Health Insurance by Province: What’s Covered in Canada

How health insurance works in Canada
Canada’s health care system splits the responsibility for providing universal public health insurance between the federal Government of Canada and the provincial and territorial governments.
Under the Canada Health Act, the federal government provides funding and upholds standards for provincial and territorial healthcare systems. The federal government also administers and provides medical coverage for veterans, refugees, inmates, and First Nations and Inuit people living on reserves, as well as members of the Canadian Armed Forces and their families.
Provincial and territorial governments, on the other hand, decide which health services are medically necessary and create their own public insurance plans. Assuming you don’t receive health insurance coverage directly from the Government of Canada, all you need to access your province or territory’s health care system is a valid health insurance card.
Each provincial health insurance plan covers a different set of services, but none cover the full cost of routine healthcare for Canadians. That’s why private health insurance exists: to help Canadians across the country balance the cost of comprehensive care.
What does public health insurance cover?
By law, provincial and territorial public health insurance must cover all medically necessary health services in Canada. While each regional government decides what’s “medically necessary,” these four services are always covered:
Public health insurance also covers the cost of emergency hospital services outside of Canada, but reimbursement is limited to public coverage. In other words, if a foreign hospital or physician bills more than what you’d pay in your home province or territory, it’s up to you to make up the difference.
Who is eligible for public health insurance in Canada?
In order to access public health care in Canada, you must have a valid health card. Health card requirements vary by province and territory, but in general, you must prove:
Once you’ve successfully registered for a health card, it’s your responsibility to renew it every 5 years or so.
What doesn’t public health insurance cover?
As you’ve noticed, public health insurance is essentially limited to doctor visits and medical treatments performed in a hospital. It leaves out several important types of coverage, including the big three: dental insurance, prescription drug insurance, and vision insurance.
Even with a provincial or territorial health card, you’ll have to pay for the following out of pocket:
That’s not to say you’re completely on your own. Children, seniors, low-income Canadians, and other vulnerable populations may qualify for financial assistance and extended health benefits through public health insurance and other programs.
Public health insurance coverage by province
Canadian public health insurance covers most medically necessary treatments and interventions that you can access through a hospital or a general practitioner. Unless you qualify for extended health benefits, most provinces and territories ask you to pay for dental care, prescription drugs, mental health services, and more out-of-pocket.
The table below compares the biggest gaps in Canadian provincial healthcare plans. The coverage categories are as follows:
- No coverage: The provincial healthcare plan doesn’t cover this service for any age group. (Note: In some cases, full or partial coverage may be available for low-income households.)
- Partial coverage: Everyone in the province has access to some coverage, but the provincial plan may only cover certain services or pay less than 100% of the cost.
- Seniors: Residents aged 65 years or older have access to coverage.
- Children: Residents under 18 years old have access to coverage. (Note: Eligible age ranges may vary by province and service category.)
- Eligible conditions: Residents diagnosed with an eligible condition (e.g. specific disabilities, cancer, or certain mental health conditions) qualify for full or partial coverage.
Public health insurance in Ontario
What’s covered? Public health insurance in Ontario covers all medically necessary hospital and physician services, plus dental and vision services performed in a hospital, under the Ontario Health Insurance Plan (OHIP), which is administered by the Ontario Ministry of Health.
Where can I get more coverage?
See OHIP’s health care services and Ontario Health’s clinical programs directory for more.
What to look for in a private health insurance plan: Ontario residents ages 25+ and those with moderate to high incomes need dental, prescription, vision, and paramedical insurance so they don’t miss essential preventative services.
Public health insurance in British Columbia
What’s covered? Public health insurance in British Columbia covers all medically necessary hospital and physician services, plus dental and vision services performed in a hospital, under the Medical Services Plan (MSP). All BC residents are eligible for income-based coverage of most prescription drugs, including contraceptives, diabetes supplies, nicotine replacement therapies, and Paxlovid, through the Fair PharmaCare program.
Where can I get more coverage?
See Child Health BC, Healthy Kids, Supplementary Benefits, Supplements and Programs, Family and Social Supports, SeniorsBC.ca, and BC PharmaCare Plans for more.
What to look for in a private health insurance plan: The average BC household pays the highest amount out-of-pocket for dental services in Canada, making good dental insurance a must. The same goes for paramedical services such as acupuncture, massage therapy, and physiotherapy.
Public health insurance in Alberta
What’s covered? Public health insurance in Alberta covers all medically necessary hospital and physician services, plus dental and vision services performed in a hospital, under the Alberta Health Care Insurance Plan (AHCIP). Certain dental surgeries are covered under the Oral and Maxillofacial Surgery Benefits program, while the Continuing Care System provides all Albertans with financial assistance with home and community care.
Where can I get more coverage?
See Alberta Child Health Benefit, Children’s Mental Health, Health Services and Benefits and Seniors Health Benefits pages for more.
What to look for in a private health insurance plan: Alberta’s provincial health plan covers a large range of dental surgeries and consultations, but it still doesn’t cover routine cleanings, fillings and other essential oral health services. With a comprehensive health plan, you can fill the gaps in the province’s public dental, prescription drug, and vision coverage.
Public health insurance in Manitoba
What’s covered? Public health insurance in Manitoba covers all medically necessary hospital and physician services, plus dental and vision services performed in a hospital, under the Manitoba Health Services Insurance Plan (MHSIP).
Where can I get more coverage?
See Health Coverage, Disability and Health Supports Unit, and Financial Benefits and Assistance for more.
What to look for in a private health insurance plan: Besides the usual dental, prescription drug, and vision insurance, Manitobans need coverage for health care supplies and equipment. The average Manitoban household paid over $1,000 out-of-pocket in this category alone in 2023. PolicyMe’s private health insurance covers up to $4,000 worth of home care, prostheses, and durable medical equipment per year.
Public health insurance in Saskatchewan
What’s covered? Public health insurance in Saskatchewan covers all medically necessary hospital and physician services, plus dental and vision services performed in a hospital, under Saskatchewan Health coverage.
Where can I get more coverage?
See the A-Z Directory of Health Topics and Services; Infant, Child & Teen Health; Seniors’ Services and Health Services in Your Area for more.
What to look for in a private health insurance plan: Saskatchewan pays the second-highest average amount per household for eye care, and health care supplies and equipment in the country. Opting for a private health insurance plan can save you an average of $1,300 per year on both expenses.
Public health insurance in Nova Scotia
What’s covered? Public health insurance in Nova Scotia covers all medically necessary hospital and physician services, plus dental and vision services performed in a hospital, under Medical Service Insurance (MSI).
Where can I get more coverage?
See the Health and Wellness Initiatives, Programs and Services for more.
What to look for in a private health insurance plan: Moderate and high-income Nova Scotians between the ages of 18-64 don’t receive dental, prescription drug, or vision coverage. PolicyMe offers the least expensive private health insurance plan with all three of any health insurer in the country.
Public health insurance in New Brunswick
What’s covered? Public health insurance in New Brunswick covers all medically necessary hospital and physician services, plus dental and vision services performed in a hospital, under Medicare.
Where can I get more coverage?
See the Accessing Health Care and Health and Wellness pages for more.
What to look for in a private health insurance plan: New Brunswick’s public health insurance plan has some of the most robust benefits of any provincial health plan, but it still has gaps. A private health insurance plan with dental, prescription drug, and vision coverage can help you save an average of 80% of your out-of-pocket health expenses.
Public health insurance in Newfoundland and Labrador
What’s covered? Public health insurance in Newfoundland and Labrador covers all medically necessary hospital and physician services, plus dental and vision services performed in a hospital, under the Medical Care Plan (MCP).
Where can I get more coverage?
See Health and Community Services for more.
What to look for in a private health insurance plan: Newfoundland and Labrador’s public health insurance plan has no major coverage gaps aside from the usual. A private health insurance plan with dental, prescription drug, and vision coverage can help ensure your family receives important health care services and supplies.
Public health insurance in Québec
What’s covered? Public health insurance in Québec covers all medically necessary hospital and physician services, plus dental and vision services performed in a hospital, under the Régis d’Assurance Maladie du Québec (RAMQ).
Where can I get more coverage?
See the RAMQ's page for Aid Programs and Programs and Services for Seniors for more.
