Health Insurance Access & Affordability in Canada (2025 Study)

Ever put off the dentist, skipped a prescription, or delayed therapy because it was too pricey? You’re not alone. 

A new PolicyMe–Angus Reid study found that 56% of Canadians are putting off health appointments due to cost — some skipping them entirely. It’s not just folks without coverage: 71% of uninsured Canadians are cutting back, but even 52% of those with insurance are doing the same.

We wanted to get a clearer picture of how rising costs and patchy coverage are affecting real-life decisions. The 2025 Insurance Access and Affordability Study shows just how stretched the system is, with Gen Z and retirees starting to slip through the cracks.
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The Choice to Delay Healthcare

Perhaps the most alarming insight? The majority of Canadians, insured or not, are putting off care because of the cost.

• 52% of insured Canadians are skipping, delaying or reducing health appointments, compared to 71% of uninsured Canadians.  
• Dental care is the most commonly delayed service, with 35% of Canadians reporting they’ve skipped or reduced dental visits. 
• This is followed by vision care (28%), physiotherapy, massage therapy, or chiropractic care (24%), and mental health services (21%).
• Younger generations are being hit the hardest, with 66% of Canadians aged 18-34 delaying health services the most of any age group, versus only 58% of those aged 35-54, and 47% of Canadians aged 55+. 

Inside the Numbers

The numbers are clear: even with benefits on paper, affordability still blocks access, especially for those early in their careers. And when coverage kicks in, the need is urgent. Over 50% of PolicyMe customers file a claim within 90 days, a sign many are catching up on delayed care.

The Health Insurance Coverage Gaps You Can’t See

The data revealed that the majority of Canadians (78%) have some form of health and dental coverage, but a deeper look shows that not all age groups are benefiting equally. 

• Older Canadians (55+) are the most likely to be uninsured, with 21% reporting no health or dental coverage at all. 
• The generational data tells a similar story: 21% of Boomers and 20% of Gen Zers say they’re uninsured, suggesting that both early-career instability and retirement gaps are leaving people unprotected. 
• Gen Z is aging out of parental plans and entering a workforce that often lacks traditional benefits, forcing many to navigate healthcare independently for the first time.
• Boomers are transitioning off of employer-sponsored coverage and into a complex individual market.

Inside the Numbers

At PolicyMe, we’ve seen a growing trend of first-time insurance buyers aged 55+, with many entering the individual market after losing their work coverage. For many, it’s their first time navigating policy details in decades — and that alone can delay getting the coverage they need.

Out-of-Pocket Health Spending Taking Its Toll 

When care isn’t delayed or reduced, Canadians are often footing the bill themselves. 

• 29% of Canadians had to pay over $1000 out of pocket in the past 12 months for health or dental-related services, and 9% paid over $3000. 
• Coverage gaps and high costs once again take their toll on older Canadians, with those aged 55+ spending the most of any age group on out-of-pocket expenses, averaging $1,321 in annual spending, compared to only $686 for ages 18-34. 
• Regionally, British Columbians are spending the most of any province on out-of-pocket health and dental-related expenses, costing residents a yearly average of $1188, compared to Saskatchewan, which pays the least at $908. 
• The most common expenses? Dental care is the highest, with 60% of Canadians having paid out-of-pocket for dental care in the past, followed by prescription drugs (55%) and vision care (54%). 

As the Canadian Dental Care Plan (CDCP) rolls out more broadly, the data highlights just how large the gap still is. While the program may offer some relief, especially for lower-income Canadians, it’s unlikely to fully address the widespread and rising out-of-pocket costs for dental care, let alone other health expenses like prescriptions and vision. 

Broader, more accessible coverage options are still needed.

Economic Uncertainty Fuelling Worry Over Insurance Coverage 

Beyond the immediate costs, Canadians are also feeling uneasy over the future of employer-sponsored coverage. As economic instability continues, from inflation and trade wars to recession risks, Canadians are worried their employers may be looking to cut costs by reducing or removing employee benefits. 

• 36% of Canadians are concerned that their insurance coverage could be reduced or eliminated entirely amid the ongoing economic instability. 
• Regionally, British Columbians are the most concerned of any province (43%), while Gen X marks the highest fear of any generation (42%). 

The uncertainty around employer-sponsored coverage may have wider, long-term implications. Without access to adequate coverage, Canadians could further delay care or dip into personal savings to cover gaps, putting both their health and finances at additional risk. 

Health Insurance Coverage: Public, Private, or Out-of-Pocket?

Findings show that Canadians get insurance coverage from a variety of sources, including employers, spouses, parents, and government programs. 

• Employer-sponsored benefits remain the most common form of coverage, with 40% of Canadians relying on a workplace plan. 
• Another 23% are covered through their spouse, partner or parent. 
• As for government support, 11% of Canadians say they’re using the new CDCP, with notable regional differences. Quebecers rely on the CDCP the most of any province (19%), while Albertans use it the least at only 4%.

Inside the Numbers

Employer benefits are still the most common, but we’re seeing a big shift among self-employed Canadians. Nearly 80% of PolicyMe applicants have no prior coverage, many are freelancers, gig workers, or small business owners turning to individual plans to protect against unexpected dental and prescription costs.

Where Do Canadians Go from Here?

This data unveils a growing reality: benefits are no longer a guarantee. High costs of living and economic uncertainty are driving Canadians to make the difficult choice between their health and their financial well-being. 

At PolicyMe, we make it simple to understand your insurance needs and find affordable solutions that fit your life. After all, access to care shouldn’t be a luxury, and planning ahead is one of the smartest ways to protect both your health, and your wallet. 

Bottom line: Coverage gaps are real, but solvable

• Coverage isn’t always simple but getting it can be. We make it easy to find a plan that fits your life.
• When group benefits stop, your health needs don’t. Explore individual health insurance that works for you.
• PolicyMe makes individual coverage simple, fast, and affordable — so you’re not stuck waiting when health issues show up.