What are out-of-pocket expenses in health insurance?
Healthcare costs that aren’t covered by insurance, and that you pay for with your own money are called “out-of-pocket” expenses. Some out-of-pocket expenses not covered by provincial/territorial health insurance plans include:
- Most eye exams
- Dental care
- Some prescription drugs (for most people)
- Procedures considered to be cosmetic in nature
- Parking at a hospital
- Some ambulance fees
- Medical accessories such as casts, crutches, wheelchairs, etc.
- Healthcare paperwork such a doctors’ notes, transferring medical files, or filling out forms
Even if you have health insurance, you’ll likely end up paying some out-of-pocket expenses. These may include:
- Premiums – The money you pay for health insurance
- Exclusions – Things not covered under health insurancesuch as experimental products or treatments, or cosmetic products or services
- Deductibles – The amount you’ll pay for covered healthcare expenses before your insurance plan starts to reimburse you. For instance, with a $100 deductible, you pay for the first $100 of expenses before your insurance kicks in.
- Coinsurance – The percentage of the cost you pay for covered healthcare expenses
- Dispense fees – A fee charged by a pharmacist to fill a prescription. Your insurance plan may only cover a certain amount for dispensing. Above that amount, you’ll have to pay
- Expenses over limits – Most healthcare plans have limits for certain categories. For instance, you may claim up to $500 for massage services. Above that amount, you’ll pay out-of-pocket.
Are out-of-pocket healthcare expenses tax deductible?
Some out-of pocket healthcare expenses may be deductible. Check with Canada Revenue AgencyOpens a new website in a new window or a list of eligible expenses and how to claim them on your tax return.