Canada is known for its universal health care system and its benefits. But our health care coverage, funded by the provinces and territories, has its limits. It’s important to understand what’s provided by provincial health plans and how those limits impact your health and finances, especially if you have a family.

Families are feeling the pinch right now due to high food costs and the rising cost of living. Bills for families can really pile up and having to find money for unexpected costs can be challenging. This is especially true for families that find themselves without health insurance from a private or group benefits plan. Many think that provincial health coverage is enough to cover basic health needs, but in many scenarios, this is not the case. In this blog we’ll help you identify what your family health needs are, the gaps in provincial health coverage and how private health insurance can help save you worry and money.

Understanding Your Family Health Needs          

We all have unique needs when it comes to our health, and families have even more to think about. There are your own needs for routine and emergency care, and then those of your partner and/or children (dependants). These needs can change quite quickly or over time too, so if you find yourself without private health insurance, it can be tough to know what to budget for.  

So what does your family really need from a health coverage perspective? Whether you’re covered under a private health plan or group benefits plan or not, it’s a useful exercise to sit down and determine what kind of health needs your family has now and how that translates to health care support. Then, consider what scenarios might arise in the future that you’d need coverage for. Apply this same process for yourself, your partner, and your children.

Next, identify your coverage gaps. If you have health insurance within a personal or group benefits plan, you’ll likely have coverage for many services that align with your needs. This includes benefits like vision, dental, and health practitioners such as massage therapists and physiotherapists. If you don’t, you’ll need a good understanding of provincial health care coverage. Let’s dive into how this differs.

What Does Canadian Health Care Cover?

Canadian health care offers a lot, but the exact kind of coverage you and your family will receive will depend on where you live. Health care falls under the responsibility of the provinces and territories to manage and deliver.  What’s covered differs from province to province. So what does Canadian health care cover?

Overall, provincial health plans will cover doctor check-ups and hospital stays for everyone. There’s also coverage available for certain populations based on income or age. For example, some provinces only offer eye exams and dental visits for kids. Certain drug coverage is also available based on where you live and your health coverage, but in general prescription drug coverage falls outside of the scope of provincial health coverage.

In many cases, these are situations of partial coverage or coverage up to a certain age or income level. After that, it’s up to the individual family to pay. This is where it’s really important to understand how your family’s health needs intersect with provincial health coverage, and what your personal health insurance covers.

Since each province and territory has it’s own plan, you’ll want to make sure you understand the information that applies to you. Visit your province or territory’s health information page below so you can get a real understanding your family’s health needs.

Assessing Your Family’s Health Needs

A family might have a long list of health needs to consider when evaluating how provincial health coverage will impact them and where a private health insurance plan fills the necessary gaps.

There are also instances where provincial health plans may cover some portion of a health need. A good example of this is vision care and glasses. These are often covered by the provincial and/or territorial health plans up to a certain age. Understanding where partial coverage is available helps to reduce your out-of-pocket expenses and gives you a true picture of what you need from a private health plan. 

It’s a good idea to start making a list of your current family health needs. Remember to include things for emergencies like ambulance and dental injuries. Then organize each health need by provincial coverage, private coverage, and partial coverage/provincial support.

Need help getting started? Try out our Household Health Needs checklist template.

GMS Private Health Plans Cover Your Family     

If your family’s health needs extend beyond your provincial health coverage, GMS can help fill the gap with private health insurance plans. Our Personal Health plans offer the flexibility to choose anywhere from basic to extensive coverage. The rates are determined by the benefits you choose and your medical history. If you’ve recently left a job with benefits, you also qualify for our Replacement Health coverage. We offer guaranteed acceptance with no medical questions and your choice between three pre-bundled plans. Learn more today!

Not sure which plan to go with? Click here to get a recommendation.