4 Benefits of Personal Health and Dental Insurance


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In This Article

For 64% of Canadians, the government-funded healthcare system—coupled with their employer-provided group benefits—provides ample coverage for their health and wellness needs. 

But what about the other 36%? Those Canadians can’t rely on employer benefits to help them bridge the gap between what the Canadian healthcare system offers and what they need to stay healthy. And if you ever lose your job in a layoff or have coverage removed for a parental leave, your insurance safety net could change at any time.

Health and dental insurance could provide crucial financial protection for that 36%—and many others who can’t get adequate coverage through their employer group benefits. 

If you’re unsure how health and dental benefits work within the Canadian healthcare system, we’ll break down the difference in coverage you can expect. If you’re not sure health & dental insurance is right for you, we’ll share the most common populations who benefit from health and dental policies. And if you’re wondering when you should purchase health and dental insurance, we’re here to help you answer that question—plus many more. 

We’ll break down the top four benefits of health and dental insurance to give you the complete picture of how a supplemental insurance plan can better your health and finances, no matter your stage of life.

What is health and dental insurance in Canada?

Health and dental insurance in Canada covers the expenses from your health and wellness needs that aren’t covered by provincial or territorial health insurance. 

Canadians have access to government-funded universal healthcare that covers their basic healthcare needs. If you’re a Canadian citizen or permanent resident, the following medical services are paid for by the government:

  • Doctor’s visits
  • Some specific tests like blood work, pap smears, EKGs
  • Emergency room visits
  • In- and out-patient surgeries
  • Immunizations
  • Prescription drugs provided in the hospital

But there are a lot of essential items missing from that list, and they can become quite expensive to pay for out of pocket. So, what’s not covered by the public healthcare plan? The following services and products are typically the financial responsibility of Canadians:

  • Most prescription drugs
  • Dental care 
  • Vision care
  • Long-term care
  • Ambulance fees
  • Psychological counseling/therapy
  • Registered specialists such as massage therapy, physiotherapy, chiropractic, etc.

While Canadians can feel confident that excellent healthcare benefits cover their basic needs, there are apparent gaps in what’s covered, especially for adults over 18 and under 65. 

It’s here that health and dental insurance can help you bridge the gap between what’s provided by the government and what you need to maintain and elevate your health. Two broad categories of health and dental insurance can help you cover your medical expenses: group insurance through your employer and personal health and dental insurance.

Employer-provided group benefits

Group benefit plans are insurance plans that cover the members of a predefined group. Companies often use them to provide their employees extended health and dental benefits.

Group benefits can help curb the personal expense of ongoing health and dental needs. But sometimes these plans aren’t enough to fully cover your expenses. If you have a child who needs occupational therapy or you’re planning to get braces as an adult, your group plan may not completely cover the costs. 

Knowledge is power, and knowing how much coverage your group benefits provides gives you the information to make informed decisions about extending your coverage with personal health and dental insurance. 

Personal health and dental insurance 

Ready to stop dipping into your rainy day fund to get your teeth cleaned? Personal health and dental insurance may be the best solution for you. With health and dental insurance, you can access extended medical care and treatment without draining your savings or going into debt. 

All health and dental insurance plans will have different annual maximums, service inclusions, premiums, and prescription percentages. Look for a plan that gives you the coverage you and your family need. Think about what life stage your dependents are at, what your current coverage looks like, research your options, and if you have questions, reach out to a professional to ensure you get the best plan for you. 

With a range of plans and coverage tiers, CAA Health and Dental plans, provided by Securian Canada, are designed with you in mind. Find a plan with comprehensive coverage that matches your budget and meets your health and wellness needs.

When should you consider buying personal health and dental insurance?

With government-funded health benefits and employer-provided group benefits, it may be hard to see why some Canadians turn to health and dental insurance. Those two benefit packages working together in a perfect world should be enough, right?

But what about people who don’t have access to employer-provided group benefits? Or those whose benefit packages at work don’t meet the needs of their families? There are a lot of scenarios when considering health and dental insurance just makes sense.

When you’re a freelancer or self-employed

When you work for yourself, odds are you don’t have employer-provided benefits. Unless you’re at the point that you’re offering your employees group benefits, there’s a high chance that you don’t have a health and dental insurance plan for yourself.

As a self-employed worker, business owner, or freelancer, getting a handle on your recurring expenses alone can be challenging. You may generate a different income month-to-month, but having set expenses can help you manage your financial health. Health and dental insurance can reduce out-of-pocket expenses and give you the financial protection that if the unexpected happens, you won’t struggle to make ends meet.

When your work doesn’t offer group benefits

Only some employers are able to offer group benefits to their employees. If you work part-time or for a small business, you may not have access to employer-provided group benefits. Whatever the reason for not having group benefits, personal health and dental insurance can fill that gap and make sure you’re covered for everything from standard dental check-ups to physiotherapy after an unforeseen accident.

