Health Insurance for Seniors Over 65 in Canada

What health insurance covers after age 65

Seniors over 65 in Canada have access to provincial healthcare, such as OHIP in Ontario, RAMQ in Quebec, and MSP in BC—but is that enough for peace of mind in old age?

Provincial plans in Canada tend to cover seniors’ medically necessary services and exclude dental, vision, hearing, and paramedical (although the CDCP may cover dental care for some seniors). 

There are senior-specific provincial programs that kick in at age 65 (or at 60, in the Northwest Territories), like the NB Drug Plan for Seniors and the Seniors’ Pharmacare Program in Nova Scotia. These provide extended health benefits and drug plans for senior Canadians. Note that both age and income are eligibility criteria for some of these programs.

Although the specifics vary by province, most provincial programs for seniors cover, in full or in part:

• Medically necessary doctor visits
• Medically necessary hospital care
• Prescription drugs
• Medical equipment and supplies
• Some home care services
• Subsidized long-term care (just medical care, not housing)

Seniors’ provincial health insurance programs do not typically cover:

• Dental
• Vision
• Paramedical services (e.g., chiropractic, massage, physiotherapy, mental health)
• Mobility aids like wheelchairs
• Hearing aids
• Non-approved prescription drugs
• Private hospital rooms
• Home support care 
• Travel medical insurance
• Experimental therapies

Data from our health insurance access and affordability study shows that gaps in provincial coverage mean that 47% of seniors 55+ in Canada are delaying doctor visits: 35% have delayed dental care, 28% have delayed vision care, and 21% have delayed mental health services.

The situation is especially dire for Canadians who are transitioning out of employer-sponsored group plans to fixed incomes. Medical needs don’t suddenly decrease in retirement—in fact, they often increase. 

Because insurance benefits, drug costs, and dental benefits vary by province, it’s important to check your province’s website carefully so you understand what’s covered (and what is not covered). If you have a gap in coverage, the solution is a personalized, affordable, and right-sized private policy. 

Do seniors need private health insurance?

Most seniors would benefit from private health insurance to close gaps in coverage since:

• Provincial programs don’t cover everything seniors need
• Employer benefits often come to an end at retirement

Health insurance can also provide financial stability in retirement. Healthcare costs continue to rise in Canada and unexpected medical expenses can dig into savings—especially for seniors, who are typically on fixed incomes.

The unfortunate reality is that 21% of Canadians aged 55+ have no health or dental coverage. Seniors are facing higher medical costs, less employer coverage, and growing uncertainty about future benefits. 

A private health insurance policy tailored to real needs is a smart solution that protects your well-being and your finances. In other words, you could enjoy more covered medical services and a more predictable budget with private health insurance.
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Out of pocket costs

29% of Canadians paid over $1,000 out of pocket for health or dental care in the past year; Boomers spent the most, on average, at $1,321 annually.

Options for health insurance coverage after 65

Seniors have several health insurance options after age 65:

Government plan: General and senior-specific programs cover medically necessary doctor visits, hospital visits, approved prescription drugs, and some medical equipment and long-term care services. The CDCP may also cover dental care for eligible seniors who fit the income and residency requirements.

Employer-sponsored plans for retirees: Some employers (mostly unions in government and education) extend health benefits to their employees in retirement—but 36% of Canadians with group coverage say they’re worried it will be reduced or eliminated in the future.

Private individual plans: Personalized health insurance plans allow you to tailor your health and dental coverage to the primary and supplemental services you need in retirement.

Supplemental top-ups: These insurance products cover only the supplemental health services you need, like dental insurance. This is a strategy employed by many retirees who are happy with the primary services covered by their province or retiree plan but who need targeted, additional coverage.

The cost of health insurance for seniors over 65

A senior over 65 in Canada may pay between $80 and $210 per month for a private medical plan, depending on the type of plan and its level of coverage. Here’s a rundown of PolicyMe’s guaranteed acceptance (no medical questionnaire) options for seniors:

Health insurance costs vary depending on a range of factors:
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• Age: Older people tend to visit the doctor more often, and they need more medications and specialist care than younger people, so they pay more for coverage.
• Province: Premiums are higher in provinces with higher medical costs, like BC and Ontario. 
• Plan level: Expect to pay higher premiums if you opt for a plan that includes things like home care, medical supplies, and high dental and vision limits.

How to choose the best health insurance for seniors

The best health insurance for seniors is one that’s tailored to your unique needs, offering essential coverage without paying for more than you’ll use.

1. Assess your healthcare usage: How often do you visit the doctor for preventive care vs. major needs? Have you been delaying necessary services, and do you anticipate more visits as you age?
2. Understand the money: Each plan has its own coverage model, including deductibles, co-insurance, co-pays, and annual maximums. Think through how much you might pay for the services you’ll use—and how much you’d save if you had a plan vs. paying out-of-pocket entirely.
3. Look for tiers that fit your needs: A supplemental plan (like dental-only) might be all you need, if you’re happy with your provincial health coverage. Otherwise, compare tiers to find the most cost-effective option for full coverage. This varies by provider. For instance, PolicyMe offers Economic, Classic, and Advanced tiers.
4. Apply and get quotes: Reach out to the health insurance companies you like and ask for insurance quotes. Read company reviews to ensure you find the best health insurance companies in Canada.

Once you find a plan you like, you can apply online or speak to an advisor. PolicyMe plans don’t require any medical information, so you don’t have to worry about being approved.

Is private health insurance worth it after 65?

Private health insurance can be worth it—but only if the value of the coverage outweighs what you’d otherwise pay out of pocket. The best way to know is to compare your expected annual healthcare expenses with and without insurance.

While provincial health plans cover basics like doctor visits, hospital care, and some prescriptions, they don’t cover dental, vision, hearing, and paramedical services. These gaps become more significant as you age.

Think about the kinds of expenses that can pop up unexpectedly:

• A root canal that costs thousands
• Physiotherapy after a fall or car accident
• Rehabilitation after surgery or a broken hip

Without insurance, you’ll need to pay for these bills in full out of pocket. With a private plan, you’ll pay a predictable monthly premium and protect yourself from large, unexpected costs.

The bottom line: If you want financial stability and coverage for the services that many seniors need, buying private health insurance might be a good idea.

FAQ: health insurance for seniors in Canada

Prices listed on this page are based on information available as of October 2025. The prices shown are for general reference only and may vary based on factors like your age, location, and product selection.