If you are new to Canada or a returning citizen, you have likely heard that we have free healthcare. Well, the rumours are true! The Canadian government offers insurance for basic medical services to anyone eligible.
Best Health Insurance Ontario
While it may not be legally required in some provinces, such as Ontario, there is no downfall to applying for it and receiving coverage. Medical issues can arise at any time, and health insurance can help you avoid paying hefty medical bills.
If you want to know more about government or private health insurance in Ontario, continue reading!
1. Sun Life
Sun Life has been operating for more than 150 years. They are one of the most trusted health insurance providers in Canada. Sun Life offers three different Personal Health Insurance plans.
| BASIC | STANDARD | ENHANCED | |
| Prescription Drugs | 60% reimbursement up to a maximum of $750 per year. | 70% reimbursement for the first $7,000. 100% reimbursement for the next $93,000. | 80% reimbursement for the first $5,000. 100% reimbursement for the next $245,000. |
| Dental Coverage | 60% reimbursement for preventative dental care, up to $500 per year. | 70% reimbursement for preventative dental care, up to $750 per year. | 80% (up to $750) for preventative care. 50% (up to $500) for restorative care. 60% (up to lifetime maximum of $1,500) for orthodontics. |
| Health Care | 60% reimbursement for supplemental healthcare. | 100% reimbursement for supplemental healthcare. | 100% reimbursement for supplemental healthcare. |
| Paramedical Expenses | 60% reimbursement, up to $25 per visit and $250 per year (per type of practitioner). | 100% reimbursement, up to $300 per year (per type of practitioner). | 100% reimbursement, up to $400 per year (per type of practitioner). |
| Vision Care | NONE | 100% reimbursement up to $150 every 2 years. | 100% reimbursement up to $150 every 2 years. |
| Semi-Private Hospital Room | OPTIONAL | OPTIONAL | OPTIONAL |
| Emergency Travel Medical | NONE | For the first 60 days of a trip – $1 million lifetime maximum. | For the first 60 days of a trip – $1 million lifetime maximum. |
Applying for a Personal Health Insurance plan may involve a medical questionnaire. Your policy will likely need to be medically underwritten. To apply, you must be 69 years or younger. Your insurance plan is renewable if you are 70 years or older.
Alternatively, if you have left group coverage within the last 60 days, you can opt for the Health Coverage Choice plan.
You can apply for Sun Life health insurance online, over the phone or via a Sun Life advisor. Visit their website today for more information.
2. Ontario Blue Cross
Blue Cross has been providing health insurance in Canada for more than 75 years. They provide health insurance to 7 million Canadians through their Canadian Association of Blue Cross Plans. Blue Cross is one of the most trusted and popular health insurers in Ontario.
They have multiple health insurance plans available.
- Elements
This is a flexible health insurance plan. You can choose the benefits you want to meet your needs and budget. You can mix and match coverage and add or remove people to the policy as you need.
You first need to choose your Health Benefits module. This can cover you for vision care, physiotherapy, dietician services, counselling, and other benefits. You can then add optional Drug Benefits or Dental Benefits. Additional modules are also available, such as Assured Access, Critical Illness and Hospital Cash.
2. Assured Access
This gives you access to a comprehensive personal health plan if you no longer qualify for group benefits. It gives you the opportunity to convert your employee health benefits to a personal health plan.
There are no medical questions, as long as you convert within 60 days of losing your group plan. This plan is recommended for those who are retiring, recently lost their employment or are changing jobs.
3. Guaranteed Issue
This provides basic health coverage for routine medical expenses. There are no medical questions asked and no medical underwriting. You can receive a range of health benefits, add optional coverage, and even use your coverage out of Ontario.
Ontario Blue Cross offers a 100% customer satisfaction guarantee and a 10 day free look period. You can apply for your health insurance plan online or over the phone. Signing up is quick and simple and health insurance plans are available for new customers up to the age of 74.
Visit Blue Cross’ website today for more information on their health insurance plans.
3. Special Benefits Insurance Services
Special Benefits Insurance Services (SBIS) is an independent broker that works with some of the top insurance providers in Ontario. They are based in Toronto and have been providing health insurance to Ontarians for more than 25 years.
SBIS is the leading agency for individual health insurance plans in Ontario. They offer affordable, high-quality insurance coverage and tailor-made plans.
SBIS offers insurance plans with insurers such as Prism, Manulife, GMS, and Ontario Blue Cross.
You will first need to answer some questions about your insurance needs, your family, your current coverage, and the type of coverage you are looking for. You will then be provided with your free, no-obligation quotes.
It takes less than 2 minutes to choose from multiple coverage options. SBIS insurance plans are designed to pick up where the Ontario Health Insurance Plan stops. They provide additional coverage for services such as:
- Prescription Drugs
- Dental Coverage
- Vision Care
- Chiropractors
- Physiotherapists
- Massage Therapists
- Podiatrists
- Ambulance Transportation
- Hearing Aids
- Home Support Services
- Medical Items
- Medical Services
- Travel
- Hospital Accommodation
SBIS has an A+ with the Better Business Bureau (BBB), the best possible rating. They provide a personalized service and help you find the best coverage options for you and your family’s needs.
Visit Special Benefits Insurance Service’s website today for more information or to find the perfect insurance for you.
4. Sure Health
Sure Health offers insurance plans that top up your Ontario Health Insurance Plan. Their plans are provided by Green Shield Canada (GSC).
