works for your needs and your budget.
You’re retired
Once you retire, you will often no longer have access to your workplace group benefits (though some employers do extend coverage into retirement). While retirement is an exciting milestone, it also creates a gap—especially when it comes to filling monthly prescriptions, attending eye care appointments, and maintaining your oral health.
As we age, it’s common to need more frequent medical visits and interventions—such as physiotherapy after joint surgery or dental replacements. Having a plan in place helps ensure those needs don’t become unexpected financial stressors.
With CAA Guaranteed Issue Health and Dental Insurance, provided by Securian Canada, you can feel confident knowing you have reliable coverage without extensive medical questionnaires. You can choose from four coverage tiers to find a plan that aligns with your budget and evolving health needs.
You’re set to retire
If you’re planning to retire soon, you’re already thinking ahead—especially when it comes to your health and dental coverage. One of the big changes on the horizon is that your employer benefits may soon end.
The good news is that by planning now, you can avoid a gap in coverage. You can transition from your employer-provided benefits to a personal health and dental plan by securing a new plan before you retire or within 90 days of your retirement date. That way, your coverage can continue seamlessly.
With CAA Next Health and Dental plans, provided by Securian Canada, you can skip the medical questions and even pre-schedule your plan to begin the day you retire, so you can step into your next chapter with confidence.
Your group benefits don’t offer enough coverage
Sometimes employer-provided group benefits do not fully meet the needs of you or your family. In these cases, purchasing an additional plan is a practical way to help bridge the gap.
When you have more than one health and dental insurance plan, you’ll always submit claims to your primary insurance first. If there are remaining eligible expenses that are not covered, you can then submit the remainder to your secondary insurance.
Here are two common coordination of benefits scenarios involving an employer-provided plan and a personal health and dental plan:
Scenario 1
You’re covered under your employer-provided benefits plan and you also have a personal health and dental plan. In this case, your employer-provided benefits are your primary insurance, and your personal plan is secondary.
Scenario 2
You’re covered under a personal health and dental plan and you’re also listed as a dependent on your partner’s employer-provided benefits. In this situation, your personal insurance policy is primary, and your partner’s employer-provided benefits are secondary.
Is health and dental insurance worth it in Canada?
Assuming you don’t need additional health and dental insurance simply because Canada has universal healthcare is a common misconception.
Without additional coverage, you’ll be responsible for many essential services out of pocket. Prescription drugs, dental care, and vision care are some of the main reasons people choose to purchase health and dental insurance.
Consider the following average costs:
● Canadians spend an average of $1,214 per year on prescription drugs.
● A dental cleaning in Canada can range from $150–$250, and dentists generally recommend a cleaning every six months. Annually, that’s approximately $300–$500 for basic dental maintenance.
● The Canadian Association of Optometrists recommends that adults have an eye exam once every two years. The average cost of an eye exam in Canada is $50–$200, which works out to about $25–$100 per year.
That means, without health and dental insurance, and when only your basic prescription, dental, and eye care needs are met, you could spend approximately $1,614–$1,814 per year. If you experience a health emergency or require additional specialist care, these costs can climb even higher.
Having a plan in place to help cover these expenses can provide greater financial security and peace of mind, while supporting your overall health.
Health and dental insurance can feel complex, but you do not have to navigate it alone. Noncommissioned advisors are available to offer clear, unbiased guidance and help you understand your options. You can book a call to discuss your needs and get expert advice.
Discover how you can find peace of mind and support your financial well-being with health and dental insurance that fits your needs at every stage of life. Learn more about CAA Health and Dental Insurance.
Securian Canada is the brand name used by Canadian Premier Life Insurance Company and Canadian Premier General Insurance Company to do business in Canada. Policies are underwritten by Canadian Premier Life Insurance Company.