When you are retired or are planning to retire soon

If you plan to retire soon or have already retired, you’ll no longer have access to the group benefits through your work. Retiring is a time full of excitement and anticipation, but it’s also an important time in your life to stay on top of your medical and dental coverage. With health and dental, you can ensure that you’re spending more time thinking about how you want to enjoy your golden years, and less time worrying how you’ll handle a large healthcare expense.

As we age, it’s common for our necessary medical visits and interventions to increase. From false teeth, to hearing aids, to physical therapy after a hip replacement, it’s good to be prepared for whatever may come your way.  

When your employer-provided benefits don’t offer enough health and dental coverage

Depending on your unique health and wellness needs, you may find that the combination of universal healthcare and employer-provided benefits leaves you paying more than you’d like out of pocket. A health and dental plan can help manage expenses when this happens. 

If your policies are with different insurance providers, you can hold multiple health and dental insurance plans, a personal plan is the perfect solution to help bridge the gap.  

What are the benefits of personal health and dental insurance?

Routine medical and dental care is the cornerstone of good health. With a health and dental insurance plan, you’re allowing yourself to maintain your health without the added stress of unexpected expenses. 

Here are four benefits of health and dental insurance policies.  

Access the health services you need

Health and dental insurance gives you access to a variety of health and wellness options that may have previously been outside your budget. Most registered specialists, as well as dental care providers, aren’t covered under government-funded healthcare.

So, if you needed anything from a routine cleaning at your dentist, to massage therapy, to counseling, you would be responsible for covering the costs through group or personal benefits or cash. 

With a health and dental plan, you can access care not covered by your provincial or territorial health insurance. Depending on your plan, your health and dental insurance would make it easier to access health services that you might have otherwise ignored. 

Minimize your out-of-pocket expenses

Health and dental procedures, as well as regular ongoing dental care, vision care, and services from registered professionals, can be expensive when you’re paying all of the costs yourself. 

  • The average cost of psychotherapy in Canada is $125-$175 per session.
  • A dental cleaning in Canada can range from $150-$250.
  • The average cost of an eye exam in Canada is $200.
  • Massage therapy will cost an average of $100 per hour.
  • A pair of prescription eyeglasses can cost up to $1,000.
  • Children’s braces can cost between $3,000-$10,000.

It’s easy to see how these costs add up. And while some of these services may be seen as “elective,” there’s no denying the positive impact they can have on your physical and mental health. 

With a health and dental insurance plan, you can feel confident knowing you have access to services without paying the full amount out of pocket. The annual or monthly fee with health and dental insurance is a fixed cost that can be incorporated into a household budget. 

But when you need to pay for unexpected health and dental services, it can add financial stress, especially for the 18.4% of Canadians already living in households experiencing financial difficulties. Health and dental insurance can help you reduce financial stress while maintaining health and wellness.

Prevent health and dental problems

When you make your health and dental care a priority, you can take proactive steps to prevent problems from happening. While government-funded healthcare covers many of the preventative care you need from a health perspective—immunizations, regular check-ups, and blood work—your province or territory may not cover your preventative and ongoing vision and dental care.

The Canadian Dental Association recommends seeing a dentist every six months for routine cleanings and preventative treatment which can cost you between $300-$500 annually. Regular dental check-ups can help you avoid common oral health problems like cavities, gingivitis, and periodontitis. They can also help you catch minor issues like a small cavity before it becomes a bigger problem—like a root canal. 

Visiting the dentist for preventative care can help you avoid other health problems linked to poor oral hygiene, like cardiovascular disease and diabetes.

22.4% of Canadians skip the dentist because of the associated costs.
22.4% of Canadians

With a health and dental insurance plan, you can mitigate those costs and feel confident getting the necessary preventative care. 

Be confident that you’re covered in case the unexpected happens

Dealing with a health or dental emergency is always stressful. You may be in physical pain, worrying about lost time at work, and struggling to manage your home life during the crisis. Add to that anxiety over how you will afford to pay for the necessary treatment, and you can make a dire situation even more stressful.

A health and dental insurance plan gives you access to the appropriate care like physiotherapy, home support services, telehealth services and more, while keeping your finances in order. And you can also cover your children’s health and dental care needs. With an adequate health and dental plan behind you, you can rest assured knowing that you and your family are protected physically and financially. Because you only pay a portion of the cost associated with the needed treatment, you’ll never have to worry about how you’ll afford unexpected or ongoing health and dental care for you and your whole family.

When should you start your supplemental health and dental coverage?

Now that you truly understand the benefit and value of having a personal health and dental insurance plan on your side, you might be wondering when the best time is to start your coverage.

