Canada’s healthcare system is often praised as one of the best in the world, providing publicly funded medical services to residents. However, while provincial health insurance covers essential medical treatments, it does not cover everything. Many Canadians wonder, is health insurance worth it Canada?
The answer depends on several factors, including your healthcare needs, employment benefits, and financial situation. In this guide, we’ll explore how the Canadian healthcare system works, the benefits and costs of private health insurance, and whether investing in it is a smart decision for you.
Is Health Insurance Worth It Canada?
Understanding the Canadian Healthcare System
Canada operates under a publicly funded healthcare system known as Medicare, which provides universal health coverage to all citizens and permanent residents. Each province and territory manages its own healthcare plan, ensuring essential medical services are covered.
However, public health insurance does not cover all healthcare expenses. Many out-of-pocket costs can add up, including:
1. Public Healthcare Does Not Cover Everything
Canada’s provincial health insurance covers doctor visits, hospital stays, and emergency care, but many essential health services are not included. Here’s what’s not covered by public healthcare:
❌ Prescription drugs (except for seniors, children, and low-income individuals under specific programs).
❌ Dental care (cleanings, fillings, root canals, etc.).
❌ Vision care (eye exams, glasses, contact lenses).
❌ Physiotherapy, chiropractic care, and massage therapy.
❌ Mental health services (therapy, counseling, and psychiatric care are often limited).
❌ Private hospital rooms and specialized treatments.
❌ Ambulance services (not covered in some provinces).
❌ Travel medical insurance (for emergencies outside Canada).
Without private health insurance in Canada, you must pay out-of-pocket for these services, which can quickly add up.
✅ Having private health insurance ensures that you don’t have to worry about high medical expenses for services not covered under public healthcare.
2. Prescription Drug Costs Can Be High
Prescription medications are one of the most significant healthcare expenses in Canada.
- On average, one in five Canadians has no prescription drug coverage.
- Many provinces offer drug coverage only for specific groups, such as seniors and low-income individuals.
🔹 Example Costs Without Insurance:
| Medication Type | Average Monthly Cost Without Insurance |
| High blood pressure meds | $50 – $100 |
| Diabetes medication | $80 – $250 |
| Asthma inhalers | $75 – $150 |
| Antidepressants | $100 – $200 |
Private health insurance can significantly reduce or even eliminate these costs by covering a large portion of prescription drug expenses.
3. Dental and Vision Care Are Not Covered by Public Healthcare
Dental treatments and eye care are expensive in Canada if you don’t have insurance.
🔹 Average Costs Without Insurance:
| Service | Estimated Cost |
| Routine dental checkup & cleaning | $100 – $300 |
| Tooth filling | $100 – $400+ |
| Root canal | $500 – $1500+ |
| Eye exam | $75 – $200 |
| Prescription glasses | $200 – $600+ |
Private health insurance typically covers 80% to 100% of dental and vision expenses, making it a smart investment for families and individuals who need regular care.
4. Mental Health Services Are Limited Under Public Healthcare
Mental health is an essential part of overall well-being, but public healthcare offers very limited coverage for therapy, counseling, or psychiatric care.
🔹 Without private health insurance, therapy sessions can cost:
- $100 – $350 per session for a psychologist or therapist.
- $150 – $300+ per session for a psychiatrist (if not covered under public healthcare).
- $20 to $90 for Online Therapy
✅ Many private health insurance plans cover mental health services, making therapy and counseling more affordable.
5. Ambulance & Emergency Medical Services Can Be Costly
Ambulance services are not always covered under public healthcare and can be very expensive.
🔹 Ambulance Costs in Canada:
| Province | Cost Per Ride |
| Ontario | $200+ |
| Alberta | $300+ |
| British Columbia | $800+ |
| Quebec | $125 – $400 |
✅ Private health insurance can cover ambulance services, helping you avoid unexpected medical bills.
6. Travel Medical Insurance Is Essential for Trips Abroad
Public healthcare in Canada does not cover medical emergencies if you travel outside your home province or abroad.
✅ Private health insurance often includes travel medical insurance, protecting you from high international medical costs.
7. Self-Employed & Retirees Do Not Get Employer Benefits
If you’re self-employed, a freelancer, or a retiree, you do not receive employer-sponsored health benefits, making private health insurance a smart investment.
✅ A private health plan helps cover prescription drugs, dental, vision, and hospital benefits, ensuring comprehensive coverage.
8. Private Hospital Rooms & Specialized Treatments Are Not Covered
If you need specialized treatments, surgeries, or private hospital rooms, you may have to pay out-of-pocket under public healthcare.
- Public hospitals only cover basic, shared rooms.
- A private hospital room can cost in Ontario $300+ per night.
✅ Private health insurance can cover private hospital rooms and faster access to certain treatments, improving comfort and quality of care.
Isn’t Healthcare Free in Canada?
