How to Compare Health Insurance Providers in Canada

Canada’s public health system covers doctor visits, hospital stays, and medically necessary procedures. But there are many services it doesn’t cover: prescription drugs, dental care, vision, physiotherapy, mental health therapy, and more. For many people on temporary status in Canada, or those still waiting for provincial coverage to begin, private health insurance can help cover medical costs from day one. 

There are many health insurance providers in Canada to choose from. Insurance plans can differ significantly in what they cover, how they pay, and who they’re designed for. This guide walks you through how to compare health insurance providers in Canada so you can choose the best health insurance plan for your situation. 

Key Takeaways

• The best health insurance plan for your needs will depend on how long you need coverage, what services you use, and your health history. 

• Comparing health insurance providers on cost of premiums alone is the most common mistake. 

• Know what to compare when evaluating health insurance providers. Look at coverage categories, reimbursement rates, direct billing, waiting periods, and exclusions. 

• Some health insurance providers let you customize your plan, so you only pay for services you expect to use. 

What Kind of Health Insurance Coverage Do You Need? 

Before you start looking at health insurance providers, it is important take stock of your own situation. Answering the following questions will help you decide which type of plan makes sense and which features matter to you. 

1. How long you need coverage for? Are you a new permanent resident or foreign worker waiting for provincial coverage to begin? Or a visitor planning to stay for a few months? Are you looking for long-term coverage to supplement your provincial or university health coverage? 
2. What services do you expect to use? Prescriptions, dental, vision, mental health, and paramedical services like physiotherapy are common coverage categories, but limits and inclusions vary widely between providers. Knowing your priorities before you start comparing will help you find a plan that best fits your needs. 
3. Do you have a pre-existing health condition that may require treatment or management in Canada? Pre-existing conditions affect whether a plan requires medical underwriting. Some providers exclude certain pre-existing conditions from coverage. 

How to Compare Health Insurance Providers in Canada 

Once you know what you’re looking for, here’s what you should compare across health insurance providers:  

Coverage Availability in Canada 

If you’re purchasing health insurance before you arrive, confirm that any provider you’re considering explicitly covers medical treatment in Canada. Cigna Healthcare, for instance, offers international policies that cover Canada and beyond. 

Not all health insurance providers extend coverage within Canada. Some multinational providers exclude Canada specifically because of the higher cost of care and availability of publicly funded health services. 

Coverage Categories and Limits 

Two providers may cover physiotherapy, but one might pay up to $300 per year and the other up to $800. When comparing your options, it’s important to check not just what’s covered but also to what extent. 

Go category by category and check the annual limits, especially for health services you’re more likely to use, such as prescriptions, dental, vision, or paramedical services. A dental plan with a $1,000 annual maximum might cover cleaning and fillings, but it won’t be sufficient if you need tooth extraction or implants. 

Also check if the health insurance provider sets lifetime and per-claim maximums. A lifetime maximum of $10,000 won’t be very useful if the per-claim maximum is $100. 

Some health insurance providers, like Cigna Healthcare, allow you to customize your insurance plan, so you’re only paying for the coverage you need. You can request a quote online in just two minutes. 

Reimbursement Percentage 

Most private health insurance plans in Canada don’t cover 100% of your costs. A plan might cover 80% of prescription costs, meaning you pay the remaining 20% out of pocket.  

That percentage varies by benefit category and by provider. Knowing the reimbursement rate for the services you use most will give you a more accurate picture of costs than the premium alone. 

Direct Billing 

Direct billing means your health insurance provider pays the clinic, pharmacy, or practitioner directly. You pay little or nothing at the point of care, depending on the reimbursement limit.  

Without direct billing, you pay the full cost upfront and submit a claim for reimbursement afterward. This can take days or weeks and requires filing receipts and paperwork through the insurance provider’s portal. 

Not all health insurance providers in Canada offer direct billing. Moreover, some clinics or pharmacy networks only accept direct billing to certain insurance providers. But direct billing can be a convenient option, especially if you have limited cash flow. 

Waiting Periods 

Many private health insurance providers impose waiting periods before certain benefits begin. If you’re buying insurance because you need a specific coverage soon, check this carefully. 

Dental coverage is a common example. A plan may cover dental services, but not for the first three to six months after you enroll. Major restorative work like crowns or root canals might have longer wait periods than basic preventive care. 

