Health Insurance by Province: What’s Covered in Canada

• Accessibility, ensuring all Canadians have reasonable access to medically necessary services
• Comprehensiveness, so Canadians can receive the help and treatments they need
• Portability, so Canadians can access emergency healthcare when travelling outside the country
• Public administration, ensuring Canadians are involved in their healthcare and make decisions on a non-profit basis
• Universality, ensuring all eligible residents receive coverage

The goal of Canada’s health system is to make sure that all Canadian citizens have access to coverage for medically necessary services. But a huge portion of the medical services Canadians use every day — from dental exams and vision checkups to physiotherapy and diabetic supplies — don’t fall under the definition of medically necessary care.

• You have a legal right to be in Canada, either as an Indigenous person, citizen, refugee, permanent resident, temporary resident or a visitor with a valid work permit or visa
• Your permanent and primary residence is located in Canada
• You are physically present in Canada for at least 150-183 days out of any 12-month period

Some provinces and territories enforce a waiting period of up to 3 months before your public health insurance coverage starts.

• Hospital services, including nursing, administering drugs, performing diagnostics, performing surgery, and providing standard meals and accommodations
• Physician services, including consultations, examinations, diagnostics, treatments and psychiatric treatments
• Dental, psychological, and vision services performed in a hospital, including eye trauma treatment, jaw surgery, and crisis counselling

Public health insurance covers the cost of medical treatment in another province, territory, or country only if the services you need are unavailable in your home province or territory.

• Ambulance services by land or air
• Dental services performed in a private practice, including exams, cleaning, fillings and emergency dental work
• Vision services, such as eye exams, prescription lenses and corrective laser eye surgery
• Home care services, including assisted living and private-duty nursing
• Medical equipment, such as blood pressure monitoring equipment, orthotics and prostheses
• Mental health services, including visits to a registered psychologist, psychotherapist or social worker in a private practice
• Paramedical services, including visits to an acupuncturist, chiropodist, chiropractor, dietitian, massage therapist, naturopath, osteopath, physiotherapist or speech therapist
• Private or semi-private hospital room fees
• Prescription drugs, including insulin, contraceptives, and fertility medications
• Travel health services, including emergency ambulance services, non-emergency treatment and return transportation from outside Canada

• Where can I get more coverage?
• Ambulance services: Ontario subsidizes ground and air ambulance services, capping fees at $45 per resident. Out-of-province Canadian residents pay $240 for ground ambulance services and the full cost of air transport.
• Dental work: Seniors may apply to the Ontario Seniors Dental Care Program (OSDCP).
• Home care: The Long-Term Care Rate Reduction Program provides financial assistance with home care expenses to eligible Ontario residents.
• Indigenous health: Ontario offers various mental health supports for Indigenous communities.
• Mental health: Visits to private practices aren’t covered, but you can access short-term and crisis mental health support in-person, online, or by telephone.
• Out-of-country health services: OHIP pays for emergency hospital and doctor services abroad at the same rates as in-province care.
• Prescription drugs: OHIP+, the Ontario Drug Benefit, and the Trillium Drug Program provide coverage for Ontario residents under 24, seniors, and households with high prescription drug costs, respectively.
• Vision services: OHIP covers eye-health services for Ontario residents 19 and under, seniors, and those with an eligible medical condition.

• Where can I get more coverage?
• Ambulance services: British Columbia subsidizes ground and air ambulance services, capping fees at $80 per resident. Out-of-province Canadian residents pay $848 for transport by land and $4,394 for transport by air.
• Dental work: Dental and orthodontic services are available for eligible residents, including recipients of income, disability, and hardship assistance.
• Home care: BC residents must undergo an assessment and agree to pay the resulting rate in order to receive .
• Indigenous health: Indigenous Health and the First Nations Health Authority offer health programs tailored to Indigenous people in BC.
• Mental health: BC’s mental health supports and resources can be accessed by phone or through regional health authorities.
• Out-of-country health services: MSP pays for emergency hospital and doctor services abroad at the same rates as in-province care.
• Prescription drugs: BC PharmaCare has 12 different plans that cover prescription drugs for a range of groups, including those on income assistance (Plan C), those in palliative care (Plan P), and low-income residents in need of psychiatric medication (Plan G).
• Vision services: Optical services are available to recipients of income, disability, and hardship assistance.

• Where can I get more coverage?
• Ambulance services: Alberta subsidizes ground ambulance services, capping fees at $385 per resident. Out-of-province Canadian residents pay $585, and air ambulance costs aren’t covered.
• Dental work and vision services: The Alberta government offers Dental and Optical Assistance for Seniors.
• Indigenous health: The Indigenous Wellness Core enables Albertans to search for health programs and services by zone.
• Mental health: Alberta’s addiction and mental health supports include information programs, helplines, and children’s and youth mental health resources.
• Out-of-country health services: AHCIP pays for emergency and non-emergency hospital and doctor services abroad at the same rates as in-province care.
• Prescription drugs: The Alberta Drug Benefit covers over 5,000 products as part of the province’s supplementary benefit plan for seniors, low-income households, and other vulnerable populations.

