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Saskatchewan Provincial Health Insurance Plan

Your Saskatchewan Health Services card gives you coverage for many medical and community services. You can make the best use of your health system by knowing what is available and what is covered. You can also make a more informed choice about buying additional insurance for you and for your family.

DENTAL
- What is covered:  Saskatchewan Health does cover the following: Certain oral surgery procedures required to treat specific conditions caused by accidents, infection, or congenital problems; Certain Orthodontic services for cleft palate when referred by a physician or dentist; Extractions of teeth when medically required before undertaking certain surgical procedures related to the heart, chronic renal disease, head or neck cancer, or total joint replacement by prosthesis; Dental implants are covered in exceptional situations where no other method of treatment is appropriate. Coverage is limited to circumstances related to tumours and congenital defects (cleft palate and metabolic disorders). Coverage will require a specialist in oral maxillofacial surgery to request prior approval from the Ministry of Health by submitting in writing information and rationale to support the request. Coverage is limited to the initial cost to provide dental implants and does not extend to ongoing maintenance costs. Dental implants for trauma, post-surgical temporomandibular joint disorder (TMJ), or cosmetic purposes will not be covered.
- What is NOT covered: Dental Services – In Saskatchewan, routine dental services, including extractions, are not covered.

DRUGS
- What is covered:
Seniors’ Drug Plan – Saskatchewan residents who are 65 years of age and older with a reported income that is less than the Provincial Age Tax Credit will be eligible for the income-tested Seniors’ Drug Plan. Individuals must submit a complete application form to be approved. This program ensures that Saskatchewan seniors pay $25 per prescription for drugs listed in the Saskatchewan Formulary or approved under Exception Drug Status. Seniors with Special Support coverage will pay the lesser of the Special Support co-payment or the $25 per prescription. Children’s Drug Plan – Saskatchewan residents 14 years of age and under, qualify automatically for the Children’s Drug Plan. This program ensures that Saskatchewan children pay $25 per prescription for drugs listed in the Saskatchewan Formulary or those approved under Exception Drug Status.
- What is NOT covered
: Saskatchewan Health does NOT cover prescription drugs outside of a hospital unless you are eligible for one of the health programs mentioned above.

TRAVEL INSURANCE
- What is covered:
Saskatchewan Health insurance plan provides limited coverage for emergency medical care from approved hospitals outside Canada if the same services would be covered in the province. Coverage includes: Up to $100 CAD per day for inpatient services; Up to $50 CAD for an outpatient hospital visit. Your Saskatchewan health coverage will not pay for more than two visits in one day.
- What is NOT covered: If a patient receives emergency medical or hospital care while outside Canada, they will be responsible for paying the difference between the amount charged and the amount the Ministry reimburses. Costs for hospital services outside of Canada may be much higher than in Saskatchewan. It is recommended to obtain additional health insurance when travelling outside the country.

VISION
- What is covered:
Optometric Services – An annual eye exam is covered for all individuals under 18 years of age, and all individuals who have a confirmed diagnosis of type I or type II diabetes (Note: routine follow up exams are not covered); Ocular emergencies are covered (i.e. injury to eyes, foreign body in the eye, etc.).
- What is NOT covered:
Eyeglass lenses and frames are not covered by Saskatchewan Health, unless receiving Family Health Benefits or Supplementary Health Benefits.

PARAMEDICAL
- What is covered
: Physiotherapy or occupational therapy and Speech-Language Pathology - Services provided through hospitals, special care homes, community agencies or by private clinics in Saskatchewan that have a contract with the Saskatchewan Health Authority. 
- What is NOT covered:
Massage Therapy/Naturopath/Osteopath/Homeopath Services – These services are not covered by the Saskatchewan Ministry of Health. Chiropractor Services – Effective July 1, 2017 chiropractic services are no longer benefits.

HOSPITAL ROOM
- What is covered:
Saskatchewan Health insurance plan covers all medically necessary services provided by physicians (in-patient and outpatient services) are covered (ward rooms only).
- What is NOT covered: Extra costs are not covered for private or semi-private ward accommodation in Saskatchewan hospitals if chosen by the patient, but the physician doesn’t order it as a medical necessity.

PRIVATE DUTY NURSING AND MEDICAL EQUIPMENT
- What is covered:
Some coverage available under the Saskatchewan Aids to Independent Living program for those suffering a long-term physical disability. Coverage available through the Children’s Insulin Pump Program for residents 17 years old or younger. In addition, the Saskatchewan Insulin Pump program covers one pump every 5 years for residents 25 years of age and under to treat Type 1 diabetes.
- What is NOT covered:
Private home care services are not covered.

HEARING AIDS
Effective July 1, 2017: The Hearing Aid Plan has been discontinued. Hearing services/hearing aids will continue to be covered for eligible individuals under Family Health Benefits or the Supplementary Health Benefits.

AMBULANCE
- What is covered:
Ambulance trips as a result of a motor vehicle collision or on the job injury are covered by Saskatchewan Government Insurance (SGI), or the Workers’ Compensation Board (WCB) respectively. There are programs to reduce or fully cover fees for seniors, children of low-income families, and northern Saskatchewan residents.
- What is NOT covered: Ambulance service is not an insured benefit covered by Saskatchewan Health (unless the patient is eligible for a supplemental program).

 

Helpful links:

Saskatchewan Health Care

- Saskatchewan Ministry of Health

- Saskatchewan Formulary

 

Visit www.ExtendedHealth.ca or call toll free 1-877-838-0020 to get a quote or apply for Extended Health care insurance.

 

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IMPORTANT NOTE: The information on this web page is for illustration purposes only. Every effort has been made to ensure the accuracy of the information. Coverage details are subject to change. For complete benefits, terms, conditions, limitations, and exclusions, please contact Saskatchewan Health.

 

Last revised in September 2020.

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