Health and Dental Insurance Explained

Health and dental plans that are easy to understand, easy to buy and easy to manage.

Think of health insurance as something that’s there to help protect your health and your budget. It covers expenses you incur from regular health care, regular dental care, illness and accidents that are not covered by your provincial or territorial health insurance.

Your particular needs and circumstances, as well as your budget, will help determine the type and amount of coverage that’s right for you. You can find flexible options that allow you to completely tailor health insurance that meets your needs. They are easy to buy and easy to manage, and best of all easy to understand.

A primer on health and dental policies and eligibility

There are two main types of supplemental health insurance policies you can choose from. They help you pay for expenses that regular insurance doesn’t cover or share the cost with other insurance plans you might have. If you’re a gig worker, freelancer or self-employed – as approximately one in three Canadians are nowadays – you might be in particular need of supplemental insurance. Depending on the type of coverage you apply for, you may need to answer a medical questionnaire when you apply. Manulife’s Flexcare® plans are an example of this type of plan.

If your situation is that you were previously covered by a work policy but lost your benefits because you left your job, lost your job or are retiring, then you may qualify for a policy that essentially continues your coverage (although not necessarily with identical benefits). With this type of policy, such as Manulife’s FollowMe™ plans, you’re guaranteed to get coverage and there are no medical questions at the time of application. You will want to apply for coverage and pay your first premium within a certain time frame after losing your work benefits – with Manulife plans that’s 90 days.

There are certain eligibility requirements for health insurance. You need to be over the age of 18, be a resident of Canada and already be covered by a provincial or territorial health plan. You can also cover your spouse and dependent children who are under the age of 21 and not employed. You can’t buy insurance for someone else, such as your parents, but you can pay the premiums for them if you wish.

What’s covered under health and dental plans

Many expenses – some of which could add up to many hundreds of dollars a year – can be covered under health and dental insurance. These include such things as:

  • prescription drugs
  • dental care, including regular checkups, cleanings and some procedures
  • vision care, including optometrist visits as well as prescription lenses, frames, contact lenses and laser eye surgery
  • extended health care, including registered specialists and therapists (such as massage therapists, chiropractors, physiotherapists and psychologists), orthotics, hearing aids, homecare and medical equipment
  • emergency travel health care, which helps cover the costs of emergency medical care for a predetermined number of days when travelling outside your home province or territory

You can pick a health and dental plan that’s the best for you

You can tailor your coverage to suit your needs and your budget. For example, you may need coverage for drugs but not dental work, or dental but not drugs — or you may need a plan that covers both. Typically, insurance companies will offer multiple types of coverage bundled as a single plan. For example, our Manulife’s Flexcare® combination plans offer drug, dental, vision and travel coverage, while Manulife FollowMe™ plans offer drug, vision, hospital coverage for a semi-private room and extended health care. Some FollowMe™ plans also include dental but travel insurance must be purchased separately. There are many options to choose from.

Plans often include accidental death and dismemberment (AD&D) coverage and a survivor benefit as well. With AD&D, the policyholder receives a payment if they’re dismembered in an accident. If an adult insured by the policy dies in an accident, a survivor benefit provides for one year of continued coverage with no premiums for the remaining people covered by the policy. These types of plans can help protect those you love something should happen to you.

You can also buy standalone health coverage

Some types of coverage can be purchased as standalone plans. For example, if your plan doesn’t include travel, catastrophic drug coverage or hospital coverage, you can buy these as standalone plans. Catastrophic drug coverage offers unlimited drug coverage once you’ve paid a certain amount in annual drug expenses, while hospital coverage provides for a semi-private or private room if you’re hospitalized.

Health insurance comes with other services, too

Many health policies provide more than just coverage – there are also non-insurance perks, too. You can get telephone or virtual health care services, for example, that provide round-the-clock, on-demand access to medical professionals who can provide such services as prescriptions, mental health care, diagnoses and referrals.

Many insurers are now offering wellness programs along with their insurance plans – which can help put you and your family on a healthier path. For example, Manulife offers our Vitality program, where you set up a member profile and can track everyday activities such as walking the dog or going to the gym. Or you can complete online nutrition courses to earn points that can be used for rewards or even reducing your premiums.

Tips for choosing the right health and dental plan and making changes to your policy

When determining what the best coverage is for you, you’ll want to consider a few things, such as:

  • Your medical history and any pre-existing conditions, which might make you need higher prescription or hospitalization coverage, or opt for a plan that doesn’t require  a medical questionnaire
  • Your age – if you’re an older individual you might want coverage for home care or nursing care
  • The needs of your dependents – your children might need vision care or orthodontic treatment that you might want to account for in your plan.

You’ll need to balance your needs with your budget too – so you’ll want to look at such things as what percentage of health and dental expenses are covered, the size of the deductible (which is the amount you pay out of pocket before the insurance kicks in), as well as the types of expenses covered.

Life is full of ups and downs, so if your circumstances change you might want to look at changing the coverage on your policy. You can increase your coverage on an existing policy by submitting a written application with updated medical information. Or, you can reduce your coverage if you’ve been covered under the existing benefits for at least 12 consecutive months. If you experience big life changes such as getting married or having a baby, you can add your spouse or baby to your coverage.

Understanding your policy

It’s important to read and understand your policy and schedule of benefits so you’re aware of what’s covered, what’s not covered and the coverage limits. Once you’ve maxed out your annual coverage limit for an expense, you must pay out of pocket until the next year. And some expenses are subject to lifetime maximums, which are maximum dollar amounts your insurance company would pay out over your lifetime for non-essential health care such as orthodontics or fertility treatments.

Keep in mind that the year for many benefits is the anniversary year of the policy, not a calendar year – so if you signed up for your policy in March, your benefits run for a year until the next March. That’s important to remember so that you can get the most out of your health insurance, especially benefits for preventive health care. Set reminders to book appointments for your doctor and dentist regularly, and make time to see your massage therapist, chiropractor or other health service providers. Consider enrolling in wellness programs and save time and hassle by using virtual health services.

Also important to understand is what happens when there are multiple policies. While you can’t have more than one private health policy from the same insurer, some of your expenses could be covered through other sources such as another health insurance policy, your spouse’s policy or your auto or credit card insurance. In this case, the amount of the eligible expenses covered by the province or territory will be paid first, and payment of the remaining eligible expenses will be coordinated between the other insurers. Your policy will outline how that works – sometimes one insurer will pay the full amount and sometimes it will be split between your insurers.

How to make a claim

In many cases your pharmacist, dentist or health-care provider will submit your claim for you directly, meaning there’s no online form or paperwork for you. Otherwise, you can submit your claim online or by mail within 12 months of the date you were charged and after you’ve paid more than any deductible in your plan.

Ready to apply? Here’s how

You can apply for Manulife health and dental insurance online at or by phone at 1-877-COVER-ME. You’ll need to have handy a list of your medications and, if you’re applying for a plan that requires a medical questionnaire, you’ll be asked questions about your medical history and contact details for your doctor. If you’re applying for FollowMe™, you’ll need the details of your previous group benefits.

Health insurance can help to ease your mind when it comes to expected and unexpected medical expenses, as well as help you manage your budget for them. It can also improve your well-being and day-to-day quality of life.

We’re here for you with support

If you already have a plan with us, and have any questions or want to submit a claim, you can call us: