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What is private health and dental insurance?

Private health and dental insurance in Canada provides coverage for medically necessary and elective services that the public healthcare system does not fully cover or at all. While provincial and territorial plans guarantee core services like physician visits, hospitalizations, and surgeries, they rarely cover routine dental care, prescription drugs, vision care, paramedical treatments (e.g., physiotherapy, chiropractic care), or preventative services.

For individuals and families, private plans act as a strategic extension of public coverage and allow access to a broader network of providers, faster treatment timelines, and financial protection against out-of-pocket medical expenses. The structure and cost of these plans are influenced by factors such as age, health status, province of residence, and the breadth of coverage, including whether the plan accommodates pre-existing conditions or specialized therapies.

Why should I compare health and dental insurance quotes?

Comparing quotes for private health insurance in Canada is crucial to finding coverage that fits your needs and budget. Premiums and benefits can differ significantly between insurers, even for plans that appear similar. Without comparing options, you risk paying more than necessary or selecting a plan with gaps in essential coverage, such as prescription drugs, dental procedures, vision care, and paramedical services.

By comparing insurance plans, you can evaluate both cost and value, and identify options that offer comprehensive care while remaining affordable. This process also helps highlight differences in coverage limits, exclusions, waiting periods, and optional benefits that can impact your healthcare experience. For individuals and families, reviewing multiple health and dental insurance quotes ensures your plan is customized to your circumstances, whether you need coverage for dependents, pre-existing conditions, or specialized services beyond provincial healthcare.

What does private health insurance cover?

Personal health insurance plans often include benefits such as:

Prescription icon

Prescription Drugs

Antibiotics, narcotics, creams, etc.

Paramedical Expenses icon

Paramedical Expenses

Mental health services, physiotherapy, registered massage therapy (RMT), chiropractic, etc.

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Medical Equipment

Crutches, nebulizers, CPAP machines, etc.

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Dental Treatment

Teeth cleaning, braces, crowns, etc.

Vision Care icon

Vision Care

Glasses, contact lenses, eye exams, etc.

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Travel Medical

Emergency medical expenses

Cost of health and dental insurance in Canada

In Canada, the cost of health and dental insurance depends on the type of plan you choose. Personal health insurance for individuals can start around $60–$100 per month for younger adults and rise to $300 or more for seniors, while family plans often range from $160 to $800 per month.

Guaranteed issue plans or policies that cover pre-existing conditions generally cost more, often beginning at about $100 per month and increasing with age and coverage needs. These are only averages—actual premiums vary by age, health status, province, and insurer—so comparing multiple providers is the best way to find affordable coverage

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Why choose PolicyAdvisor for health and dental insurance quotes?

Finding the right health and dental insurance in Canada shouldn’t be complicated. PolicyAdvisor gives you a simple, transparent way to compare plans, understand your options, and get covered—all in one place. Here’s why Canadians trust us:

  • Compare top providers within minutes: View quotes from Canada’s leading health and dental insurers side by side. No need to jump between websites or talk to multiple brokers
  • Save money without losing coverage: See competitive rates at a glance, so you can balance affordability with comprehensive protection for prescription drugs, dental care, vision, and more
  • Plans customized for your needs: Whether you’re self-employed, between jobs, retired, or just need extra coverage beyond provincial healthcare, we’ll match you with a plan that fits your lifestyle
  • Clear, jargon-free guidance: We break down coverage details, exclusions, and costs in plain language. You’ll always know what’s included with no hidden fees or surprises
  • Fast and secure online application: Apply in minutes and get your policy documents digitally. Everything is secure, paperless, and travel-ready
  • Expert advisor support: Our experienced advisors help answer all your questions, compare plan types, and guide you every step of the way

What should I ask before buying private medical insurance with dental coverage?

Choosing private medical insurance in Canada is an important decision, and asking the right questions helps you avoid gaps in coverage or unexpected costs. Before you buy, make sure to ask:

What is the annual maximum, and are there per-service limits?

