Under Canada’s health care system, all medically necessary hospital stays, including those needed for treatment of an illness or surgical and maternity services (such as childbirth, prenatal, post-natal and newborn care, and treatment of complications surrounding a pregnancy) are covered, as are the prescription drugs while in hospital.
You will also not be asked to pay the clinic, hospital or physician directly, and there are no deductibles or fees levied on any specific insured service. However, there are some services that are only partially covered, depending on the province, and therefore require a fee for service from the patient. And there are some “uninsured” services, meaning they are not covered at all.
Some examples of services not covered by any plan in Canada include:
- medical examinations requested by third parties (such as for employment, insurance or driver’s licence)
- cosmetic surgery that is not medically necessary
- dental care
- vision care
- limb prostheses
- prescription medication
- podiatry and chiropractics.
With the exception of the Yukon Territory, ambulance service in Canada is generally not fully covered by the health insurance plans of any province or territory. The only exceptions are when it is necessary to transfer a patient from one hospital to another. Some provinces have capped the costs of an ambulance ride, but in other provinces, ambulance service can be very expensive.
Certain groups of the population, however, such as seniors, children, and those on social assistance, may be able to obtain these extended health services through a Pharmacare program provided by their province.
Canadians in every province, however, can purchase private extended health insurance to cover some of these uninsured health services not included in the national health care plan. Some employers also provide extended health care benefits to their employees that cover some of these costs.