Understanding Health Benefits in Saskatchewan: What’s Covered and What’s Not
In Saskatchewan, health benefits combine provincial public coverage with private health insurance plans to offer additional support.
This article explains how health benefits work in Saskatchewan, who has access to them and what services are included or excluded. It also outlines how private insurance can work alongside public coverage.
Both individuals and employers often look at health benefit plans to understand how medical costs are managed. This includes knowing what is paid for, what is not, and what options exist for additional protection.
What Health Benefits do Saskatchewan Residents receive?
In Saskatchewan, health benefits refer to programs that assist with covering the cost of medical care when it is needed. These programs help make essential care more accessible for many residents, though gaps still exist, especially for services not included in the public plan or when travel is necessary.
Saskatchewan’s health coverage starts with the publicly funded Saskatchewan Health Plan, which is the foundation for doctor visits, hospital care and most diagnostic tests. To help with costs the provincial plan doesn’t cover, like routine dental work, prescription drugs or physiotherapy, private or employer-sponsored insurance can complement your public coverage.
Health benefits aren’t just about shrinking day-to-day bills; they’re your financial safety net. By covering routine costs and unexpected hits like a $300-plus ambulance ride, a last-minute prescription, or an emergency doctor visit while you’re travelling, the right mix of public and private coverage can keep surprise medical expenses from derailing your budget and provide you with peace of mind.
Who Is Eligible For Public Health Benefit Coverage
Residency Requirements
To qualify for public health benefits in Saskatchewan, you need to live primarily in the province. This means making Saskatchewan your home for at least five months of each year.
A Saskatchewan resident is someone who:
- Makes the province their primary home
- Is legally entitled to be in Canada
- Lives in Saskatchewan for the minimum required time
Some groups like full-time students studying outside the province, temporary foreign workers and members of certain Indigenous communities, have special eligibility rules.
When you apply for health coverage, you’ll need to prove your identity and address with documents like:
- Government-issued photo ID (driver’s license or passport)
- Proof of address (utility bill or rental agreement)
- Immigration documents (if applicable)
Registration Process
Getting public health coverage in Saskatchewan involves a simple registration process:
- Complete the Health Services registration form (available online or at service centers)
- Submit your documents in person, by mail, or online
- Wait for your application to be processed (usually 4-6 weeks)
- Receive your Health Services card
You’ll need to present this card whenever you access medical services.
If you need help with registration, you can contact eHealth Saskatchewan directly or visit one of their service offices.
Which Services Are Fully Covered
Physician And Hospital Care
Saskatchewan’s public health plan covers most services provided by doctors. This includes:
- Visits to family doctors
- Specialist consultations when referred by your doctor
- Medical assessments and examinations
- Hospital-based care
When it comes to hospital services, the public plan covers:
- Room and board in standard hospital wards
- Nursing care during your stay
- Surgeries and medical procedures
- Emergency room visits
These services come at no direct cost to you as long as you show your valid Health Services card.
Diagnostic Tests And Procedures
Many diagnostic tests are fully covered under Saskatchewan’s public health benefits. These include:
- Blood tests and laboratory work
- X-rays and ultrasounds
- CT scans when medically necessary
- MRIs when ordered by a physician
Not all diagnostic services have the same coverage. Some specialized tests might require approval, need to be ordered by a physician and performed in a publicly funded facility, or they may not be covered.
Which Services Are Partially Covered Or Excluded
Prescription drugs
Unlike doctor visits, medications aren’t automatically covered. Through the Saskatchewan Drug Plan’s Special Support Program, what you pay depends on household income. Lower-income families receive a larger subsidy, while higher-income households pay a bigger share. Most prescriptions are partially covered.
- Seniors’ Drug Plan: Eligible residents 65 + pay up to $25 per eligible prescription; the province covers anything above that cap.
- Targeted supports: Children under 14 and people living with certain chronic conditions (such as diabetes or cystic fibrosis) benefit from similar cost-sharing programs.
These measures keep medications affordable for Saskatchewan residents, but it’s always good to plan ahead for unexpected out-of-pocket expenses.
Dental care
Routine dentistry like check-ups, fillings, crowns and similar work is not paid for by the public plan. Coverage only applies when dental surgery must be performed in hospital under general anaesthetic, or when treatment is required after significant trauma or disease.
The table that follows breaks down which dental services are publicly funded and where private insurance, such as a Saskatchewan Blue Cross personal health plan, can close the gap.
Ambulance And Vision Care
Ambulance services in Saskatchewan aren’t fully covered by public health benefits. Residents pay a fee for each ambulance trip, which can range from $245–$325 (plus mileage in rural areas) depending on the location and distance travelled. For non-residents, a basic rate of $360 will apply.
