Who Counts as a Dependent for Health Insurance in Canada?

What is the meaning of a “dependent” in insurance?

In the insurance world, a dependent is someone who relies on you for financial support and can be added to your insurance plan to receive coverage. 

Dependents are typically close family members and must meet certain eligibility criteria defined by your insurance provider. Marriage, entering a common law relationship, and birth are the main qualifying life events that determine who is eligible for health benefits under your policy.

Who can be a dependent on health insurance in Canada?

Private health insurance plans in Canada typically cover the following types of dependents:

When you add a dependent, your insurer extends your health insurance coverage to that individual, like prescription drugs, dental, vision, and other health services. A new PolicyMe—Angus Reid study found that around 23% of Canadians have health insurance coverage through their spouse, partner or parent. 

Rules related to health insurance dependents can vary slightly between private, group, and public plans. While private insurance plans generally follow standardized guidelines across Canada, group plans can vary from one employer to another. Public healthcare plans (like OHIP in Ontario or MSP in BC) typically have different rules for coverage based on the province, age, and immigration status.

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Does my group benefit plan offer dependent coverage?

Group health insurance plans often cover dependents, but eligibility rules can vary from one employer to the next. Some limit coverage by age or relationship type, like stepchildren or common-law partners. If your group plan is too restrictive, private health insurance may offer more flexibility to ensure your dependents are fully covered.

Who isn’t eligible to be added as a dependent?

While spouses and children who meet the criteria can be included on your health insurance policy, others in your household are usually excluded from coverage unless specific exceptions apply.

Excluded dependents typically include:

• Parents or in-laws
• Ex-spouses
• Non-common law partners
• Siblings
• Grandparents
• Nieces or nephews
• Aunts or uncles
• Adult children over the age limit who are not financially dependent or disabled

However, there may be exceptions when it comes to benefit programs like Private Health Services Plans (PHSPs) and Health Spending Accounts (HSAs). For example, if an extended family member (by blood or marriage relationship) lives in your household and is financially dependent on you, they may be eligible for coverage under your plan.

At what age does dependent coverage end?

Your children, including biological, adopted, or step children, are usually covered up to age 18 or 21, or until they are 25 years old as full-time students at a recognized educational institution.

The exact age for eligibility will depend on: 

• The type of plan (private or group)
• Your child’s school enrollment status
• Your dependent’s disability status

There is no age limit for spousal coverage under most private or group health insurance plans in Canada. As long as your spouse or partner:

• Meets the definition of a legal spouse or common-law partner (typically defined as cohabiting in a relationship for at least 12 months, or with a child by birth or adoption)
• Is still married to or in a relationship with you

However, coverage typically ends if:

• The marriage or common-law relationship ends (unless otherwise specified)
• The spouse becomes ineligible (e.g., receives coverage under a different plan and opts out)
• You remove them

Dependents with long-term disabilities can often remain covered well past standard age limits. Typically, private and group insurers will require documentation that the child’s disability is long-term, and that they remain dependent on you for financial support due to the disability.

Should you add dependents to your health insurance?

Yes, adding eligible dependents like your partner or children can help protect your family from out-of-pocket health expenses. Since provincial health plans don’t cover most everyday health needs, extending your private plan ensures your loved ones have access to essential care when they need it.

A PolicyMe–Angus Reid study also found that 56% of Canadians are delaying health appointments due to cost, and even skipping them entirely. Opting for a private plan helps reduce out-of-pocket costs and provide peace of mind knowing your loved ones have access to essential care when they need it, especially if you don’t have a health insurance plan for your child.

For example, private insurance solutions like PolicyMe’s health insurance can help you secure coverage for you and your family, ensuring you only pay for the coverage you need. The process is 100% digital, from quote to purchase, so it’s easy to compare coverage options, understand what’s included, and add your partner or children whenever it makes sense for your situation.

Is it more expensive to have dependents on your policy?

Yes, your monthly or annual health insurance premiums can increase when you include dependents on your policy. However, the added cost is worth the financial protection it provides for health-related expenses.

If you’re unsure how your premiums will be affected by pricing or eligibility, it’s a good idea to speak with your insurance provider directly. They can clarify what’s included, help you estimate the costs, and ensure you’re making the most of your coverage. 

Are there provincial differences in who you can add to your plan?

Private health insurance plans, like those offered by PolicyMe and other providers, generally follow consistent Canadian guidelines when it comes to who qualifies as a dependent. These guidelines are based on relationship, age, and financial dependence. 

For example, most private plans will cover the following dependents across all Canadian provinces: 

• Spouses of common-law partners
• Children under 21 (or under 25 if they are full-time students)
• Dependent children with disabilities

Consistency in dependent eligibility for private health insurance can be especially helpful for Canadians who move between policies.

In contrast, public health insurance programs like OHIP (Ontario), MSP (British Columbia) and RAMQ (Quebec) have province-specific rules about who qualifies as a dependent. These rules are often based on age, education status, and legal residency. 

FAQs: Dependent health insurance