What services and treatments ARE covered under my provincial health plan?
What’s covered by your provincial health plan depends on where you live since each province has its own health insurance plan. While these plans are required to cover “medically necessary” physician and hospital services, it’s up to each province to determine what other services they cover.
For services or treatments that aren’t considered “medically necessary,” most provincial governments have programs that provide coverage for certain groups, such as low-income residents and seniors.
For everyone else, these health services are usually funded privately, either by an employer-sponsored group benefits plan, or by patients themselves – through the purchase of personal insurance coverage or by paying directly, out-of-pocket.
What services and treatments ARE NOT covered under my provincial health plan?
Services not covered vary by province, but typically include:
- Drugs administered outside hospitals;
- Ambulance services;
- Hearing care, including audiology exams and hearing aids;
- Vision care, including eye exams for adults, eyeglasses, contact lenses and laser eye surgery;
- Dental services provided in a dentist’s office, as well as braces and dentures;
- Non-medically-required surgery, such as cosmetic procedures;
- Private and semi-private hospital rooms, and private nursing services;
- Services provided by health care providers other than physicians, such as acupuncturists, chiropractors, massage therapists, naturopaths, homeopaths, physiotherapists, dieticians, speech therapists, podiatrists, counsellors and psychologists; and
- Medical appliances, prosthetics, supplies, and mobility devices.
Where can I find out more?
Find out what’s covered in your province or territory by clicking on the appropriate link below: