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FinancialNavigator

What's Covered By Medicare

In Canada, we have a system of universal coverage for basic medical care.   It is informally referred to as “medicare”.  It is not a national program – under legislation, our provinces and territories are required to fund hospital and doctor services and make sure their residents have reasonable access to these services.  The federal government’s role is to provide funds from tax revenue so the provinces can operate these services.   Under our Canada Health Act, all provinces are accountable to ensure their hospital and physician services are accessible to all, universal (i.e. everyone can get the same services) and portable.

Over time, what is considered “basic” hospital and physician care has expanded to include many services and products.

What is Covered by Medicare

  • Family doctor visits, emergency room visits, outpatient clinic appointments
  • Inpatient care/surgery
  • Medicines you receive as part of your inpatient care
  • Diagnostic Tests, Bloodwork, Scans, Genetic Testing
  • Radiation therapy
  • Medicines infused or injected in an outpatient clinic (e.g. chemotherapy, hydration)
  • Cancer support services offered in hospitals (e.g. dietician, counselling, physio)
  • Mental health services through the cancer centre

There are numerous health services and products that are not covered under our medicare system because they are used outside of hospitals and physician offices.

What is not Covered by Medicare (not exhaustive)

  • Ambulance services
  • Transportation to/from treatment
  • Wound care and post-op supplies
  • Home Care (i.e. help with personal care and household tasks)
  • Prescription Drugs (including take-at-home cancer treatments)
  • Over the counter treatments and supplies
  • Smoking cessation therapies
  • Dental treatment
  • Fertility preservation
  • Sexual Aids (e.g. estrogen, lube)
  • Alternative therapies (e.g. acupuncture, reiki, naturopathy, herbal medicine, massage)
  • Mobility supports
  • Breast prostheses
  • Wigs and head wraps
  • Lymphedema devices and pressure garments
  • Nutritional supplements or feeding supplies
  • Physiotherapy/Occupational Therapy (outside of what is provided through the hospital)
  • Private counselling or therapy
  • Tattooing and other reconstructive supports/processes

It is the responsibility of the patient to pay for these services/products.  A province or territory might choose to provide a program to help with the cost of a particular service/product, but this is up to each provincial/territorial government.  If a program is offered, it is usually not 100% coverage and is a voluntary program.  Subsidized home care service and provincial drug plans are examples of these kinds of programs.   Community groups and charitable organizations may also offer assistance programs like volunteer transportation services, wig and prosthesis funds, etc.  Again, this varies by region.

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Additional Information

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If you have additional information that would be helpful to include in this tool please email cbcn@cbcn.ca or call us at 1-800-685-8820.

Contacting CBCN

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Connect with us via email at cbcn@cbcn.ca or on the phone at 1-800-685-8820.