What does Canadian health insurance not cover?

Provincial health insurance in Canada covers doctor visits and hospital care but does NOT cover dental care, prescription medications (outside hospital), vision care and glasses, physiotherapy and most allied health, mental health counselling (psychologists), ambulance fees in most provinces, cosmetic procedures, and most medical devices. These are paid out of pocket or through private insurance, often provided by employers.

Are prescriptions free in Canada?

No. Prescriptions are generally not covered by provincial health insurance in Canada. You pay out of pocket or through private insurance. However, some provinces have public drug programs for specific groups — seniors (65+), people on social assistance, and children. In British Columbia the Fair PharmaCare program covers part of drug costs based on income. In Ontario the OHIP+ program covers prescription drugs for people under 25 without private insurance.

Is dental free in Canada?

Dental care is generally not covered by provincial health insurance. Most Canadians pay through employer-provided private insurance or out of pocket. However, the Canadian Dental Care Plan (CDCP) provides coverage for uninsured Canadians with adjusted family income under $90,000. As of 2026, all eligible Canadians (seniors, children under 18, persons with disabilities, and adults) can apply. Co-payments range from 0% (income under $70K) to 60% (income $80-90K). The application/renewal window opens each spring and closes around June 1.

What Your Health Card Does NOT Cover

The gaps in Canadian provincial health insurance that surprise most people.

📋 Source: Canada Health Act. Provincial health insurance plan summaries (OHIP, MSP, RAMQ). Canadian Dental Care Plan — Service Canada. Provincial drug benefit programs, provincial ambulance fee schedules.
Your doctor or healthcare provider knows your history and circumstances — always follow their personalised advice over general information. Verified September 2026.

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The basics — what IS covered

Your provincial health card (OHIP, MSP, RAMQ, etc.) covers:

✅Doctor visits (family doctor and specialists) ✅Hospital stays, surgery, and emergency care ✅Diagnostic tests (blood work, X-rays, CT, MRI) ordered by a doctor ✅Medications while in hospital ✅Maternity care and childbirth

That's it. Everything below is not covered.

What is NOT covered

Service	Covered?	Typical cost & how to get it
🦷 Dental	❌	$200–$500+ for a check-up and cleaning. Most people use employer insurance. CDCP now open to all eligible Canadians (uninsured, income under $90K). Co-payments: 0% if under $70K, 40% ($70-80K), 60% ($80-90K). The annual application/renewal window opens each spring and closes around June 1 — apply early rather than assuming it's open year-round.
💊 Prescriptions	❌	Varies widely. Private insurance, provincial drug plans for seniors/low income, or out of pocket. ON: OHIP+ covers under 25. BC: Fair PharmaCare income-based.
👓 Vision / glasses	❌	Eye exams $75–$150. Glasses $200–$600+. Some provinces cover eye exams for under 20 and 65+. Private insurance or out of pocket.
🧠 Psychologist / counsellor	❌	$150–$250 per session. Psychiatrists ARE covered (they're doctors). Psychologists are not. Private insurance or out of pocket.
💪 Physiotherapy	❌	$80–$120 per session. Some provinces cover hospital-based physio. Community physio is out of pocket or private insurance.
🚑 Ambulance	⚠️	Varies by province. ON: $45 copay (residents); $240 if a hospital doctor later rules the transport not medically necessary. BC: $80 flat fee. AB: $385 with transport, $250 for assessment-only. QC: $125 base fee + $1.75/km for most residents — free for seniors 65+, social-assistance recipients, and accident victims via SAAQ. Check your province.
🏥 Private / semi-private hospital room	❌	Ward bed is covered. Private room upgrade $200–$400/night. Often covered by employer insurance.
🦶 Podiatry / orthotics	❌	$60–$100 per visit. Custom orthotics $400–$600. Private insurance or out of pocket.
🌐 Travel health insurance	❌	Provincial coverage is limited or nil outside Canada. Always buy travel insurance. Even coverage between provinces may be incomplete.

How most Canadians fill the gaps

🏢Employer benefits — most full-time jobs include extended health benefits covering dental, prescriptions, vision, and paramedical services (physio, psychology, massage). This is the primary way Canadians access these services. If you have benefits, use them — many people underuse what they have. 🛡️Private insurance — if you don't have employer benefits (self-employed, part-time, retired), you can buy individual plans from providers like Sun Life, Manulife, Blue Cross, or Green Shield. Plans vary widely — compare carefully. 🏛️Provincial programs — most provinces have programs for lower-income residents, seniors, and children. Check your province's website for drug coverage, dental programs, and vision care subsidies. 🏫University health plans — most post-secondary institutions include health and dental coverage in tuition fees. Check your student union for details.

New federal programs

🦷Canadian Dental Care Plan (CDCP) — now open to all eligible uninsured Canadians with family income under $90,000. Covers preventive, diagnostic, restorative, and some surgical dental care. Apply through Service Canada or My Service Canada Account. The application/renewal window opens each spring and closes around June 1 — apply early. 💊National Pharmacare — under the federal Pharmacare Act (2024), the Government of Canada has signed agreements with British Columbia, Manitoba, Yukon and PEI to cover a range of contraceptives and diabetes medications (and menopause hormone therapy in some) at little or no cost. Manitoba’s coverage began in 2025 and BC’s Plan NP launched in March 2026; in participating provinces it is automatic at the pharmacy. Other provinces have not signed, so it is not yet nationwide. Check canada.ca pharmacare agreements for coverage in your province.

Step 1: Apply for your provincial health card (OHIP, MSP, RAMQ, etc.). There may be a waiting period (up to 3 months in some provinces) — get private interim coverage.

Step 2: Find a family doctor. This can be difficult — some areas have long waitlists. Walk-in clinics are an alternative. How to find a family doctor →

Step 3: If your employer offers benefits, enrol immediately. If not, consider private insurance for dental, prescriptions, and vision.

Step 4: Buy travel insurance if you travel outside your province or outside Canada — your provincial card may not cover you.

Many provinces have programs for people on low income: Ontario Works, BC Employment and Assistance, and similar programs in other provinces cover basic dental and prescriptions.

Community health centres often offer services on a sliding scale or for free. Dental schools provide reduced-cost treatment. Ask your family doctor about available programs in your area.

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Healthcare in Canada

How the system works.

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Find a Family Doctor

How to get on a waitlist.

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Canadian Immunisation Schedule

Free vaccines by age.

What Your Health Card Does NOT Cover

The basics — what IS covered

What is NOT covered

How most Canadians fill the gaps

New federal programs

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