PolicyMe Health & Dental Insurance Review

Canadian healthcare is universal however, there are areas where MSP doesn’t cover you- like dentist, optometrist, or massage therapist visits. Prior to my husband coming onto my extended health benefits plan, I think he went for a teeth cleaning every 3 years. That’s okay, his teeth are still great even though he didn’t go for a check-up often. Now we go every six months.

I love my extended benefits that I get from my employer and regularly check how many massages or acupuncture sessions I have left until the end of the year. My husband has prescription drugs that would cost about $180 every three months out of pocket if we didn’t have extended benefits.

This post may contain affiliate links. Please see genymoney.ca’s disclaimer for more information.

Our family is quite dependent on my extended health benefits and I feel that using these benefits really has improved our family’s health on both the health promotion and health treatment front.

That’s why if I were to retire early (I don’t plan to work until 65, I am thinking about Freedom 55 or possibly even 50) I think we would need to pay into a health insurance plan.

I know that the mental accounting might not make sense (it will probably make more sense to just pay the costs up front) but it just feels better to pay into something regularly and know that it is covered under insurance.

Kind of like a buffet. You probably pay more and you’ll eat more than you would if it were not a buffet. But it feels better for the wallet and budget.

Anyway, I thought I would take a look at the new PolicyMe Health and Dental Insurance, which came into effect October 1, 2024.

What is PolicyMe?

PolicyMe is an online insurance company that offers Term Life Insurance, Health and Dental Insurance, and Critical Illness Insurance.

PolicyMe’s term life is both convertible and renewable.

PolicyMe is available nationwide across all Canadian provinces and territories.

They also offer a T100 product, which is a permanent life insurance product.

PolicyMe Health and Dental Insurance Review

All of the extended benefits do not require a pre-existing health condition medical questionnaire, and the prescription plan covers pre-existing medication use. For example, if you are on a blood pressure medication it is covered, even though when you sign on to the plan you already have high blood pressure.

The plans do not cover medications for erectile dysfunction, infertility, medicinal marijuana, quitting smoking, and weight loss (Ozempic anyone?).

There are three Protect Plans available, the Economic, Classic, and Advanced Plan (these are for people who are coming off of previous employer benefits). There’s also a plan excluding prescription drugs.

Here’s a brief glimpse of each of the plans offerings:

Economic Plan

• Dispensing fee is not fully covered, it is $10 per prescription
• $1000 max per year in prescription drugs
• $500 every year in dental benefit (per person covered)
• $200 every 2 years in vision wear including laser eye surgery
• 50% co-insurance and $600 max per year for RMT, physio, acupuncture, podiatry etc. combined
• $500 per year on mental health support like clinical counsellors, psychologists (with $60 per session max paid out)

Classic Plan

• Dispensing fee is covered
• $1600 max per year in prescription drugs
• $750 for the first year, then $900 per year in dental benefits max coverage
• $250 every 2 years in vision wear including laser eye surgery
• 80% co-insurance and $750 max per year for RMT, physio, acupuncture, podiatry etc. combined
• $800 per year on mental health support like clinical counsellors, psychologists (with $100 per session max paid out)

Advanced Plan

• Dispensing fee is covered
• $2800 max per year in prescription drugs
• $800 for the first year, then $1200 per year in dental benefits max coverage
• Braces/ orthodontics only after year two, and it is a $2500 lifetime maximum
• $450 every 2 years in vision wear including laser eye surgery
• 80% co-insurance and $1000 max per year for max per year for RMT, physio, acupuncture, podiatry combined
• $1300 per year on mental health support like clinical counsellors, psychologists (with $100 per session max paid out)

No-Prescription Drugs Plan

• It is basically the Classic plan without prescription drugs
• $750 for the first year, then $900 per year in dental benefits max coverage
• $250 every 2 years in vision wear including laser eye surgery
• 80% co-insurance and $750 max per year for RMT, physio, acupuncture, podiatry etc. combined
• $800 per year on mental health support like clinical counsellors, psychologists (with $100 per session max paid out)

For my family of four the Advanced Plan would cost around $408 per month.

You can also get your free quote here. You can also click here for more information on how the PolicyMe plans compare.

In comparison with Pacific Blue Cross, the Advanced Plan comes out more than the Gold Plan, but the medication coverage is better with the PolicyMe plan.

Here’s the Pacific Blue Cross plan below- they ask you for the oldest person that is covered under your plan and this is a plan for a family of more than three people.

Here are some of the pros and cons of the PolicyMe Extended Health and Dental Benefits plan.

PolicyMe Extended Health Pros

The PolicyMe plan doesn’t require you to disclose any pre-existing medical issues.

There is no lifetime maximum for extended health benefit benefits (the Pacific Blue Cross plans have a lifetime maximum).

The pharmaceutical medication coverage is pretty good, $2800 per year for the advanced plan compared to Pacific Blue Cross which is a maximum of $750 per year for the Gold Plan. That’s a big difference.

In addition, for the Advanced Plan, it covers $1300 a year in mental health (counselling, psychology) services, which is excellent.

Finally, the dental coverage is better for the PolicyMe plan than the Pacific Blue Cross plan (shown below).

PolicyMe Extended Health Cons

The plan for paramedical coverage is not very robust. With the Advanced Plan, the chiropractor, physiotherapist, massage therapist, acupuncturist coverage is $1000 annually combined for all. Unfortunately each of these paramedical services are expensive with each visit, the $1000 would be less than 10 visits for all of these services annually (with a 80% coinsurance with the Advanced Plan).

Genymoney.ca’s Verdict

If you do not have workplace benefits or you are retired (and your income is not low enough so that you don’t qualify for the Canada Dental Benefit plan), having extended health and dental benefits is beneficial to cover the areas where MSP doesn’t cover. Thankfully in Canada you can claim private health insurance premiums on your tax return or if you are self-employed you can also deduct the premiums as a business expense.

The PolicyMe extended health and dental benefits plan has very strong pharmaceutical medications and dental coverage- not to be nihilistic, this is something that as you get older, you will likely need more of.

It also has excellent counselling (therapy) and psychology coverage especially for the advanced plan.

If you are not in need of paramedical coverage and want a strong plan for dental benefits and medication coverage the PolicyMe plan is good for this.

Here’s more information on the PolicyMe Health and Dental Benefits plan.

What is your PolicyMe Health and Dental Benefits review?