How does health insurance work in Canada?

[dphotawala]

Hi,
Could someone please explain how health insurance works in Canada? Last I heard was that Canadian govt provides health insurance for free. However, some random person recently told me that it's not true.

FYI, I would like to know the input free of employer provided insurance; meaning, where do I stand if unemployed and on PR status.

 

[steaky]

The federal government of Canada does not provide each individual health insurance for free. What you heard was merely rumours.

 

[Copingwithlife]

Hi,
Could someone please explain how health insurance works in Canada? Last I heard was that Canadian govt provides health insurance for free. However, some random person recently told me that it's not true.

FYI, I would like to know the input free of employer provided insurance; meaning, where do I stand if unemployed and on PR status.

Start here

https://www.canada.ca/en/health-canada/services/canada-health-care-system.html

And btw it is not free. That is a widely circulated misnomer. Some provinces charge a monthly/quarterly fee based upon income. Some roll it into your taxes based upon income. Like they say, Nothing is ever free. You gotta pay for it somewhere. It may not be perfect, but it gets the job done in times of need. Example. Over Xmas I was sick in Alberta, showed the Dr in Alberta my OHIP card from Ontario. Alberta bills Ontario, I paid nothing except for the prescription.
You would have to search online for how each province handles their medical care. However just because you are unemployed does not mean your healthcare coverage is cut off. I was unemployed for one year. My healthcare continued.However, when my job stops, that also meant my prescription/dental coverage stopped. Any prescription I had to get during that period I personally had to pay for. There was nothing paid by my insurance provider connected to my job I had lost

 

[Anna007]

You have to apply for government insurance and it usually takes about 3 months to get a card. Government insurance is not free though, the price ranges ;for example MSP cost is 37.50 CAD a month for residents of BC.
To be covered during the waiting period (for these 3 months) I recommend to get private insurance plan.

 

[canuck78]

Every province has a different plan and there can be up a 3 months before you receive coverage. Some have modest premiums. There are many things that are not covered under healthcare plans including medication, dental, vision, physiotherapy, many medical devices. There are also residency requirements that you need to fulfill to qualify or you could be asked to pay back. When settling in Canada the residency requirements make it hard to switch provinces in the year that you land especially the first 6 months. I would google.

 

[APPNOV2014NY]

What do people normally do for coverage of medication, dental, vision, physiotherapy, many medical devices?

 

[canuck78]

What do people normally do for coverage of medication, dental, vision, physiotherapy, many medical devices?

They mostly pay out of pocket or don't seek regular care unless necessary when it comes to especially dental. Also people try to find a job with benefits even if it means being paid less especially in a family. Having at least one parent with insurance is a very good idea. There are a whole list of things that are covered on top of this like a semi-private or private room in hospital vs ward room just to name another one.

 

[dphotawala]

They mostly pay out of pocket or don't seek regular care unless necessary when it comes to especially dental. Also people try to find a job with benefits even if it means being paid less especially in a family. Having at least one parent with insurance is a very good idea. There are a whole list of things that are covered on top of this like a semi-private or private room in hospital vs ward room just to name another one.

Assuming I am NOT working for any employer and that I live in Toronto area, what are my options as a first time PR applicant? I would love to know about both, healthcare provided by Canadian govt, plus the additional medical insurance needed to cover for missing items (dental, vision, prescription, etc) not provided via govt healthcare.

 

[canuck78]

Assuming I am NOT working for any employer and that I live in Toronto area, what are my options as a first time PR applicant? I would love to know about both, healthcare provided by Canadian govt, plus the additional medical insurance needed to cover for missing items (dental, vision, prescription, etc) not provided via govt healthcare.

You can google OHIP to see what is covered. Insurance will likely cost more than paying cash but you can look into private coverage. Hard to really comment with very few details about what you're doing in Canada. Clearly you have income or savings to e living without employment.

 

[YVR123]

Echo with the rest, dental, vision, prescription drugs, physiotherapy, ...etc are NOT included in provincial healthcare.
If you don't planned to be employed, buying insurance to cover them is an option but insurance companies are running a valid business.
So you need to do your math to calculate the cost of getting the insurance vs the cost of paying out of pocket.
Even for people who get extended coverage from our jobs, not all the procedures are covered. (e.g. It's common that there is a limit for how much major dental work is covered per year, so you could still have to pay out of pocket if something really expensive needed to be done)

 

[canuck78]

Coverage limits on most things. You only have so many physiological appointments per year for example. Coverage is usually not 100% it is often something like 80%. There also can be long waits to see specialists. Waiting 9 months to see a particular GI specialist. Thankful for our system but the sicker you are the more you realize what isn't covered. Also things like public longterm care (nursing home) involve parents contributing a good chunk of their monthly pension so if you want to sponsor your parents you'll be paying that fee. Also the care isn't great so you will need to be there or maybe hire extra care. I find many immigrants have very unrealistic expectations of what they will receive under the healthcare plans like daily care in the home by a nurse but lots of Canadians also have unrealistic expectations. If a family member has health issues be prepared to take on quite a lot of the expenses and be the primary caregiver. In many cases families would be better off in their home countries where they can pay for a lot more care and therapy.

 

[dphotawala]

Coverage limits on most things. You only have so many physiological appointments per year for example. Coverage is usually not 100% it is often something like 80%. There also can be long waits to see specialists. Waiting 9 months to see a particular GI specialist. Thankful for our system but the sicker you are the more you realize what isn't covered. Also things like public longterm care (nursing home) involve parents contributing a good chunk of their monthly pension so if you want to sponsor your parents you'll be paying that fee. Also the care isn't great so you will need to be there or maybe hire extra care. I find many immigrants have very unrealistic expectations of what they will receive under the healthcare plans like daily care in the home by a nurse but lots of Canadians also have unrealistic expectations. If a family member has health issues be prepared to take on quite a lot of the expenses and be the primary caregiver. In many cases families would be better off in their home countries where they can pay for a lot more care and therapy.

Does American insurance work in Canada? Just curious..

Do you have any insurance provider that you would suggest. I am a 29 year old male with no major medical history.

 

[dphotawala]

You can google OHIP to see what is covered. Insurance will likely cost more than paying cash but you can look into private coverage. Hard to really comment with very few details about what you're doing in Canada. Clearly you have income or savings to e living without employment.

Most likely, I will be working on a remote consulting job - Kinda offshore contractor. And my clients won't be from Canada.

 

[snowflayc]

Does anyone have experience with moving from ON to BC and changing their health insurance? I have been covered with OHIP once in Toronto, but not sure how exactly it works here in Vancouver, BC. Any insights are appreciated!

 

[Steevy]

Does anyone have experience with moving from ON to BC and changing their health insurance? I have been covered with OHIP once in Toronto, but not sure how exactly it works here in Vancouver, BC. Any insights are appreciated!

Unlike ON, in BC you pay $37.50 per person for the provincial insurance plan (unless you qualify for premium assistance, in which case it is a lower rate). When you are changing provinces of residence, you should notify OHIP that you are leaving Ontario and will be residing in BC, so that your current OHIP coverage is still in effect during BC MSP waiting period (2 full months + the remainder of the month when you arrive in BC). You should also apply for BC MSP plan as soon as you arrive as it takes some time to have your application processed.

Here is the source - https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/msp/bc-residents/eligibility-and-enrolment/how-to-enrol/coverage-wait-period

As for your OHIP coverage during your transition to MSP, OHIP will cover certain services outside ON i.e. physician services and hospitalization as long as it is considered medically necessary - https://www.ontario.ca/page/ohip-coverage-across-canada