What to look for in a private health insurance plan: Prescription drug insurance is compulsory for Québec residents 18 and over. PolicyMe’s private health insurance plans offer $500-$2,600 of prescription drug coverage (plus a ton of other perks).
Do I need private health insurance in Canada?
Canadian public health insurance has several major coverage gaps that you can address with group health insurance or private health insurance. You can get group health insurance through your employer or organization, or buy the private health insurance coverage you need online.
Self-employed Canadians, retirees, or anyone between jobs can only fill provincial healthcare gaps by purchasing a private health insurance policy. If you regularly access services not covered by public health insurance, private coverage could mean year-to-year savings and peace of mind for both you and your loved ones.
To see if you need a private plan, add up the cost of every health-related product and service you paid for last year. Unless you qualified for conditional coverage under a provincial or territorial health program, you likely spent thousands of dollars per year on uninsured products and services:
* Figures reflect the average amount paid out-of-pocket for select health products and services per Canadian household in 2023, adjusted for 2025 using the Bank of Canada inflation calculator.
** Total cost figure represents combined monthly premiums for adults aged 21-44 on PolicyMe’s Guaranteed Issue Classic plan for a 12-month period.
How to choose the best health insurance plan based on your province
To choose the best private health insurance plan in your province, start by considering the coverage your province offers:
- Make sure you’re maximizing existing coverage: Review the coverage included in your province’s public healthcare plan, along with any group benefits you’re eligible for through your job (or your partner’s). Are you taking advantage of all your existing healthcare coverage?
- Identify your personal healthcare gaps: What health expenses are you regularly incurring that aren’t covered by your public or group coverage — e.g. dental costs, vision care, paramedical services, or prescription drugs? These costs are different for everyone; estimate your total.
- Review insurance plans: Each insurance company offers a unique set of health insurance policies with different coverage, limits, deductibles, and exclusions.
- Avoid overlapping coverage: Don’t overpay for a health or dental care plan that overlaps significantly with the coverage you already have through your province or employer.
- Consider additional coverage: If you also need life insurance, critical illness insurance, or other coverage typically included in workplace benefits packages, there may be advantages to buying them from a single insurer.
PolicyMe’s health and dental insurance plans are designed with provincial coverage gaps in mind, with four distinct tiers of coverage to match your individual needs.
“Paramedical benefits and mental health services are underused and overlooked in all of our individual health plans. PolicyMe has some of the best coverage in the industry for these services.” –Jeremy Burbano, Licensed Insurance Advisor
How much does private health insurance cost in Canada?
The cost of private health insurance varies by province, product, and age group.
Fortunately, the best health insurance in Canada is also the least expensive. PolicyMe’s comprehensive health insurance includes dental, prescription drug, vision coverage, and more, starting at $71.26 per month for a Canadian resident age 21-44:
How much can private health insurance save you?
While your exact savings will depend on your healthcare expenses and which private health insurance plan you choose, our research suggests that most Canadian households can save between $1,000 and $2,000 per year.
We compared the healthcare expenses of the average Canadian household in every province to the coverage included in PolicyMe’s three comprehensive health insurance plans. Assuming every expense qualified for coverage, the amount saved ranged from $800 - $2,198 per year:
* Figures represent the average total amount spent on selected health-related products and services per Canadian household in 2023.
Methodology
For this article, we consulted only the official Canadian national, provincial, and territorial websites for public health insurance information and resources. Always consult your province or territory’s health system directly for up-to-date coverage and program details.
Statistics Canada provided the data on healthcare-related spending per household in 2023. While calculating the amount saved with private health insurance, we assumed every expense qualified for coverage and incorporated PolicyMe’s health plan maximums.
The resulting calculations are presented for illustrative purposes only.
FAQs: Health Insurance by Canadian Provinces

Jasmine specializes in converting complex insurance data into actionable guidance. Her background includes auto, life, and health insurance and financial planning. Lately, she’s leveraging AI to extract insights from the numbers and help Canadians make better decisions.
Jasmine specializes in converting complex insurance data into actionable guidance. Her background includes auto, life, and health insurance and financial planning. Lately, she’s leveraging AI to extract insights from the numbers and help Canadians make better decisions.
Prices listed on this page are based on information available as of October 2025. The prices shown are for general reference only and may vary based on factors like your age, location, and product selection.