Supplementary Health Insurance
See Extended Health Care Insurance: A type of insurance that pays for hospital and medical expenses not covered by your provincial health plan.
It can be part of a group plan or you can buy it on its own.
How It Works
In Canada much healthcare is delivered in the private sector and is not funded through public health insurance plans, so Canadians rely on supplementary health coverage to access the services of providers working outside publicly funded health systems. Provincial and territorial public plans generally cover medically necessary services such as doctor visits, hospital care, emergency treatment, and certain diagnostic tests, but they do not cover every health-related expense. The services that public plans typically do not fully cover, and that supplemental coverage addresses, include prescription drugs outside hospital, dental care, vision care, paramedical services such as physiotherapy or chiropractic, and medical equipment. These supplemental benefits are optional, and Canadians obtain them either through employer-sponsored group plans or by purchasing individual or family policies from a private insurer.
Example:
A Canadian whose provincial plan covers doctor visits and hospital stays but not routine dental cleanings, prescription eyeglasses, or physiotherapy can enrol in a supplementary health plan, either through an employer group benefits plan or an individual policy from an insurer like a provincial Blue Cross, to be reimbursed for a share of those out-of-pocket costs after meeting any deductible.
What to Watch For:
Employer-sponsored group supplemental plans can have coverage limits and typically end if you leave your job. For dental coverage, coordination of benefits means a primary plan pays first and a supplemental plan may cover part or all of the remaining balance, helping fill gaps left by group insurance, the CDCP, or provincial benefits that have annual limits, waiting periods, or exclusions. A provincial Ministry of Health may also offer supplementary health benefits to specific groups such as low-income individuals, people enrolled in social services, residents of long-term care facilities, or First Nations individuals. Keep in mind that medical expenses paid under the terms of a private health services plan are not a taxable benefit, and the CRA considers a plan a private health services plan where 90 percent or more of the premiums paid relate to expenses eligible for the medical expense tax credit and the plan meets other conditions.
