[Report] Health Insurance Market in Canada : Key Figure & Trends in 2023

As in many countries, the Canadian health insurance system is made up of provincial public health insurance plans, supplemented by private insurance offerings that cover the bulk of health expenses for the citizens of our country. In this study, we look at the key data, statistics and figures for the health insurance market in Canada, analyzing trends over the last 5 years.

PART I: The private health insurance market in Canada

In Canada, 27 million citizens are covered by a supplemental health insurance plan, which covers expenses not covered by public plans (the RAMQ in Quebec or the OHIP in Ontario, for example). Below, we explore the main statistics and trends in the private health insurance market in Canada since 2018.

Private health insurance companies collected $55.9 billion in premiums in 2022 across Canada

In 2022, 27 million Canadians had private supplemental health insurance, representing a little bit more than two-thirds of the total population (67.8%). Over the year as a whole, a total of $55.9 billion was collected by private health insurers for supplemental health, disability, accident and other risks. The trend over the last 5 years is as follows:

• The total amount of premiums collected increased by 20.7% between 2018 (when it was $46.3 billion) and 2022
• At the same time, total refunds paid by private health insurers rose from $37.6 billion to $43.9 billion, an increase of 16.6%.

90% of private health insurance premiums are collected via group plans

If Canadians benefit massively from supplemental health insurance, it is above all thanks to the existence of group plans financed by companies for the benefit of their employees. As the graph below shows, 90% of the premiums collected by private insurers are collected through those group plans, compared with just 10% through individual policies.

In 2022, Manulife is the leader in the private health insurance market in Canada with a 20% market share

In 2022, the private health insurance market in Canada sees fierce competition between several large companies. Among these, Manulife stands out as the leader, with a 20% market share. Sun Life is also in a strong position, with a 15% market share. RBC Insurance, Great-West Lifeco and Desjardins also maintain significant market shares, illustrating the diversity of players in this sector.

32.5 billion: total refunds paid under supplemental health insurance in Canada in 2022

In 2022, private health insurers paid out a total of $32.5 billion in Canada, in the form of refunds to supplement the coverage provided by public health insurance plans in the various provinces. The graph below shows that:

• Drugs ($14.3 billion) and dental care ($10 billion) are the two largest refunded items for supplemental health insurance in Canada
• Hospital care, which is largely covered by public plans, comes third, representing $1.7 billion for supplemental health insurance in 2022, ahead of vision care ($1.3 billion), other paramedical services ($1.3 billion) and massage therapy ($1.1 billion)
• Lastly, we find physiotherapy ($0.8 billion), chiropractic ($0.7 billion), travel expenses ($0.7 billion) and mental health care ($0.6 billion) as main items covered by supplemental health insurance in 2022.

In 2022, 44% of refunds by supplemental health insurance relate to drugs

In terms of breakdown, there is a clear predominance of drugs (44%) and dental care (30.8%), which together will account for more than two-thirds of the refunds made by supplemental health insurance providers in 2022 in Canada. Here is a breakdown of other spending by supplemental health insurers in Canada for the year 2022 as a whole:

Overall refunds made by private health insurance providers rose by 22.2% between 2020 and 2022 in Canada

Although public health insurance plans have assumed the majority of the costs (particularly hospital costs) associated with Covid-19, private health insurers have also been called upon to contribute. In fact, their total expenditure rose from $26.6 billion in 2020 to $32.5 billion two years later, an increase of 22.2% over the period ($5.9 billion in additional costs).

Supplemental dental care refunds in Canada have risen by 17.7% in 5 years

As we have seen, overall expenditure on supplemental health insurance has increased over the last 5 years. If we look in a little more detail at the different categories of care covered, we can see that:

• Refunds made by private health insurance providers for drugs rose from $11.7 billion to $14.3 billion between 2018 and 2022, an increase of 22.2%
• Spending on dental care by supplemental health insurers jumped from $8.5 billion to $10 billion, an increase of 17.7% over the same period
• On the other hand, hospital expenditure covered by private insurance has fallen by 10.5% over the last 5 years, as public schemes have largely covered the costs associated with Covid-19.

These figures illustrate how spending in these service areas has changed over the years, highlighting trends and priorities in healthcare funding in Canada.

PART II : Private health insurance data and trends in the Canadian provinces

In Canada, each province has its own specific health insurance system. The aim of this second section is to provide a comparative analysis of the health insurance systems in the various Canadian provinces.

In Canada, 43% of all supplemental health insurance refunds are made in Ontario

The data presented below offers insight into the annual private health insurance benefits paid across the Canadian provinces. Ontario emerges as the province with the highest annual benefits paid at $48,984 million, showcasing its substantial investment in providing benefits to its residents. Then :

• Quebec follows with a significant amount of $24,908 million in annual benefits. British Columbia and Alberta also allocate substantial resources, with $13,676 million and $11,648 million, respectively.
• In contrast, Prince Edward Island has the lowest annual benefits paid among the provinces, at $364 million, followed by Newfoundland and Labrador ($1,248 million) and New Brunswick ($2,548 million).

Quebec is the province with the highest proportion of its population benefitting from private health coverage: 83%

It is always interesting if all provinces have the same proportion of their people having a private health insurance cover. We observe that :

• Quebec has the highest percentage of people with private health insurance at 83.1%, followed closely by Newfoundland and Labrador at 78%
• Manitoba and Saskatchewan also have relatively high rates of private health insurance coverage, with 77.5% and 77.2%, respectively
• Conversely, British Columbia and Alberta both exhibit the lowest rates among the provinces, with 70.9% each.

These statistics shed light on the varying levels of reliance on private health insurance across different regions of Canada, which can be attributed to factors such as provincial healthcare policies, economic conditions, and population demographics.

In Ontario, the average annual private health insurance benefit is about $4,453 per beneficiary

Where in Canada do private health insurance providers pay the most for their beneficiaries? As the graph below shows:

• Ontario ($4,453 per beneficiary on average) and New Brunswick ($4,177) have the highest annual private health insurance reimbursements.
• Conversely, Saskatchewan ($3,086), Newfoundland and Labrador ($3,044), and Prince Edward Island ($2,800) are the Canadian provinces with the lowest annual private health insurance reimbursements.
• In between are Alberta ($3,640), British Columbia ($3,599) and Quebec ($3,412).

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