Best Health Insurance in Canada Ratings & Methodology

How we found the best health insurance in Canada

Nobody should put off healthcare, which is why we streamlined the research process by ranking the best health insurance plans in Canada. Our rankings are based first on star rating (from highest to lowest) and then on price (from lowest to highest).

Below, we explain the thinking behind every star and our data sources.

About star ratings

Here’s the recipe for PolicyMe’s star ratings, from most to least important. Every health insurance plan in our study gets a star rating based on: 

• Financial stability
• Customer satisfaction
• Affordability
• Value for money

Star ratings are rounded to the nearest half-star. To ensure the quality of our recommendations, PolicyMe’s rankings exclude less than three-star health insurance plans. 

Financial stability 

Financial stability reflects a company’s ability to fulfill its financial obligations, including paying your health insurance claims. You and your loved ones should be able to count on reimbursement for important medical care, which is why we consider it a must-have for health insurance.

We use two criteria to measure financial stability:

1. An “A-” credit rating or higher from a respected agency such as A.M. Best, Morningstar, DBRS, or S&P Global
2. Membership in Assuris

Customer satisfaction

Encompassing customer service, ease of purchase, communication, and more, a high customer satisfaction score is essential to choosing the right health insurance provider. You should be able to get all your coverage questions answered and receive reimbursement promptly so you and your loved ones receive the care you need. 

To ensure fairness, we recorded only the Google Reviews score of each health insurance provider’s Canadian headquarters. Using a single score prevents providers with lots of brick-and-mortar locations from gaining an advantage (or suffering a disadvantage), and head offices tend to receive a higher number of reviews.

Health insurance providers with a Google Reviews score of 4.0 or more earn one star for all their products. 

Affordability

Affordability is essential because if you can’t afford your health insurance premiums, you can’t keep your plan. We measure affordability by comparing plan prices to the industry average and expressing the difference as a percentage. For example, “above the industry average” means the plan costs more than the average for similar plans.

To ensure fairness and accuracy, we always compare health insurance rates to the industry average for plans:

• In the same coverage category (drug and dental, no drug, no dental, or high drug)
• In the same price tier (basic, mid, or premium)
• With the same eligibility requirements (guaranteed, replacement, or underwritten)
• And for the same age group, sex at birth, and home province.

Health insurance plans that cost less than the industry average receive a half-star for affordability. 

For example

We compare the cost of a guaranteed, mid-tier, no dental health insurance plan for a 34-year-old man in Saskatchewan with the industry average for all guaranteed, mid-tier, no dental plans priced for the same customer profile in Saskatchewan. We calculate costs for “Canada” by averaging the premiums of 8 provinces (Alberta, British Columbia, Manitoba, New Brunswick, Nova Scotia, Ontario, Quebec, and Saskatchewan).

Value for money

Value for money measures how much coverage you receive versus the monthly premiums you pay. Although the advantages of having health insurance can extend beyond the dollar value of its coverage (for example, by covering the right services for your family), a cost-benefit analysis is a good place to start.

To get an accurate picture of the total value of each health insurance plan, we calculated the out-of-pocket costs associated with claiming the maximum amount possible during the first year of enrollment. In other words, what’s the minimum you have to spend to claim the maximum coverage possible during your first year with a new plan?
‍

For example

Let’s say Plan A reimburses 70% of your visits to 10 paramedical practitioners (up to $650 per year combined), while Plan B reimburses 90% of your visits, but only up to $55 per visit and $250 per practitioner per year.

Plan A offers up to $650 per year, with $279 in out-of-pocket costs (($650 / 0.7) - $650) for a total value of $371 ($650 - $279). Laying aside the per-visit maximum, Plan B offers up to $2,500 per year ($250 x 10), with $278 in out-of-pocket costs (($2,500 / 0.9) - $2,500) for a total value of $2,222.

Your choice may seem obvious, but these calculations omit several details. If you use Plan B and each visit costs over $55, the out-of-pocket cost will be higher and the total value lower. Meanwhile, you can claim $650 per year with Plan A by visiting one or more types of practitioners, but you have to visit at least three types to get your money’s worth out of Plan B.

To make our coverage calculations workable, we had to make several omissions and assumptions:
‍

• Our calculations represent the total value of a health insurance plan during the first year of enrollment only.
• Plans that cover prescription dispensing fees do not factor the extra value into their total value calculations.
• Plans with a per-prescription deductible use $22.33 (the average cost of a generic prescription in Canada in 2023) to calculate out-of-pocket costs.
• Plans with coverage “per injury”, “per accident”, or “per lifetime” are compared directly to plans whose coverage applies per year, assuming one injury or accident per year.
• Plans with different types of dental coverage use only the highest reimbursement rate to calculate the maximum claimable coverage.
• Plans with per-visit limits do not factor the average cost of visiting a professional in the relevant coverage category into out-of-pocket costs.
• Plans with unlimited coverage are not awarded extra value over the plan(s) with the highest amount of coverage in the relevant category.
• The value of accidental death and dismemberment, travel insurance, and other add-ons is not reflected in a plan’s total value.

Using these assumptions, we carefully calculated the total value of 60+ health insurance plans in three categories–preventive (dental and vision); injury recovery and chronic condition care (prescription drugs, paramedical, and mental health); and hospitalization (accidental dental, ground ambulance, air ambulance, and hospital cash)–by subtracting out-of-pocket costs from stated annual maximums. 

We then compare the value of each plan in each category to every other plan in the running. For example, if we’re evaluating the best health insurance plan for kids in Ontario, we compare the value provided by all mid-tier, guaranteed or underwritten no-drug health insurance plans against each other. As such, a plan’s value can change depending on the available competition.

Plans offering more value than other entries receive up to one extra star. Generally, a plan must offer top value in at least one category to receive a half-star, and at least two categories to receive a full star.

About the data

PolicyMe’s rankings pair 1,700+ quotes with hours of meticulous research on health insurance providers, perks, and customer ratings. Here’s what we found and where we found it, from most to least used:

PolicyMe’s findings are based on unaltered data and are free from paid placements or sponsored influence. While we strive to keep our information current, we cannot guarantee the accuracy of third-party data. These rankings are intended as a general reference and should not be considered a substitute for personalized financial or health advice.

FAQ: Best health insurance methodology