• Where can I get more coverage?
• Ambulance services: Manitoba subsidizes ground ambulance services, capping fees at $250 per resident. Out-of-province Canadian residents and air ambulance services aren’t covered.
• Dental work, prescription drugs, and vision services: Manitobans who have received Employment and Income Assistance (EIA) for 3-6 months are eligible for dental, prescription drug, and vision coverage.
• Home care: The MSP subsidizes the fees of 124 licensed personal care homes throughout the province, and insures most of their services.
• Indigenous health: Indigenous Wellbeing Supports are available in-person, online, and by phone, as well as through in Winnipeg.
• Mental health: Manitoba provides mental health services through regional health authorities, the Selkirk Mental Health Centre, and self-help and family support organizations. You can also use the Mental Health & Wellness Resource Finder.
• Out-of-country health services: Manitoba pays for emergency hospital and doctor services abroad at the same rates as in-province care.
• Prescription drugs: The Manitoba Pharmacare Program provides coverage to families who spend a large proportion of their income on prescription drugs.
• Vision services: The Seniors’ Eyeglass Program, Infant Contact Lens Program, Prosthetic Eye Program, and Children’s Opti-Care Program provide vision and eye care to Manitobans in need.

• Where can I get more coverage?
• Ambulance services: Saskatchewan subsidizes ground and air ambulance services, charging $325 and $465 per resident, respectively. Out-of-province Canadian residents pay $460 for ground ambulance transportation; air transport isn’t covered.
• Dental work, prescription drugs, and vision services: Saskatchewan’s Supplementary Health Benefits program provides extended medical supplies, drugs, hearing, dental, and emergency benefits to vulnerable residents.
• Home care: Saskatchewan Aids to Independent Living (SAIL) provides coverage for disability-related equipment and supplies with a referral from an authorized health care provider.
• Indigenous health: First Nations and Metis Health Services can be accessed through the Indigenous Health page of the Saskatchewan Health Authority.
• Mental health: The Saskatchewan Health Authority provides various supports for mental health and addictions.
• Out-of-country health services: Saskatchewan pays for emergency hospital and doctor services abroad at the same rates as in-province care.
• Prescription drugs: The Children’s and Seniors’ Drug Plans provide drug benefits to Saskatchewan residents in need.

• Where can I get more coverage?
• Ambulance services: Nova Scotia subsidizes ground services, capping fees at $147 per resident. Out-of-province Canadian residents pay $733; air transportation isn’t covered.
• Dental work: The province of Nova Scotia provides dental coverage to residents in need through 6 dental programs.
• Home care: Nova Scotia’s Continuing Care program provides long- and short-term home care to eligible residents of various groups.
• Indigenous health: First Nations and Indigenous health resources are available in-person, online, and over the phone.
• Mental health: The Mental Health and Addictions page provides links to services, locations, topics, and partners.
• Out-of-country health services: Nova Scotia pays for emergency and non-emergency hospital services abroad at the same rates as in-province care.
• Prescription drugs: Nova Scotia manages 6 Pharmacare Programs for seniors, families, cancer patients, palliative care patients, and other residents.
• Vision services: Children under 10 and seniors aged 65+ can access vision care through two MSI optometry programs.

• Where can I get more coverage?
• Ambulance services: New Brunswick subsidizes ground ambulance services, capping fees at $130 per resident, and air transportation is free. Out-of-province Canadian residents pay $650 for ground ambulance and $6,500 for air ambulance services.
• Dental work: The Health Services Dental Program provides financial assistance to clients of the Social Development office over the age of 19.
• Home care: NB residents can get financial assistance for Home Support based on their needs.
• Indigenous health: Horizon NB provides Indigenous Health resources to Mi’kmaq, Wolastoqey, and Peskotomuhkati communities around the province.
• Mental health: New Brunswick offers crisis resources, mental health locations, and a list of services on its mental health support page.
• Out-of-country health services: New Brunswick pays for emergency hospital and doctor services abroad at the same rates as in-province care.
• Prescription drugs: There are 11 NB Drug Plans providing coverage to seniors, children, nursing home residents, and other populations in the province.
• Vision services: The Health Services Vision Program is available to Social Development clients and individuals with special health needs in New Brunswick.

• Where can I get more coverage?
• Ambulance services: Québec subsidizes ground and air ambulance services, capping fees at $125 per resident, plus $1.75 per kilometre travelled. Out-of-province Canadian residents pay the same for ground transport, but air ambulances aren’t covered.
• Dental work: Children under 10 and Québec residents receiving financial assistance qualify for partial dental services coverage.
• Home care: Quebec residents can receive financial assistance with accommodation in a public facility or accommodation with domestic help.
• Indigenous health: First Nations and Inuit people can access help and support through the Government of Québec or the Institut National de Santé Publique du Québec.
• Mental health: Mental health care and resources are available through local and community groups.
• Out-of-country health services: RAMQ pays for emergency and non-emergency hospital and doctor services abroad at the same rates as in-province care.
• Prescription drugs: Prescription drug insurance is mandatory for Québec residents 18 and over. Some residents without coverage can register for the Public Prescription Drug Insurance Plan.
• Vision services: RAMQ covers some optometric services for eligible residents, and the See Better to Succeed program covers $300 for children’s eyeglasses or prescription lenses.

The territorial governments of Northwest Territories, Nunavut, and Yukon also provide public health insurance coverage to residents. These territorial plans may offer even less coverage than provincial healthcare plans, making private health insurance a valuable supplement.

The numbers above are averages. To see how much your own family could save with a private health insurance plan, add up the total you spent on out-of-pocket medical expenses in the last year, then divide that number by 12. Compare your resulting number with premiums for PolicyMe’s health insurance plans in your province to see your potential savings.