OHIP Covers a Lot — But Not Everything
OHIP pays for doctor visits and hospital care, but many everyday health costs fall outside it: prescription drugs, dental cleanings and fillings, eyeglasses, physiotherapy, massage therapy, and more. If you don't have a benefits plan through work, those costs come straight out of your pocket.
Personal health and dental insurance helps you manage those costs for yourself and your family, with a plan you own and control.
What a Health & Dental Plan Can Cover
Plans are built from different coverage areas, and you can often choose the level that fits your needs and budget. Depending on the plan, coverage may include:
- Prescription drugs — help with the cost of eligible medications
- Dental care — routine checkups and cleanings, fillings, and in some plans major work such as crowns or dentures
- Vision care — eye exams, glasses, and contact lenses
- Health practitioners — such as physiotherapy, chiropractic, massage therapy, and psychology services
- Hospital and medical extras — such as semi-private hospital rooms, medical equipment, and ambulance services
Each plan has its own limits, reimbursement percentages, and waiting periods — for example, major dental work often has a waiting period before it's covered. We'll walk you through exactly what a plan includes, and what it doesn't, before you apply.
Who Personal Health & Dental Insurance Is For
A personal plan is worth considering if you:
- Are self-employed, a contractor, or a small business owner with no group plan
- Are leaving a job, or your workplace coverage is ending
- Are retiring early and losing your employer benefits
- Work part-time or contract and aren't eligible for benefits
- Have new arrivals or family members who need coverage
- Have a group plan but want extra coverage on top of it
Losing Your Group Benefits? Timing Matters
If your workplace benefits are ending, some insurers offer plans you can apply for without answering health questions — but often only if you apply within a limited time after your group coverage ends. Waiting too long can mean going through medical questions or losing that option altogether.
If you've recently left a job or retired, reach out early so we can review your options while they're still available.
Plans With or Without Health Questions
Personal health and dental plans generally come in two types:
Guaranteed-acceptance plans. No medical questions to qualify. These are a good fit if you have existing health conditions, though coverage levels may be more limited.
Medically underwritten plans. You answer health questions when you apply. In return, these plans may offer richer coverage or broader benefits.
Neither is automatically better. The right choice depends on your health, your budget, and the kinds of expenses you expect. You can also learn more on our Group Benefits, Travel Insurance, and Insurance Solutions pages.
What Does It Cost?
Your premium depends on factors such as:
- Your age and where you live in Ontario
- Whether you're covering yourself, a couple, or a family
- The coverage areas and levels you choose
- Whether the plan is guaranteed-acceptance or medically underwritten
There's no one-size-fits-all price. A short conversation will help you see which coverage is worth paying for, and which isn't, given what you actually use.
Frequently Asked Questions
I'm self-employed. Can I get health and dental coverage?
Yes. Personal plans are designed for people without a workplace plan, including the self-employed. Self-employed people may also be able to claim premiums for tax purposes; speak with your accountant about your situation.
Can I get coverage if I have a pre-existing condition?
Often, yes. Guaranteed-acceptance plans don't ask health questions, though some may limit coverage for certain conditions. We'll explain the terms clearly before you apply.
How does this work with government programs?
Some Ontarians may be eligible for government programs that help with drug or dental costs. Private coverage can work alongside these. We'll help you understand where a personal plan fits with what you may already have.
Is there a waiting period?
Some benefits, especially major dental services, commonly have a waiting period before they're covered. Waiting periods vary by plan, and we'll point them out before you choose.
Does this include travel medical coverage?
Some plans include emergency travel medical coverage, and some don't. If you travel, we'll check what's included, or see our Travel Insurance page for standalone options.
Get Your Free Health & Dental Quote
Share a few basic details and we'll get back to you with options to compare — no pressure and no obligation to buy. Prefer to talk? Call 613-703-1726 or 613-703-0815, Monday–Sunday, 9:00 AM–6:00 PM.
Protect with Oneil — O'Neil Creighton, licensed life insurance & group benefits advisor in Ontario. FSRA licence #26245008, contracted through Experior Financial Group Inc.
Coverage is subject to eligibility, and to the terms, limits, definitions, waiting periods, and exclusions of the plan issued. Covered services and reimbursement levels vary by plan and insurer. This page is general information only and is not insurance, medical, tax, or financial advice.