Private Health Insurance in Ontario
Ontario Health Insurance Plan (OHIP) covers many essential physician and hospital services. However, it does not cover every health-related expense. Many residents still pay out of pocket for prescription drugs, dental care, vision care, physiotherapy, and other services.
Private health insurance can help cover some of these costs. It may suit self-employed individuals, employees without adequate workplace benefits, and international students who need eligible coverage. Our advisors compare plans from multiple insurers to help you find suitable benefits within your budget.
Private health insurance fills exactly those gaps. Whether you are self-employed with no group plan, an employee whose employer benefits do not fully cover your needs, or an international student living and studying in Ontario, a private health insurance policy provides the coverage that OHIP does not — giving you access to the care you need without paying entirely out of pocket. We work with multiple leading insurers to find the policy that best complements your existing coverage and fits your budget.
What OHIP Does Not Cover
Understanding exactly where OHIP coverage ends is the first step to understanding what private health insurance can do for you. The following health-related services and expenses are not covered or are only partially covered by Ontario’s provincial health plan:
Prescription medications:
OHIP does not cover most prescription drugs for working-age adults. Some residents may qualify for assistance through Ontario’s Trillium Drug Program. Private insurance may help pay eligible medication costs.
Dental care:
OHIP generally does not cover routine dental exams, cleanings, fillings, crowns, or orthodontic treatment. These expenses can add up quickly. A suitable private plan may help cover eligible dental services.
Vision care:
Coverage for eye exams depends on your age and eligibility. Many working-age adults pay for routine eye exams, glasses, and contact lenses themselves. Check your eligibility and policy benefits before choosing a plan.
Physiotherapy:
Many residents pay privately for physiotherapy and rehabilitation. These costs can continue over several visits. Individual or workplace health insurance may cover eligible treatments up to the plan’s limits.
Chiropractic care:
Many adults pay out of pocket for chiropractic treatment. If you use these services regularly, compare plans that include eligible chiropractic benefits.
Hearing aids and audiology:
Hearing aids can be a significant expense. Some private health plans provide benefits for eligible hearing aids and audiology services. Check the benefit limits and replacement rules.
Mental health services:
OHIP coverage depends on the provider and service. Private psychologists and registered psychotherapists may charge fees that OHIP does not cover. Some private plans include benefits for counselling or psychological services.
Massage therapy and other paramedical services:
Some plans cover eligible services such as registered massage therapy, acupuncture, and naturopathy. Benefits and limits vary by insurer, so review the policy before enrolling.
Who Needs Private Health Insurance?
Private health insurance can help people manage expenses that OHIP does not cover. It may benefit anyone who regularly pays for prescription drugs, dental treatment, or other eligible services. The following groups may find individual coverage especially useful.
Self-Employed Individuals
When you are self-employed, you have no employer providing a group benefits plan. Every dollar you spend on prescription drugs, dental work, eye exams, or physiotherapy comes directly from your own pocket. Private health insurance gives you access to the same type of comprehensive health coverage that salaried employees take for granted at a premium you pay yourself. In many cases, self-employed individuals can also deduct health insurance premiums as a business expense, making coverage even more cost-effective.
Employees Without Group Benefits
Many employees, particularly those working part-time, on contract, or for smaller employers, are not covered under a workplace group benefit plan. Others have group coverage but find it inadequate: low maximums, high co-payments, or limited paramedical benefits that leave significant expenses uncovered. A private individual health plan fills those gaps and provides the comprehensive protection your employer plan does not.
International Students
International students studying in Ontario are not eligible for OHIP coverage during their first three months in the province, and many remain uninsured or inadequately insured throughout their studies. A private health insurance policy designed for international students provides comprehensive coverage including emergency medical care, prescription drugs, dental, and vision, ensuring that a health issue does not derail your academic experience or create a financial crisis far from home.
Retirees and Seniors
When you retire, your employer group benefits plan typically ends. While OHIP covers eye exams for seniors, prescription drug costs for those 65 and older are partially covered through the Ontario Drug Benefit (ODB) program, but dental and other paramedical services remain uncovered. A private health insurance plan for retirees ensures continued access to the health services you rely on without the shock of paying full price out of pocket.
What Private Health Insurance Typically Covers
Insurers offer different benefits depending on the plan and coverage level, but most comprehensive individual health plans in Ontario include some or all of the following:
- Prescription drug coverage up to an annual maximum
- Dental care including preventive, basic restorative, and major services
- Eye exams, prescription eyeglasses, and contact lenses
- Physiotherapy and occupational therapy
- Chiropractic care
- Registered massage therapy
- Hearing aids and audiology services
- Psychological and counselling services
- Acupuncture and naturopathy
- Emergency travel medical coverage
- Hospital accommodation upgrades (semi-private or private room)
How We Help You Find the Right Health Insurance Plan
Private health insurance plans differ in their benefits, deductibles, co-payments, waiting periods, and coverage limits. A low-cost plan may not cover the services you use most. Compare the policy details before choosing your coverage.
As independent advisors, we review your current benefits, health expenses, and budget. We then compare available options and help you identify a plan that complements your OHIP coverage and any existing workplace benefits.
You may also need new coverage after retirement, job loss, or a change in employment. We can help you explore replacement or conversion options. Review the deadlines and eligibility rules to avoid an unwanted gap in coverage.
Frequently Asked Questions
Yes, in most cases. Many private health insurance plans in Canada are available on a guaranteed-issue basis with no medical questions — particularly if you apply within a certain period after losing group coverage. For plans that do require health underwriting, pre-existing conditions may be excluded from coverage while all other benefits remain fully in force. We will identify the best available option based on your health history.
The cost of a private health insurance plan varies based on your age, the level of coverage you choose, the deductible you select, and whether the plan covers one person or a family. Basic plans for a healthy individual can start at under $100 per month, while comprehensive family plans with robust drug, dental, and paramedical coverage will cost more. We will present you with options across multiple price points so you can choose the level of coverage that fits your budget.
Yes. We have access to health insurance plans specifically designed for international students studying in Canada, providing comprehensive coverage that includes emergency medical care, prescription drugs, dental, and vision. These plans are available regardless of your country of origin and can be put in place quickly upon your arrival in Ontario.