All guides
Private health insurance in Canada, explained: what provincial plans don't cover, group vs individual plans, drug and dental coverage, CDCP, Quebec's RAMQ rules and tax credits.
Coverage Gaps, Costs and 2026 Rules
- Canadian Dental Care Plan: who qualifies, co-payments and how it fits with private dental insurance
CDCP eligibility explained: the $90,000 income limit, the no-access-to-dental-insurance rule, co-payment tiers, extra charges, renewal and when private dental cover is better.
- Group vs individual health insurance in Canada: how they differ and which to choose
Employer group benefits versus individual health and dental plans in Canada: underwriting, maximums, premiums, taxes, Quebec rules and what happens when you leave a job.
- How individual health insurance is priced in Canada: the factors behind your premium
What sets the price of an individual health and dental plan in Canada: age band, province, plan level, underwriting, family size, taxes and why premiums rise at renewal.
- National pharmacare in Canada in 2026: what the Pharmacare Act covers and what it changes for you
Where national pharmacare stands in 2026: the Pharmacare Act, first-phase coverage of contraception and diabetes drugs, provincial agreements and what it means for private plans.
- Private health insurance in Canada: what it covers, what it costs and when you need it
How private and group health insurance fits around provincial plans in Canada: the gaps it fills, how plans are priced, public programs to check first and how to decide.
- Provincial drug programs in Canada compared: who gets public prescription coverage
How public drug coverage works in each province: seniors' plans, income-based programs like Trillium and Fair PharmaCare, youth coverage, and how they work alongside private plans.
- Quebec drug insurance: when you must join a private group plan and when RAMQ covers you
How Quebec's mandatory prescription drug insurance works: private group plan obligation, RAMQ public plan, premium on the tax return, deductible and coinsurance, age 65 and taxes.
- What OHIP, MSP, RAMQ and other provincial health plans don't cover
The services Canadian provincial health plans leave to you, including drugs, dental, vision, therapy and ambulance fees, with the exceptions for children, seniors and low incomes.
Worked Costs and Plan Checklists
- How to choose a health and dental plan in Canada: a step-by-step checklist with numbers
A practical checklist for choosing, switching or dropping supplementary health and dental coverage in Canada, with worked arithmetic and the clauses to check first.
- Coinsurance, deductibles and annual maximums in Canadian health plans, with worked numbers
How deductibles, coinsurance, per-visit limits, annual and lifetime maximums and dispensing fee caps decide what a Canadian health or dental plan actually reimburses.
- Coordination of benefits in Canada: claiming under your plan and your spouse's plan
How coordination of benefits works when you and your spouse both have health or dental plans in Canada: which plan pays first, the birthday rule for children and a worked claim.
- Dental insurance vs paying the dentist yourself in Canada: when a dental plan pays off
Compare an individual dental plan with paying out of pocket in Canada: fee guides, coinsurance tiers, waiting periods, annual maximums, CDCP and a three-year worked example.
- Is individual health insurance worth it in Canada? Break-even maths for a real household budget
Work out whether an individual health and dental plan pays for itself in Canada: break-even formula, three household examples, the tax credit effect and when insurance is for protection.
- Losing group health benefits in Canada: conversion plans, deadlines and your options
What to do when employer health and dental benefits end after a job loss, layoff or retirement in Canada: conversion deadlines, guaranteed-issue plans, Quebec RAMQ and a cost comparison.
- Medical expense tax credit in Canada: a worked example with premiums, dental and drugs
How to calculate the federal medical expense tax credit step by step: the 3% threshold, the 12-month period, which spouse claims, eligible premiums and Quebec's separate credit.
- Health and dental insurance for the self-employed in Canada: plans, deductions and health spending accounts
Options for self-employed Canadians and small business owners: individual and association plans, deducting premiums, health spending accounts, Quebec rules and a worked tax comparison.
Claim Problems, Mistakes and Official Sources
- Health or dental claim denied in Canada? How to appeal and where to complain
Step-by-step: what to do when a health, drug or dental claim is refused in Canada, from the insurer's internal review to OLHI and provincial regulators, with a sample appeal outline.
- Common private health insurance mistakes in Canada and how to avoid them
The costly mistakes Canadians make with health, drug and dental coverage: gaps between plans, missed deadlines, non-disclosure, duplicate coverage and claims refused on technicalities.
- Moving to another province: keeping health, drug and dental coverage without a gap
How provincial health coverage transfers when you move within Canada, the up-to-three-month rule, Quebec's billing differences, drug programs and what to update in a private plan.
- New to Canada: covering the provincial health insurance waiting period
Which provinces make newcomers wait for public health coverage, how to bridge the gap with private visitor or newcomer insurance, what it covers and what to check before buying.
- Official sources for health, drug and dental coverage in Canada: who to check for what
Where to verify Canadian health coverage rules: provincial health plans, Health Canada, CDCP, CRA and Revenu Québec, RAMQ, insurance regulators and complaint bodies, with what each covers.
- Pre-existing condition exclusions in Canadian health insurance: how they work and your options
How individual health plans in Canada treat pre-existing conditions: look-back periods, exclusion riders, guaranteed-issue alternatives, disclosure duties and what to do if you are declined.