Вental health insurance

What is personal health insurance?
Personal health insurance products help lower your risk of being burdened by expenses for preventive care or medical bills as a result of an illness or accident. While provincial health plans provide coverage for many health expenses, there are gaps that can have a significant impact on your finances. For example, depending on the province or territory where you live, you may have to pay for:

Prescription drugs to treat a chronic or serious health condition
Emergency medical services provided in another country
Practitioners like physiotherapists to promote wellness or help with injury recovery
Medical equipment to assist with your mobility
Sun Life offers 2 personal health insurance products: Personal Health Insurance and Health Coverage Choice.

You should consider personal health insurance if:
You don’t have health benefits through your employer
You’re losing your group coverage
You’d like additional benefits not offered by your employer’s plan or your province’s health coverage. You must have provincial health coverage to apply for personal health insurance.
Learn more about eligibility requirements for this product.

Which product is right for you?
Personal Health Insurance
If you want higher coverage levels and are willing to be medically underwritten – where we review your health in greater depth through tools such as a detailed health questionnaire – then you should consider Personal Health Insurance. See plan details below.

Health Coverage Choice
If you’ve lost your group benefits coverage in the last 60 days – or will be losing your group benefits – because you are leaving your job or retiring, and you want coverage for your current health needs, you should consider Health Coverage Choice. There is no medical underwriting with this product.

Learn more about Health Coverage Choice

We offer 3 Personal Health Insurance plans:
Personal Health Insurance is for you if you don’t have adequate employer group benefits coverage. You can choose among plans with differing levels of coverage. Each person included on a Personal Health Insurance application must have provincial health coverage and will be medically underwritten.

Basic plan
Our lowest-cost plan helps you budget for basic medical and dental needs.

60% reimbursement for prescription drugs with a $750 annual maximum
60% reimbursement for supplemental healthcare expenses. 60% reimbursement with a $25 per-visit maximum on paramedical practitioner services up to $250 per year per practitioner
60% reimbursement for preventive dental care with a $500 annual maximum
Semi-private hospital room coverage is optional. No coverage for emergency travel medical or vision care
Learn more about the Basic plan
Standard plan
Our most popular plan includes catastrophic drug, emergency travel medical and optional preventive dental coverage.

For prescription drugs, 70% reimbursement for first $7,000 and 100% reimbursement for next $93,000 of annual eligible expenses
100% reimbursement for supplemental healthcare. 100% reimbursement for paramedical practitioner services up to $300 per year, per practitioner. 100% reimbursement for vision care up to a $150 maximum every 2 years
Emergency travel medical for the first 60 days of a trip and $1 million lifetime maximum on emergency travel medical claims
Optional preventive dental and semi-private hospital room coverage
Learn more about the Standard plan
Enhanced plan
Our most comprehensive coverage, with a higher prescription drug maximum than the standard plan and optional dental coverage that includes restorative and orthodontic services.

For prescription drugs, 80% reimbursement for first $5,000 of annual eligible expenses and 100% reimbursement for next $245,000 of annual eligible expenses
100% reimbursement for supplemental healthcare. 100% reimbursement for paramedical practitioner services up to $400 per year, per practitioner. 100% reimbursement for vision care up to $200 maximum every 2 years
Emergency travel medical for the first 60 days of a trip and $1 million lifetime maximum on emergency travel medical claims
Optional dental coverage for preventive, restorative and orthodontics and optional semi-private hospital room coverage
In the Health Insurance Marketplace, you can get dental coverage 2 ways: as part of a health plan, or by itself through a separate, stand-alone dental plan.

IMPORTANT:
You can’t buy a Marketplace dental plan unless you’re buying a health plan at the same time.

Dental coverage is available 2 ways
Health plans that include dental coverage. Dental coverage is included in some Marketplace health plans. You can see which plans include dental coverage when you compare them.

If a health plan includes dental, the premium covers both health and dental coverage.

Separate, stand-alone dental plans. In some cases separate, stand-alone plans are offered. You can see them when you shop for plans in the Marketplace.

If you choose a separate dental plan, you’ll pay a separate, additional premium.

How to preview dental plans

Click the button below and answer a few income and household questions. You can then preview health plans with dental, and stand-alone dental plans.

Dental plan categories: High and low
There are 2 categories of Marketplace dental plans: High and low.

The high coverage level has higher premiums but lower copayments and deductibles. So you’ll pay more every month, but less when you use dental services.
The low coverage level has lower premiums but higher copayments and deductibles. So you’ll pay less every month, but more when you use dental services.
When you compare dental plans in the Marketplace, you’ll find details about each plan’s costs, copayments, deductibles, and services covered.

Adult & child dental insurance in the Marketplace
Under the health care law, dental insurance is treated differently for adults and children 18 and under.

Dental coverage is an essential health benefit for children. This means if you’re getting health coverage for someone 18 or younger, dental coverage must be available for your child either as part of a health plan or as a stand-alone plan. Note: While dental coverage for children must be available to you, you don’t have to buy it.
Dental coverage isn’t an essential health benefit for adults. Insurers don’t have to offer adult dental coverage.