Vision care coverage is limited under the public plan. Children under 18 receive one covered eye exam yearly, while adults between 18-64 generally don’t have coverage for routine eye exams. However, adults with Type 1/2 diabetes also receive annual coverage. Seniors over 65 may receive partial coverage for eye exams
Neither eyeglasses nor contact lenses are covered under the public health plan, regardless of age. These items require private insurance or out-of-pocket payment. You can always get a free personal health insurance quote to determine if a plan is right for you.
How Private Coverage Complements Public Health Benefit Plans
Additional Dental And Vision Coverage
Private health benefit plans can help cover the cost of Dental and Vision services. For dental care, private plans typically cover:
- Regular checkups and cleanings
- Fillings and basic procedures
- Major work, like crowns and bridges
- Orthodontics (often for those under 18 years of age and with lifetime maximums)
For vision care, private plans usually include:
- Eye examinations
- Prescription eyeglasses
- Contact lenses
- Some corrective procedures
Most private plans set annual maximums for these services. For example, our Blue Choice® plan covers unlimited coverage for accidental damage to natural teeth, or as an optional add-on, up to $1,500 dental coverage after 2 years. On the same plan, vision care covers up to $100 for eye examinations, and $150 for prescription eyewear or laser eye surgery in a 24-month period. Our plan comparisons will provide you with a detailed breakdown of coverage across our different plans.
The advantages of having a personal health plan include lower out-of-pocket costs for routine care and everyday peace of mind, knowing surprise health expenses won’t derail your finances
One of the key benefits of choosing any one of our Saskatchewan Blue Cross health insurance plans is access to Virtual Care services and an Individual Assistance Program (IAP). These services give our members fast, convenient access to medical professionals, licensed counsellors and certified life coaches without the hassle of travel or long wait times. This is especially beneficial to those living in rural communities.
Expenses and Deductibles
It can be difficult to comprehend the expenses related to health benefits. Below is a list of frequently used terms:
Premiums: Regular payments to maintain private insurance coverage are known as premiums. In Saskatchewan, there are no premiums for public health benefits.
Deductibles: The amount you pay before your insurance begins to cover expenses is known as your deductible. Private plans frequently have deductibles, while public plans hardly ever do.
Co-payments: A co-payment is the fixed dollar amount you pay for a covered service. For example, some private plans ask members to pay the first $25 of each specialist visit, and the benefits provider pays the balance of the eligible cost.
Coverage limitations vary between plans. Private insurance typically sets annual or lifetime maximums for different services.
Your health benefit card is essential for accessing covered services. Always carry both your provincial health card and private insurance card (if you have one) when seeking medical care.
Moving Forward With Your Coverage Options
Public health benefits in Saskatchewan give residents a strong foundation of coverage for essentials like doctor visits, hospital care, and many diagnostic tests. Building on that foundation, private health benefits add protection for unexpected expenses and services not publicly funded.
Private health benefits can include:
- Dental care
- Vision care
- Prescription medications
- Paramedical services like physiotherapy, massage and chiropractic
When considering your health coverage needs, think about:
- Your typical healthcare usage
- Family medical history
- Prescription medications you take regularly
- Budget for insurance premiums
Our personal health benefit plans offer coverage that works alongside the provincial coverage. These plans range from basic to comprehensive, allowing you to choose coverage that fits your specific needs and budget.
To explore options and get personalized information, you can view our personal health insurance plans here.
FAQs About Health Benefits
If I relocate to a different province, what will happen to my health benefits?
When you relocate within Canada, your current province continues to pay for medically necessary care for up to three months while you apply for a health card in your new province; at the same time, simply tell Saskatchewan Blue Cross (or your existing Blue Cross carrier) about the move and we’ll seamlessly convert or transfer your personal plan to the Blue Cross partner in your new province, or welcome you to ours. You can enjoy uninterrupted coverage for all with no waiting period, if you contact us within 90 days.
Does obtaining health benefits require a waiting period for new residents?
Most newcomers to Saskatchewan will have a three-month waiting period before their provincial Health Services card becomes active, but if you apply for (or transfer) a Saskatchewan Blue Cross personal health plan right away, your private coverage can begin immediately.
How can I determine which health benefits services have extra costs?
On their website, Saskatchewan Health offers a thorough list of services that are covered and those that are not. To prevent unforeseen expenses, always confirm coverage prior to receiving non-emergency care.
Do health benefits cover prescription medications completely?
The Saskatchewan Drug Plan provides partial coverage based on income and eligibility factors. The plan reduces medication costs but only covers prescriptions completely if you qualify for special programs.