Private Health Insurance in Canada

Private help insurance offers many benefits, one being access to a large number of medical services and procedures. Many Canadians opt for additional coverage to benefit from personalized care and shorter waiting times.

Why You Might Need Private Coverage

Medical services are expensive in Canada, especially specialized services for challenging medical conditions. Hospital stay and surgery can easily cost $18,000 and up. Public health insurance offers coverage for basic medical services, and many Canadians find it difficult to pay for treatments and medications that are not fully covered. Private health insurance, on the other hand, helps pay for medical equipment, private duty care nursing, hospital accommodation, and a lot more. Private plans are tailored to the needs of different categories of people, including students, self-employed persons, employees and contract workers, part-time employees, retirees, and others.

Insurance Providers and Coverage

There are different providers to choose from, including Pacific Blue Cross, Sun Life Financial, Great-West Life, and others. Pacific Blue Cross, for example, offers coverage for medical equipment, prescription medications, preventive care, physiotherapy, nursing and hospital care, etc. Medical supplies and services are covered, including blood pressure monitors, orthotics, hearing aids, hospital-type beds, and scooters and wheelchairs. The list of covered supplies also includes permanent prostheses, oxygen supplies, ostomy supplies, and casts and crutches. Customers are also offered dental coverage for recall visits, oral surgery, periodontal cleaning, and restorative and preventive care. Dental care also includes repairs to bridges, crowns, onlays and inlays and diagnostic services such as x-rays and oral examinations.

Sun Life Financial also features different types of health insurance plans, including enhanced, basic, and standard plans. The enhanced plan covers emergency travel medical expenses, paramedical services, prescription medications, and vision and dental care. Paramedical practitioner services include services offered by speech language specialists, chiropractors, acupuncturists, massage therapists, naturopaths, psychologists, and physiotherapists. Sun Life also offers supplemental healthcare coverage for in-home nursing, medical equipment, ambulance, and hearing aids. Covered medical services and equipment include artificial limbs, traction kits, walkers, orthopedic shoes, diagnostic laboratory tests, etc. Great-West Life also offers private health insurance coverage, including dental and health coverage for unexpected expenses, prescription medications, medical treatments and services, etc. The plan provides coverage for ambulance, paramedical, vision, and hospital services. Patients with pre-existing conditions also qualify. Persons who are about to lose coverage and those with no coverage and limited benefits are also offered health insurance. Sure Health is yet another insurance provider in Canada that offers coverage to retirees, persons with no or little group coverage, and freelance and contract workers and self-employed individuals. There are plans for seasonal workers, small business owners, unemployed persons, and part-time workers. Customers are offered coverage for emergency medical services, psychological and physical therapy, corrective vision care, dental care, prescription medications, and more. Customers benefit from access to private and semi-private rooms at hospitals, therapeutic and specialist care, and other medical services. The company offers lifetime coverage and mobile-friendly online services.

Further Finance Reading

Public Health System in Canada

The public health system in Canada faces some serious challenges like long wait times and ever increasing costs. At the same time, public health care saves Canadians a lot of money on basic services, ambulance transportation, emergency medical care, and others.

How It Works

In Canada, there are 13 territorial and provincial plans that are publicly funded. The federal government is tasked with developing national standards while the territorial and provincial governments are tasked with the delivery and management of medical services. The federal government offers financial assistance to this end. The Canada Health Act specifies the criteria to receive funding by the federal government as well as the standards to receive payments. These include accessibility, portability, universality, comprehensiveness, and public administration.

Under the territorial and provincial plans, medical services and treatments are offered by dentists, physicians, and hospitals. Medical services are offered to all residents, including specific categories of people such as refugee claimants, inmates, veterans, Canadian forces members, Inuit, and First Nations peoples. Supplemental coverage is offered to recipients of financial assistance, children, and senior citizens.

Extended Health Provision

The list of eligible medical services and treatments is quite long and includes services offered by speech language pathologists, massage therapists, naturopaths and osteopaths, psychologists, etc. Prescription medications are covered, including smoking cessation aids, some life-sustaining drugs, and medications prescribed by healthcare professionals. In general, the Extended Health Provision includes out-of-province, dental, miscellaneous expense, medical practitioners, vision, and drug benefits. The miscellaneous expense benefit, for example, covers things like orthotics, orthopedic shoes, emergency air ambulance, emergency ground ambulance, and others. Other eligible expenses include temporary artificial limbs, drainage bags and caterers, braces, cervical collars, and more.

Basic Plan and Coverage

The basic plan, on the other hand, provides coverage for eligible expenses such as ambulance services, laboratory tests and services, x-rays, surgery, and treatment of dislocations and fractures. The plan also offers coverage for obstetrical care, anesthetics administered at hospital settings, and treatment and diagnosis of different medical conditions and injuries. In general, territorial healthcare plans help pay for home care, ambulance, prescription drugs, and dental and vision care. Out-patients and in-patients are offered medical services in hospital settings to treat and diagnose medical conditions, disability, and injuries.

Challenges and Flaws

Access is one of the main flaws of the public health system in Canada. Citizens and residents have timely access to medical services and treatments for emergent and life-threatening conditions such as cancer, stroke, and heart attack. However, many complain about long wait times for medically necessary treatments for less urgent problems. While it takes about 3 weeks to begin treatment for oncological and malignant conditions, patients wait about 42 weeks for orthopedic surgery on average. Long wait times are also a problem for patients who require a cataract, ankle, or shoulder surgery or knee replacement. Another problem is that the public health system does not pay for certain essential medications. What is more, a government report shows that some 700,000 people in the low-income bracket have no coverage for prescription medications. Some experts also point to the fact that the territorial and provincial governments spend a lot of money on medical services that are low quality. Only countries such as Switzerland and the Netherlands spend more toward diagnostic services, healthcare services, hospital care, and medications. At the same time, the fact that there are 2 beds per 1,000 persons means more cancelled surgeries and treatments and long wait times for medical services and specialist care services. Canada also ranks 20th when it comes to modern diagnostic tools, mammography equipment, PET and CT scanners, and magnetic resonance imaging.