Canada Health Insurance Calculator

How does Canadian health insurance actually work?

Canada's Medicare system covers medically necessary physician services and hospital care — but that's where public coverage largely ends. Dental care, most prescription drugs for working-age adults, vision, physiotherapy, and chiropractic are not universally covered. The result is a two-layer system: free public care for serious medical needs, plus out-of-pocket spending (or supplemental insurance) for everyday health costs.

Most employed Canadians have employer-sponsored group benefits covering these gaps. The roughly 6–7 million Canadians without workplace benefits — the self-employed, gig workers, part-time employees, and new immigrants — must buy individual coverage or pay out of pocket.

What the provincial plans actually cover (and don't)

• Covered everywhere: medically necessary hospital stays, physician visits, surgery, diagnostic imaging, emergency care.
• Not covered for most working-age adults: dental care, prescription drugs (unless you qualify for a provincial drug program), eye exams after age 18, physiotherapy, massage, chiropractic, ambulance fees (partially in some provinces), and private/semi-private hospital rooms.
• Partially covered: mental health (limited psychiatry sessions through public system; psychologist sessions typically not covered), some provinces cover eye exams for under-19s and seniors.

Provincial health premiums

Most provinces fund healthcare entirely through general taxation — there is no separate premium bill. The main exceptions:

• Ontario: The Ontario Health Premium (OHP) is collected through your provincial income tax. It ranges from $0 (income ≤ $20,000) to $900/year (income over $200,000). It appears on your Notice of Assessment — you don't pay it separately.
• Quebec: The health contribution was eliminated in 2017. However, Québec residents without employer drug coverage must enrol in the RAMQ public drug plan and pay an annual premium ($0–$736 in 2024) based on income.
• British Columbia: The Medical Services Plan (MSP) premium was eliminated in January 2020. BC now funds it through the Employer Health Tax.

Supplemental (extended) health insurance

Individual supplemental plans typically come in three tiers:

Essential (~$70–$100/month, single adult, age 30–44)

Prescription drug coverage + semi-private hospital room upgrade. Suitable if you rarely use dental or paramedical services.

Standard (~$140–$190/month)

Adds preventive dental (cleaning, X-rays), vision ($150–$200 every 2 years), and limited paramedical (2–4 physiotherapy visits). The most popular tier for self-employed Canadians.

Comprehensive (~$240–$320/month)

Adds major dental (fillings, crowns, extractions), unlimited or high-limit paramedical services, travel medical insurance, and sometimes orthodontics. Suitable for families or those who use health services regularly.

Premiums rise significantly with age (roughly ×2 from age 30 to age 60) and with household size.

The Canadian Dental Care Plan (CDCP) — 2024

The federal government launched the Canadian Dental Care Plan in 2024. Key facts:

• For households with net income under $90,000 and no employer or private dental insurance.
• Seniors (65+) were the first cohort enrolled. Children under 18 and adults with disabilities followed.
• Coverage includes preventive, diagnostic, and some restorative dental care.
• Apply at canada.ca/dental or through Service Canada.
• Those with income under $70,000 pay nothing; $70,000–$80,000 pay 40% copay; $80,000–$90,000 pay 60% copay.

Provincial drug plans at a glance

• Ontario (ODB): Covers seniors 65+, those on social assistance, and residents with high drug costs relative to income (Trillium Drug Program). Working-age adults without employer plans typically pay out of pocket.
• British Columbia (Fair PharmaCare): Sliding-scale deductible based on net family income. After the deductible, 70% of eligible drug costs are covered. Low-income families may pay no deductible.
• Quebec (RAMQ): Universal drug plan for those without employer drug coverage. Premium paid via tax return ($0–$736/year). Provides broad formulary access with a modest copay per prescription.
• Alberta: The Alberta Blue Cross non-group coverage program covers some residents. Otherwise, most working-age Albertans pay out of pocket without employer benefits.

Frequently asked questions

Is this calculator free?

Yes — completely free, no account needed. It runs in your browser and nothing is saved.

I have employer benefits. What do I actually pay?

With group benefits, most of your health costs are covered. Your out-of-pocket is typically $0–$100/month for items above plan limits — dental overages, paramedical beyond annual limits, or drug copays. Some employers also require a premium contribution that comes off your paycheque.

I'm self-employed. What's my best option?

Self-employed Canadians can buy individual supplemental insurance (see rates above), join a health spending account (HSA) or personal health services plan (PHSP) for tax-deductible reimbursement of expenses, or join a professional association group plan. Many find a combination works best — a lower-cost individual plan plus an HSA for larger expenses.

What if I just moved to Canada?

Most provinces have a waiting period (typically 3 months) before your provincial health card is active. During this period, you need private insurance to cover physician and hospital costs. After the waiting period, you're eligible for provincial coverage and only need supplemental insurance for dental, drugs, and vision.

Does Quebec really require drug insurance?

Yes. Quebec is the only province with mandatory drug insurance. If you don't have employer or group drug coverage, you must enrol in the RAMQ drug plan and pay an annual premium based on income. You cannot opt out.