Private medical insurance usually includes both an overall coverage cap and service-specific limits. For example, vision care may have a $200 cap every two years, while paramedical care could be limited to $500 per practitioner annually. Always confirm both types of limits.

What are the waiting periods for basic and major dental?

Basic dental services such as exams, cleanings, and fillings may be covered immediately, while crowns, bridges, dentures, and orthodontics often require a waiting period of 6–12 months.

What is the reimbursement rate and deductible?

Plans generally reimburse between 70% and 100% of eligible expenses. Ask what deductible applies since \this is the amount you must pay before your private health insurance coverage begins.

How are pre-existing conditions defined and treated?

Most insurers require conditions to be “stable” for a set period (commonly 3–12 months) before coverage applies. Some providers may exclude pre-existing conditions entirely or limit coverage. Always get a written explanation before applying.

Is direct billing available for pharmacies, dental clinics, and paramedical providers?

Direct billing can save you from paying upfront and waiting for reimbursement. Confirm whether your insurer has a provider network that supports this.

Does the plan include emergency out-of-country medical coverage?

Not all private medical insurance includes travel benefits. If you travel frequently, confirm whether the plan covers medical emergencies abroad, including evacuation or repatriation.

What is the claims process and turnaround time?

Ask whether claims can be submitted online or by app, what documentation is required, and the average reimbursement time. Digital claims portals often process payments within a few business days, while paper claims may take longer.

Get health and dental insurance quotes today!

Choosing the right health and dental plan is one of the best ways to protect yourself and your family from out-of-pocket medical costs not covered by provincial healthcare. Our health and dental insurance quotes tool helps you compare and buy coverage in just minutes.

  • Compare plans from Canada’s top insurers
  • Review coverage levels for prescription drugs, dental care, vision, hospital stays, and more
  • Explore options for individuals, families, retirees, or self-employed Canadians
  • Customize deductibles and benefits to match your budget and needs
  • Apply online quickly and securely, today!

Get your health and dental insurance quote today and get peace of mind knowing you have protection for everyday care and unexpected expenses.

