Canadian citizens can benefit from universal public health insurance funded by their payroll taxes. While Canada’s universal health system is of high quality, it is not always enough when faced with large medical expenses. Did you know that roughly 30% of healthcare expenditures are private or out-of-pocket?
In Ontario, emergency and preventive care are largely covered. The Ontario Health Insurance Plan does not guarantee access to full dental care, vision care or prescription medications. If you find yourself without coverage, the associated costs can be a lot to bear out-of-pocket.
Interested to learn more about health insurance coverage in Ontario? This guide will explain what is covered under the Ontario public system, along with private insurance options, reviews and the best insurance for you.
How does health insurance work in Ontario?
In Ontario, healthcare costs are covered by a mixture of universal public insurance known as OHIP and by private insurance from providers like Manulife, Sun Life, Canada Life or Blue Cross.
Individual health insurance helps pay medical expenses incurred from illness or injury. It can also cover some everyday medical costs like dental, vision and prescriptions. On top of access to universal public health insurance through Ontario’s OHIP, one may obtain additional health insurance through one’s employer or buy it independently.
Concerning health care for Indigenous peoples, including First Nations, Inuit and Métis, the federal, provincial and territorial levels of government share jurisdiction. The Canadian health system allows Indigenous peoples to access health services. Indigenous Services Canada directly provides services for First Nations and Inuit that supplement the health coverage provided by the government, including coverage such as primary health care.
About the Ontario Health Insurance Plan
OHIP, or the Ontario Health Insurance Plan, is Ontario’s public health insurance. It covers many emergency and preventative medical care costs. It is funded through payroll deduction taxes and transfer payments from the federal government.
Many people are aware of the basics covered by OHIP, such as doctor visits and emergency health care. However, costs that are not covered can sometimes cause confusion, frustration and surprise expenses.
For more information refer to our comprehensive OHIP guide.
You will need a supplemental, private health insurance plan for full comprehensive health coverage beyond what the Ontario Health Insurance Plan covers.
Think a private health insurance place is the right move for you and your family? You can get started shopping with our free and anonymous health insurance comparison tool at the top of this page. Get personalized quotes in just seconds. No email is required to get started comparing quotes.
Which are the best individual health insurance plans in Ontario?
There are many private individual health insurance plans available in Ontario. It may seem like a daunting task navigating providers and plans. Our insurance comparison tool makes it easy. Compare Ontario health insurance plans now.
Popular insurers include:
- Blue Cross Canada Health Insurance
- CAA Health Insurance
- Canada Life Health Insurance
- Costco Health Insurance
- GMS Health Insurance
- Manulife Health Insurance
- Odyssey Health Services
- Star Health Insurance
- Sun Life Health Insurance
How do I get health insurance in Ontario?
To make sure you have basic health insurance in Ontario, you must apply for coverage through OHIP.
The public health insurance provided in Ontario will pay for basic services, but what about the services that they do not cover? A private health insurance plan ensures coverage for many additional unforeseen medical needs. Use our comparison tool to shop for the best rates.
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Alternatively, you contact insurers directly or work with an insurance broker.
How to get an Ontario health card?
To get an Ontario health card, you will need to have applied for OHIP coverage. Once you are accepted, you will be issued a health card. Your health card proves that you are covered by OHIP. You will need to show it every time you see your doctor, visit an emergency room, have a medical test or go for surgery.
For more information see our guide to OHIP.
How do I renew my Ontario health card?
You can renew your Ontario health card online.
Before you renew online, make sure you have:
- Your most recent health card
- Your current driver’s licence
- Proof of identity (driver’s license, passport, permanent resident card) (utility bill)
- Proof of Ontario residency (driver’s license, utility bill)
You can also renew your health card by visiting a ServiceOntario centre.
What does OHIP cover?
OHIP provides full coverage for many medical necessities.
OHIP covers part or all of:
- Doctor visits
- Hospital visits and stays
- Medical or surgical abortions
- Eligible dental surgery
- Eligible eye-health/optometry services
- Ambulance services
- Counsellors or psychologists
- Travel for health services if you live in Northern Ontario
What does OHIP not cover?
OHIP provides covers services that a physician deems medically necessary, including doctor’s visits, hospital visits and stays and emergency dental services.
While OHIP does cover some medical services, there are many things that it does not cover such as:
- Prescription drugs provided in non-hospital settings for individuals under the age of 65
- Dental services provided in a dentist’s office
- Eyeglasses, contact lenses
- Laser eye surgery
- Alternative medicine consultation treatments, including Chinese medicine, homeopathy and Reiki
- Chiropractic services
- Cosmetic procedures
- Immunizations for travel (Hepatitis A, Hepatitis B, Twinrix, HPV)
Services not covered under OHIP are expensive and can bring on a massive financial burden when you are least able to deal with them. We highly recommend getting a private insurance plan.
It can help you not only access better care when you need it but also offer peace of mind that you will be covered for large, unexpected expenses that will avoid out-of-pocket costs.
How much does private health insurance cost in Ontario?
Our experts were quoted $168.26 per month with Blue Cross for a 41-year old with no pre-existing conditions for full comprehensive hospital, dental and prescription drug coverage. Cost varies depending on the level of coverage you choose.
Other factors that may affect premiums would include:
- Lifestyle including smoker status
- Pre-existing conditions that may apply
- Specific coverages (dental, prescription drug coverage, etc.)
What benefits can you expect under a similar comprehensive plan and price? Here is an example:
|Dental (waiting periods applies)|
|Vision (6-month waiting period)|
If you are an Ontario resident, you cannot completely replace OHIP with private insurance, meaning the cost of private health insurance is not impacted by OHIP coverage.
To get your a personalized health insurance quote try HelloSafe's insurance comparision tool:
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Is it possible to combine health and dental insurance in Ontario?
Combining health and dental insurance in Ontario is standard practice for insurers. This is known as Coordination of Benefits (COB).
We recommend getting an extended health plan while you are healthy. Often, coverage excludes pre-existing conditions.
Are health insurance premiums tax-deductible in Ontario, Canada?
Premiums paid towards a private health plan, including medical, dental and hospitalization, may be eligible tax-deductible medical expenses by the Canada Revenue Agency.
We recommend speaking to your tax advisor for further information regarding premiums and tax deductions,
What health insurance plan is best for international students in Ontario?
As an international or exchange student, you are not eligible for the Ontario Health Insurance Plan (OHIP). This means you will need to purchase health care. Your school may mandate that you purchase coverage under the University Health Insurance Plan (UHIP).
Schools that require students to have UHIP insurance include:
- Carleton University
- University of Ottawa / Université d’Ottawa
- York University
- Western University
- University of Toronto
In fact, all public universities in Ontario participate in UHIP except the University of Windsor.
How do I cancel my personal health insurance plan in Ontario?
If you need to cancel a private health insurance plan in Ontario, contact your provider directly. Each provider has different requirements and steps for cancelling your policy.
We recommend asking your insurance company to confirm in writing that your insurance policy was cancelled.
Keep in mind, that you may have to pay a penalty if you cancel your policy before its expiry date.