A common misconception is that healthcare in Canada is entirely free. While doctor visits and hospital stays are publicly covered, many medical services require private health insurance or out-of-pocket payments.
Here’s a comparison table of what’s covered under public vs. private health insurance in Canada:
| Service | Public Healthcare | Private Health Insurance |
| Doctor visits | ✅ Covered | ✅ Covered |
| Hospital stays | ✅ Covered | ✅ Covered |
| Prescription drugs | ❌ Not covered (except for seniors, children, and low-income) | ✅ Covered |
| Dental care | ❌ Not covered | ✅ Covered |
| Vision care | ❌ Not covered | ✅ Covered |
| Physiotherapy & Chiropractic | ❌ Not covered | ✅ Covered |
| Mental health services | ❌ Limited coverage | ✅ Covered |
| Ambulance services | ❌ Not covered (in some provinces) | ✅ Covered |
| Private hospital rooms | ❌ Not covered | ✅ Covered |
| Travel medical insurance | ❌ Not covered | ✅ Covered |
While public healthcare provides basic medical services, private health insurance in Canada ensures comprehensive protection.
Cost vs. Benefit Analysis: Is It Worth It?
The decision to get private health insurance depends on your personal needs, employment status, and financial situation. Let’s break it down.
Cost of Private Health Insurance in Canada
The cost of private health insurance varies based on coverage, age, and provider. Here’s an estimate of average monthly premiums:
| Coverage Type | Individual Cost | Family Cost |
| Basic Plan (Drugs, Dental, Vision) | $60 – $120 | $150 – $400+ |
| Comprehensive Plan (Includes Physio, Mental Health, etc.) | $100 – $300+ | $250 – $800+ |
Out-of-Pocket Expenses Without Insurance
If you don’t have private health insurance, here’s what some common healthcare services cost:
| Service | Average Cost Without Insurance |
| Prescription drugs | $30 – $200 per month |
| Dental cleaning & checkup | $100 – $300 per visit |
| Eye exam & glasses | $100 – $600 |
| Physiotherapy | $80 – $150 per session |
| Mental health therapy | $100 – $250 per session |
| Ambulance ride | $200 + |
If you require frequent prescription drugs, dental care, or physiotherapy, the cost of private health insurance in Canada is often lower than paying out-of-pocket.
Who Benefits Most from Private Health Insurance?
✅ Self-employed individuals & freelancers – No employer-sponsored coverage.
✅ Seniors & retirees – Provincial plans may not cover everything.
✅ Families with children – Regular dental & vision care is essential.
✅ Individuals with chronic conditions – Prescription drugs & physiotherapy can be expensive.
✅ People who travel frequently – Travel medical insurance is critical.
On the other hand, if you have a solid employer-sponsored benefits package or rarely need medical services beyond public coverage, private health insurance may not be necessary.
Final Verdict: Should You Get Health Insurance in Canada?
The decision to purchase private health insurance depends on your medical needs, employment benefits, and financial situation.
✔ You Should Get Private Health Insurance If:
- You don’t have employer-sponsored benefits.
- You require frequent prescription drugs, dental, or vision care.
- You travel frequently and need additional coverage.
- You want peace of mind for unexpected medical expenses.
❌ You May Not Need It If:
- You have comprehensive employer health benefits.
- You are healthy and rarely visit the doctor.
- You prefer to pay out-of-pocket for occasional medical expenses.
If you’re unsure, consider comparing private health insurance plans and calculating your expected medical costs before making a decision.
Conclusion
So, is health insurance worth it Canada? The answer depends on your healthcare needs and financial situation. While public healthcare covers essential medical services, private health insurance fills critical gaps, ensuring better access to dental, vision, and prescription drug coverage.
For many Canadians, having private health insurance provides peace of mind and financial security. Before purchasing a plan, compare providers, assess your health needs, and make an informed decision.
FAQs: Frequently Asked Questions
1. Is private health insurance mandatory in Canada?
No, private health insurance is not mandatory in Canada, but it can help cover services not included in public healthcare.
2. Can I use private health insurance alongside public healthcare?
Yes, private health insurance complements public healthcare by covering additional medical services like dental, vision, and prescription drugs.
3. How much does private health insurance cost in Canada?
The cost varies based on coverage type and provider, but on average, individuals pay $50-$100/month, while families pay higher..
4. What happens if I don’t have private health insurance?
Without private health insurance, you’ll need to pay out-of-pocket for services like prescription drugs, dental care, and physiotherapy.
5. What’s the best health insurance provider in Canada?
Some of the top private health insurance providers in Canada include Manulife, Sun Life, Blue Cross, and Canada Life.
Final Thought: If you’re unsure whether private health insurance is right for you, consider comparing plans and evaluating your expected medical costs. Investing in the right coverage can save you money and ensure access to essential healthcare services.