They offer several different plans with a variety of coverage levels.
| ZONE Fundamental | ZONE 2 Primary | ZONE 3 Basic | ZONE 5 Choice | ZONE 6 Premier | ZONE 7 Ultimate | |
| Guaranteed Acceptance | YES | YES | YES | NO | NO | NO |
| Prescription Drugs | YES | NO | NO | YES | YES | YES |
| Dental Care | YES | YES | YES | YES | YES | YES |
| Vision Care | YES | YES | YES | YES | YES | YES |
| Extended Health Care | YES | YES | YES | YES | YES | YES |
| Travel | YES | YES | YES | YES | YES | YES |
| Optional Hospital Accommodation | NO | NO | NO | YES | YES | YES |
As long as you are a Canadian resident, have valid Ontario health coverage and are under 80 years of age, you can qualify for a Sure Health insurance plan.
Plans are also available for people who are retiring and those who are going to lose their employee benefits.
All Sure Health’s insurance plans include:
- MindBeacon online mental health therapy.
- GenXys pharmacogenetic testing to help you find the best medication based on your genes.
- Multi-trip travel protection.
- Virtual physiotherapy with a licensed physiotherapist.
- Free legal assistance over the phone.
- Virtual doctor’s visits 24/7 with Maple.
- PocketPills online pharmacy with free delivery.
Sure Health also offers GSC Everywhere mobile app. This gives you convenient access to your health insurance plan 24/7 and the ability to locate GSC-approved specialists.
Customers will also have access to the Change4Life rewards program. You can earn points and win gift cards.
Visit Sure Health’s website today to access some of these great benefits or to receive your free, no-obligation quote.
5. CAA
CAA has been operating for more than 115 years. They have been partnered with Manulife for more than 20 years to offer health insurance to individuals and families. Their health insurance plans allow you to supplement your Ontario Health Insurance Plan and save on out-of-pocket medical expenses.
All plans include Basic Extended Health Care. This provides coverage for vision care, registered specialists and therapists, home care, and nursing.
You can choose from pre-packaged plans or build a plan that works best for you. You can customize your insurance plan by mixing and matching different levels of drugs and dental coverages. This means you only pay for the coverage you actually need.
You can choose additional coverage, including:
- Drugs Plans – Three plans are available, with coverage ranging from 70%-90%.
- Dental Plans – Three plans are available, with coverage ranging from $450-$1,200 per year. Coverage for different dental services ranges from 60%-100%.
CAA offers all customers growing coverage. Your coverage amount increase over time to meet your changing needs as you age.
CAA also offers you some discount options. If you bundle your health insurance with your life insurance, you can save 10% on your premiums.
CAA offers a 30-day guarantee. If you are not fully satisfied with your health insurance plan, you can request a refund in the first 30 days.
There is no upper age limit for CAA plans. As long as you are above 18 years of age, you can qualify for health insurance.
Visit CAA’s website today for more information, or to receive your free health insurance quote.
How Health Insurance Works
In Canada, the government provides a free health insurance plan. In Ontario, it is called the Ontario Health Insurance Plan, which we’ll discuss in more detail in the next section.
Health insurance coverage exists to help residents receive medical services for free or at a lower cost. With the insurance plan from the province, you will not pay for medical services or coverage directly. You simply pay for the insurance through your taxes to the government. This post focuses on Ontario, but you can also go to the best health insurance pages dedicated to Alberta, British Columbia, and Quebec.
If you have private coverage through a provider or assistance program, you typically pay a monthly or annual premium.
The end result with both insurance types is the same. You will receive coverage when you go to the doctor or hospital. People tend to get private health insurance in addition to the government one. This is because they can then receive comprehensive coverage. This allows them to avoid paying for a lot for things such as prescription drugs or travel insurance.
Is Health Insurance Necessary in Ontario?
In ON, personal health insurance is not a legal requirement. That being said, if you want to receive free medical care in Canada, you will need a health insurance plan.
The good news is the existence of a government-run health insurance plan. It is often referred to as OHIP, which stands for the Ontario Health Insurance Plan. To be eligible for OHIP, you must reside in the province either permanently or longer than six months as a student or temporary worker.
Citizens and residents pay for OHIP through their taxes. It allows any eligible person to receive health care services for free. Most necessary medical services and health care is covered by OHIP. This includes things such as surgery, a general check-up, and maternity care.
OHIP does not, however, cover extended health care such as vision care (eye exams or glasses), dental, and prescription drugs.
To visit a doctor or hospital for free, you will need an Ontario service health card. To get your Ontario health card, you need to first reside in the province for three months. Then, you can go to a ServiceOntario office to get your health card, Ontario.
Benefits of Health Insurance
The main benefit of health insurance plans is to receive health coverage for any of your medical needs. You never know when you’ll need medical attention, and having to pay for it out of pocket could bankrupt you. Especially if you are self-employed.
As great as the health coverage that the government offers is, it can also be limiting. This is why some Canadians choose to take out personal health insurance or receive health insurance plans from work. Personal health insurance plans provide the coverage that the government health insurance lacks.
We touched on it a bit already, but you are not covered for obvious things such as vision care (eyeglasses or eye exams), prescription drugs, and dental. OHIP also only offers you the minimum amount of coverage for medical services. For example, if you want a semi-private room in a hospital, you would have to pay more. OHIP provides coverage for hospital wards rather than private or semi-private rooms.
Travel insurance is often available as an add-on to your personal insurance plan. This is recommended if you are leaving the country. OHIP does not include travel insurance.
So, the benefit of personal health insurance is that extended services such as vision care, eye exams, or travel insurance would be covered. You wouldn’t lose your OHIP either. Personal health insurance is just seen as an add-on that allows you to access further coverage.
The Bottom Line
Canadians are very lucky as we receive excellent health care by paying our taxes. Paying big medical bills for surgeries or chronic illnesses can bankrupt people. Canadians, however, do not need to worry about medical bills as much as others. Government coverage is quite comprehensive.
If you want insurance options for things such as travel insurance, prescription drugs, or vision care, you will need additional coverage. For more information, head to the insurer’s website directly.