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Frequently asked questions

What does health and dental insurance typically cover? Toggle Icon
Coverage varies by plan, but most plans include prescription drugs, routine dental (cleanings, fillings), major dental (crowns, bridges, dentures, often with longer waiting periods), vision (exams and eyewear), paramedical services (physiotherapy, chiropractic, massage, psychology, etc.), hospital accommodation top-ups, ambulance, diagnostic supplies and equipment (hearing aids, mobility aids), and limited out-of-country emergency care. Always check annual maximums, per-service limits and whether a service requires pre-approval.
How do plan levels differ (Basic / Enhanced / Elite or Guaranteed / Guaranteed Plus / Guaranteed Elite)? Toggle Icon
Plan levels differ on three practical axes: annual maximums, reimbursement rate (e.g., 70%–100% for many services), and service-specific limits (paramedical sessions, vision frequency, major dental maximums). Higher tiers usually reduce waiting periods and increase acceptance of pre-existing conditions or offer optional riders (orthodontics, hearing aids). Choose a level that reflects your likely use, budget and tolerance for out-of-pocket risk.
What are waiting periods and how will they affect me? Toggle Icon
Waiting periods are the time after your policy starts during which certain services are not covered. Common patterns: little or no wait for prescription drugs and basic dental, but 6–12 months (or more) for major dental and orthodontics. Waiting periods protect insurers from immediate claims; if you need urgent major treatment soon, get a predetermination or consider a plan with shorter waits.
How are pre-existing conditions handled? Toggle Icon
Insurers treat pre-existing conditions differently: some exclude them, some cover them if they’ve been “stable” for a defined look-back period, and some offer conditional coverage for an extra premium. Always disclose medical history on application, nondisclosure can void claims. If you have a chronic condition, obtain written details from the insurer on what will and won’t be covered before you buy.
Can I get coverage without a medical exam? Toggle Icon
Yes, there are three common paths to get coverage without a medical exam: guaranteed-issue (no medical answers; often limited benefits or stricter age caps), simplified issue (short health questionnaire), and full medical underwriting (detailed questionnaire and possibly exams). Guaranteed-issue is convenient but typically has higher premiums and tighter limits; simplified or full underwriting usually yields broader coverage and lower long-term costs if you qualify.
What determines my premium and why do premiums increase? Toggle Icon
Premiums are mainly driven by age, plan level, geographic factors, family composition, deductible/reimbursement choices and underwriting outcome. Premiums also rise over time due to inflation in drug and dental costs, changes to fee guides, and claims experience. Expect annual renewals and age-band increases; compare quotes periodically to ensure value.
How do claims and direct billing work? Toggle Icon
Some providers and networks offer direct billing (pharmacies, dental clinics, physiotherapy chains). Where direct billing isn’t available you pay up front and submit an itemized receipt for reimbursement. Always keep original itemized receipts, dentist/dental clinic treatment plans and receipts for prescriptions, insurers will require them for claims.
How long does it take for claims to be processed? Toggle Icon
Simple online claims are often processed within a few business days; paper or complex predeterminations can take longer. Turnaround varies by insurer and by whether additional information (clinical notes, X-rays, predetermination) is required. If timing matters, choose insurers with fast digital claims portals and good customer service.
Can I add family members or dependents to my plan? Toggle Icon
Yes, most individual policies allow spouse/partner and dependent children up to a specified age (often with student extensions). Definitions and age limits vary; confirm whether full-time students, disabled dependents or stepchildren qualify and whether adding family changes your premium structure.
How does portability work if I move provinces or leave Canada? Toggle Icon
Individual plans are generally portable across provinces but coverage details can be affected by your new provincial plan. If you permanently leave Canada, most individual plans can be maintained for a limited time but travel/out-of-country limits and renewability should be checked. Group plans are tied to employment and the coverage usually ends when the job ends.
What is coordination of benefits (COB) if I have more than one plan? Toggle Icon
COB determines which plan pays first (primary) and which pays secondary. The combined reimbursement cannot exceed 100% of eligible expenses. When submitting claims, provide both policy details and insurers will coordinate automatically if you declare the other coverage.
Will paramedical or psychological services be covered? Toggle Icon
Many plans include paramedical services but with per-visit maximums and an overall annual maximum. Coverage generally requires licensed practitioners and may require a doctor’s referral for certain services. Check session limits, eligible provider lists and whether virtual sessions are accepted.
Are orthodontics or major restorative dental procedures covered? Toggle Icon
Orthodontics is commonly excluded from standard plans or available only as an optional rider with long waiting periods and lifetime maximums. Major restorative (crowns, bridges) is usually available but often subject to longer waiting periods and higher co-insurance. Always request a predetermination for major work.
Does the plan cover emergency medical care when I travel? Toggle Icon
Some health plans include limited out-of-country emergency coverage; amounts vary widely and often have per-incident or aggregate limits and sublimits for evacuation. For extended travel or higher protection consider dedicated travel medical insurance, it will be designed specifically for overseas evacuations and repatriation.
What paperwork do I need to apply and to submit a claim? Toggle Icon
To apply: government ID, residency information, and medical history details. To claim: itemized receipts, provider invoices, prescriptions, predetermination letters, and any referral or diagnostic reports. Keep originals and, when possible, submit digitally to speed up processing.
Why do health and dental quotes vary so much between insurers? Toggle Icon
Insurers use different fee schedules, definitions of eligible expenses, reimbursement structures, waiting periods, networks, administrative fees and underwriting standards. Two plans with similar premium tags can deliver very different out-of-pocket exposures so you must compare the real benefit numbers (annual maximum, per-service limits, reimbursement %) rather than only price.
Is my premium tax deductible? Toggle Icon
Tax treatment depends on how the plan is structured. Employer-paid group benefits are generally a taxable benefit to the employee in specific situations, and self-employed individuals may be able to deduct group plan premiums as a business expense in certain circumstances.