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Canada - ENWhat is Hospital Insurance and Do You Need It?
In Canada, our universal healthcare is highly regarded for providing people with the essential care they need – that includes hospital stays. However, it’s a common misconception that your provincial health plan will cover all the services and/or procedures you may need if you end up in hospital. That’s where hospital insurance comes in.
Learn more about what hospital insurance covers and how it can supplement your provincial health plan.
Key takeaways
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Hospital insurance can cover any additional expenses you’re likely incur if you end up in hospital as a result of an accident or an illness.
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Hospital insurance can provide a daily benefit of up to $200 per day, in addition to a lump sum totalling your daily amount.
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Hospital insurance benefits are flexible; you can use them to pay for a private hospital room, paramedical treatments, in-home care, prescription medications, transportation or post-hospital appointments.
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Hospital insurance can benefit Canadians who are self-employed, retire early, have a health condition that requires frequent hospital visits, or want extra protection.
What is hospital insurance?
Hospital insurance provides coverage for hospital-related services and procedures not covered under Canada’s universal healthcare or employer group plans.
If you are admitted to hospital, you’ll receive a tax-free daily benefit of up to $200 a day. In addition, you will receive a lump-sum payment that equals the total amount of your daily benefits. Maximum length of hospital coverage is one year per condition, with a maximum possible benefit of $146,000 tax-free.
Hospital insurance is available for Canadian resident between the ages of 18 and 69 with RBC Insurance, and premiums will not increase. You can enroll your spouse or common-law partner in your plan if they are between the ages of 18 and 74.
Hospital insurance vs. provincial health coverage
While your provincial/territorial health insurance plan will cover the cost of your stay in hospital for accident or illness, this coverage is not extensive. Universal health care typically includes a standard ward accommodation, nursing, meals, in-hospital diagnostic testing, and standard physician consultations and examinations.
However, hospital insurance can cover additional services and procedures that your provincial or territorial healthcare plan doesn’t cover. For example, if you have a lengthy stay in hospital, you may wish to move to a private or semi-private room. In addition, you may use your benefits to cover costs post-hospitalization that your provincial health care might not cover.
What does hospital insurance cover?
Hospital insurance benefits are flexible; you can use them to pay for a private hospital room, paramedical treatments, in-home care, prescription medications, transportation or post-hospital appointments.
Hospital insurance covers any additional services or procedures that you may need while in hospital because of an accident or an illness. For example, you can use your daily benefits and/or lump sum to cover paramedical treatments such as physiotherapy, any necessary counselling, prescription medications, or pay any expenses such as childcare or housekeeping.
RBC Insurance offers two types of hospital insurance coverage: basic and enhanced.
If you purchase basic hospital insurance, you or your spouse/partner will be covered for hospitalization resulting from an accident only.
If you purchase enhanced hospital coverage, you or your spouse/partner will be covered for hospitalization resulting from an accident or an illness.
What does hospital insurance not cover?
Hospital insurance only covers you for hospital stays due to accident or illness. Coverage does not apply for hospital stays due to any of the following reasons:
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Self-injury (e.g., attempted suicide)
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Intoxication
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Voluntary ingestion of drugs, poison, toxic/non-toxic substances, or gas
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Elective cosmetic surgery
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High-risk activities (e.g., scuba diving, skydiving, parachuting, rock/mountain climbing)
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Criminal offence or assault
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Involvement in war, riot, or insurrection
Who needs hospital insurance in Canada?
While many people have private or group health insurance through their employer, if you’re one of approximately 30 per cent of Canadians who rely on provincial or territorial health care alone, then you could benefit from getting hospital insurance, especially if:
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You own your own business or are self-employed
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Don’t have group health benefits
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Have a health condition which you require in-hospital treatments or visit the hospital frequently
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Retired early
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Want enhanced healthcare coverage for you and your family
How to choose the right hospital insurance coverage
When choosing the right hospital insurance consider the following:
Your circumstances: What do you need from your insurance? Do you go to hospital often? Do you have a condition in which you need regular treatments? If so, you may want to consider a hospital insurance policy.
Any existing coverage: Review what your provincial or territorial plan covers. While most jurisdictions cover essential medical treatments, some specifics (e.g., in-home care) may not be covered depending on where you live. Check your provincial Ministry of Health website to find out what is and isn’t covered.
Policy specifics: Compare plans from different insurance companies. Look at the monthly premium you pay, the deductible you pay before the insurance starts, and any out-of-pocket maximums.
Get expert advice: Even if you conduct your own research, you still may want to contact a licenced insurance advisor for personalized advice.
Hospital insurance helps protect you against the high cost of hospitalization, giving you peace of mind to rest and recover. With RBC Insurance, it’s easy to enroll online quickly and easily.
RBC Hospital Insurance
Hospital insurance can help fill the gap left by your other coverage. If you’re an RBC client, age 18 to age 69, and a Canadian resident1, your acceptance is guaranteed.
1.You are eligible to enrol for hospital insurance if you are a current customer of any RBC company, age 18 to 69, and a Canadian resident. You may also enrol your spouse if he or she is between the ages of 18 and 74. Online enrolment is not available for Quebec residents.
FAQs about hospital insurance in Canada
Is hospital insurance the same as health insurance in Canada?
Hospital insurance and health insurance are not the same insurance product. Hospital insurance pays you a tax-free benefit for hospital stays due to illness and/or injury, whereas health insurance helps cover the cost of extended health benefits like prescription drugs, dental care, vision care, and paramedical services.
Can I get hospital insurance if I’m self-employed?
Yes, you can get hospital insurance if you’re self-employed in Canada. Hospital insurance will help provide small business owners and self-employed individuals with additional coverage above their provincial or territorial health plans.
What’s the difference between hospital insurance and critical illness insurance?
With hospital insurance, you receive a daily tax-free benefit of up to $200 to cover extra expenses incurred while in hospital due to an accident or illness. However, critical illness (CI) insurance pays out a one-time lump sum if you are diagnosed with a specific serious illness or condition such as life-threatening cancer, heart attack, or stroke.
*Home and auto insurance products are distributed by RBC Insurance Agency Ltd. and underwritten by Aviva General Insurance Company. In Quebec, RBC Insurance Agency Ltd. Is registered as a damage insurance agency. As a result of government-run auto insurance plans, auto insurance is not available through RBC Insurance in Manitoba, Saskatchewan and British Columbia.
This article is intended as general information only and is not to be relied upon as constituting legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. Information presented is believed to be factual and up-to-date but we do not guarantee its accuracy and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the authors as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by Royal Bank of Canada or any of its affiliates.
