Health Insurance in Toronto
Ontario Health Insurance (OHIP) covers hospital and physician services. It does not cover dental care, prescription drugs, vision, physiotherapy, or dozens of other health expenses. Extended health insurance fills those gaps.
The OHIP Gap: What Ontario's Public Health Plan Does Not Cover
OHIP covers medically necessary hospital and physician services for Ontario residents. What most people do not realize until they need it is how much falls outside that coverage. A 2023 study by the Canadian Institute for Health Information found that roughly 30% of total health spending in Canada is paid out of pocket or through private insurance.
The most common gaps include dental care (cleanings, fillings, crowns, orthodontics), prescription drugs (outside of hospital), vision care (eye exams for adults 20-64, glasses, contacts), mental health services (psychotherapy, counselling), and paramedical practitioners (physiotherapy, massage, chiropractic, osteopathy).
Types of Health Insurance Plans
Group Benefits are the most common form of extended health coverage in Canada, provided through an employer. If you have access to employer-sponsored group benefits, they are typically the most cost-effective option. I help small business owners set up and manage group plans.
Individual Health Plans are available for those without employer coverage — self-employed professionals, freelancers, retirees, and anyone between jobs. Individual plans offer flexibility in coverage levels and are medically underwritten, meaning your health history affects eligibility and pricing.
Health Spending Accounts (HSAs) are a tax-effective option for incorporated business owners. The corporation funds the HSA, and eligible medical expenses are deducted as a business expense. This can be used as a standalone solution or to supplement a traditional plan.
Association Plans are group-style plans available through professional associations, chambers of commerce, or industry groups. They offer group rates to members who might not otherwise have access to employer benefits.
Why Use a Broker for Health Insurance
Health insurance plans vary significantly across carriers in terms of coverage limits, drug formularies, provider networks, and pricing. A direct plan from one carrier may seem affordable but have a restrictive drug formulary that does not cover your medications. As a broker with access to multiple carriers, I compare the details that matter — not just the headline premium — to find the plan that actually fits your health needs and budget.
Frequently Asked Questions
A broker works for you, not the insurance company. I shop 40+ carriers to find you the best rate and coverage. Direct insurers only sell their own products. With a broker, you get unbiased advice and someone who advocates for you during claims.
No. Brokers are paid by the insurance companies, not by you. There's no additional cost for using a broker, and we often find lower rates because we can compare across dozens of insurers.
Most quotes are ready within 24 hours. For straightforward auto or home insurance, I can often provide a quote the same day. Complex commercial or multi-policy packages may take 2-3 business days.
I serve clients across Ontario. Whether you're in Toronto, the GTA, or anywhere in the province, I can help with your insurance needs.
Absolutely. I work with high-risk insurers as well as standard markets. Whatever your situation — tickets, accidents, or new driver — I'll find you the best available rate.
You call me directly. I'll guide you through the process, advocate with the insurer on your behalf, and make sure your claim is handled fairly and promptly. That's the broker advantage.
Extended health insurance typically covers prescription drugs, dental care, vision care (glasses and contacts), paramedical services (physiotherapy, massage therapy, chiropractic, psychology), medical equipment, ambulance fees, and semi-private or private hospital rooms. The specific coverage varies by plan.
Yes. Individual and family health insurance plans are available for self-employed people, freelancers, and anyone without employer-sponsored benefits. As a broker, I compare individual plans from multiple carriers to find the best coverage for your situation.
Health insurance reimburses specific medical expenses as they occur — a dental visit, a prescription, a physiotherapy session. Critical illness insurance pays a one-time lump sum if you are diagnosed with a covered serious condition like cancer, heart attack, or stroke. They serve different purposes and many people carry both.
An HSA is a tax-effective alternative to traditional health insurance for incorporated business owners. Instead of fixed premiums, you allocate a dollar amount that can be used for any eligible medical expense. It can be used alongside or instead of a traditional health plan.
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