Pre-existing Condition Exclusions 

Some health insurance providers require to you answer health questions during the application. These plans typically require medical underwriting and may exclude conditions you already have. Or the provider may decline your application altogether if you have a pre-existing condition.  

Guaranteed issue plans skip the health questions and accept most applicants. But they often come with lower annual limits or higher premiums to offset the added risk. Neither option is universally better. The right health insurance plan for you will depend on your health history and what you need covered. 

Premium Cost vs. Coverage Value 

Affordable health insurance in Canada exists, but the cheapest plan may not necessarily be the best value. A lower monthly premium usually means lower annual limits or fewer covered categories. The question to ask here is what will this provider reimburse for the services you’re likely to use? 

The premium cost also varies by province, age, and the level of coverage selected. Ontario tends to have higher private health insurance costs than Atlantic Canada or Quebec, partly due to demand and cost of living.  

Claims Process and Customer Support 

When you’re navigating the healthcare system in a new country, a cumbersome claims process can be extremely inconvenient and can even affect your financial situation. 

So, it’s important to assess how easy it will be to actually use the plan. Some providers offer an app with digital claims submission and same-day processing. Others rely on paper forms and phone calls.  

Check whether the provider has English and French support and what their average processing time is. It’s also a good idea to go through customer reviews and see what kind of experience others have had with the insurance provider. 

Steps for Choosing a Health Insurance Provider 

Once you have a clear picture of what you need, here’s how to move from comparing to choosing the right health insurance provider. 

1. Check your provincial health insurance eligibility. If you are eligible, find out whether a waiting period applies to your immigration status and the province you’re settling in. This determines how long you’ll need private coverage and what kind of plan makes sense. 
2. List your actual health priorities. This is what you’ll use to evaluate coverage categories and limits across providers. 
3. Determine whether you need travel health insurance or a long-term health insurance plan. If you plan to be in Canada for less than 4 months, a travel insurance plan that covers emergency care may be enough. 
4. Research and make a list of popular health insurance providers. Make sure they cover Canada, have good user reviews, and offer the coverage you want. Our partner, Cigna Healthcare, is a leading health insurance provider that offers flexible plans. 
5. Get quotes from providers. Average premiums listed on the internet don’t mean much. Get customized quotes using your age, province, and health situation. 
6. Compare coverage limits per category. Look beyond just the monthly premium. For each provider, check the annual limit and reimbursement percentage for your priority benefits to ensure you’ll have adequate coverage. 
7. Ask about direct billing. If cash flow is a consideration in your first months in Canada, this is worth confirming before you buy. 
8. Read the fine print. Before you purchase a policy, read the terms and conditions about waiting periods, pre-existing condition exclusions, and renewal terms. 

FAQs About Choosing Health Insurance 

What is the Best Health Insurance in Canada? 

There is no single best health insurance provider in Canada. The right choice depends on your situation: how long you need coverage, which province you’re in, what services you expect to use, and whether you have pre-existing conditions. Comparing your specific needs against what different health insurance providers offer will help you make a better choice. 

Ideally, you want to pick a provider that gives you flexibility, both in terms of what your policy covers and the coverage amounts. If you have provincial coverage, you also want to avoid paying for services that the provincial health insurance covers, such as doctor visits or emergency care. 

Our partner, Cigna Healthcare, offer plans that can be tailored to fill the gaps between your provincial coverage and the holistic coverage you need. 

How Much Does Health Insurance Cost in Canada? 

Private health insurance in Canada typically runs between $150 and $500 per month for an individual, depending on your age, province, and level of coverage. Basic plans that cover emergency care will be cheaper than plans that also include out-patient care, or add-ons such as dental care or massage therapy. 

Some providers like Cigna Healthcare, let you adjust the deductible and add or remove coverage modules to modify premium costs.   

Can I Get Health Insurance Before Arriving in Canada? 

Yes. Several health insurance providers offer plans that can be purchased before you land. If you’re doing this, confirm the plan covers care within Canada. 

What is the Cheapest Health Insurance in Canada? 

The cheapest options are typically short-term visitor or travel insurance plans. These can start around $50 to $85 per month for emergency coverage. If you have pre-existing conditions to cover, the cost will be higher. 

Cheaper plans usually have lower annual limits and higher out-of-pocket costs. Make sure you compare total value, not just monthly premium.