Simply put, the best time is now. You can’t wait until an emergency happens or you’re due for your next check-up. 

Health and dental insurance FAQs

Does the Canadian government cover dental care?

The Canada Health Act (CHA) doesn’t include general dental care. Most Canadians pay for their dental care out of pocket or through group benefits or personal dental insurance. Some dental services are covered under government programs at a provincial level. We’re currently seeing a big push from government political parties to expand dental care to all Canadians, but at the moment, not everyone is eligible. 

Below is a list of provincial government dental programs:

Why can’t you pay out-of-pocket for your health and dental needs?

You can pay for your health and dental needs out of pocket, but the costs can quickly add up. Often, the costs become unmanageable, and instead, individuals end up skipping appointments and check-ups that they need to attend. 

For example, if you need to see a psychotherapist once a week, you could easily be paying up to $700 per month out of pocket. Add to that your bi-annual dental appointments ($300-$500), yearly prescriptions ($1,214 average per year in Canada), and a pair of progressive lens eyeglasses ($1,300), and you can see how quickly the costs add up—and that’s just for one person.

If you have children, you’re also managing their health and wellness expenses. Braces, for example, can cost between $3,000-$10,000. And psycho-educational testing for autism or ADHD can range from $1,500 to over $4,000, depending on the requirements of the assessment.

With health and dental insurance, you pay a fraction of that cost through monthly payments that are easy to manage and incorporate into your household budget. And with CAA Health and Dental Insurance, you can easily cover your children through your plan so you don’t pay out-of-pocket for their health and dental needs

Is private dental insurance worth it in Canada?

Private dental insurance can definitely be worth it in Canada, especially if you have regular dental needs or a family to care for. Basic plans often cover routine check-ups, cleanings, and minor procedures, which can save you money on out-of-pocket expenses. If you anticipate needing more extensive dental work, like fillings, crowns, or orthodontics, having insurance can significantly reduce those costs. Plus, many plans offer benefits like coverage for emergencies and preventive care, helping you maintain good dental health without breaking the bank.

However, the value of private dental insurance depends on your specific situation. Consider your dental health, frequency of visits, and potential future needs. For those with generally good oral health and low dental expenses, a more basic plan might suffice. On the other hand, if you expect higher dental costs, a more comprehensive plan could offer better value. Always compare different plans and their coverage options to find the one that best fits your needs. Consulting with an insurance advisor can also help you make an informed decision tailored to your financial situation and dental health requirements.

What’s covered under health and dental insurance plans?

Every health and dental insurance plan has different inclusions and exclusions based on a unique set of criteria. Most health and dental plans offer coverage for prescription drugs, dental care, vision care, ambulance fees, psychological counseling, therapy, and registered specialists such as massage therapy, physiotherapy, chiropractic, etc. 

CAA Health and Dental Insurance plans, provided by Securian, deliver comprehensive coverage for a range of health needs:

  • Prescription drugs
  • Routine and emergency vision care
  • Routine and emergency dental care
  • Mental health care
  • 24/7 access to Telehealth
  • Extended health coverage benefits including hearing aids, massage therapists, orthotics, and more. 

Is the Canada dental benefit for adults without insurance?

The Canada Dental Benefit is designed to help families with children under 12 who don't have access to private dental insurance. Unfortunately, it does not extend to adults without insurance. The focus of this benefit is to cover basic dental care for kids in lower-income families, ensuring they can get the necessary dental treatments.

For adults without dental insurance, there are other options to explore. Provincial programs like Ontario’s Healthy Smiles or Alberta’s Dental Assistance for Seniors Program offer some support. Additionally, community health centres and dental schools often provide services at reduced rates. It’s worth checking local resources to see what might be available in your area to help cover dental expenses.

What does annual maximum mean for health and dental insurance?

Most health and dental plans have annual maximums for each service they cover. Some plans run on a consecutive month basis, while others apply the maximum for the calendar year, from January to December. CAA Insurance plans are based on Anniversary Year—your maximums reset after each successive 12-month period following the effective date of the policy.

For example, you may have $1,000 in dental coverage, $700 in vision coverage, and $800 for other registered services between January 1, 2024 through December 31, 2024. Once the new year rolls around, your maximums reset for 2025. 

So, if you have a dental visit at the beginning of the year that includes cleaning, polishing, and an exam, the total cost will be applied to your maximum. Later that year, if you chip a tooth and require a repair, the cost will also be deducted from your maximum. If the cost of the second treatment exceeds the yearly maximum, you’ll be required to pay the balance out of pocket. 

Securian Canada is the brand name used by Canadian Premier Life Insurance Company and Canadian Premier General Insurance Company to do business in Canada. Policies are underwritten by Canadian Premier Life Insurance Company.

Marianne Wright

About the Author

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