Government Health Programs in Canada, and Where Each One Stops

1. Canadian Dental Care Plan — federal, launched 2024

What it does: pays for exams, cleanings, fillings, root canals and dentures for residents with adjusted family net income under $90,000. The catch: you are disqualified if you have access to dental coverage through any employer, pension or private plan, whether or not you use it — and that includes health and wellness spending accounts. It is built to sit behind workplace plans, not to replace them. A journeyman with a working spouse clears $90,000 easily and receives nothing.

• Access disqualifies, not usage — declining your workplace plan does not restore eligibility
• Health and wellness spending accounts count as access
• Eligibility is cross-checked against T4 and T4A slips, where a coverage code appears in box 45
• Income ceiling of $90,000 adjusted family net income on top of the access rule

2. National pharmacare — federal, prescription drugs

What it does: free contraception and diabetes medication, with no deductible and no co-ordination with private insurance. The catch: two drug categories, and only where a province has signed a bilateral agreement. As of 2026 that is British Columbia, Manitoba, Prince Edward Island and Yukon. Ontario has not signed. For an Ontario employer, this programme currently changes nothing at all, and every other medication stays exactly where it was.

• Contraception and diabetes medication only
• Signed: British Columbia, Manitoba, Prince Edward Island, Yukon
• Ontario has not signed a bilateral agreement
• No effect on any other drug class, in any province

3. OHIP+ — Ontario, drugs, age 24 and under

What it does: covers formulary prescription drugs for Ontario residents aged 24 and under at no cost. The catch: it stops at 25, and where a private plan exists, that plan pays first. It is a floor for the uninsured, not coverage for a workforce. For a construction employer this reaches the youngest apprentices and nobody else, and it reaches them only until their 25th birthday.

4. Trillium Drug Program — Ontario, high-cost drugs, ages 25 to 64

What it does: covers formulary drugs for Ontario households with no private plan and heavy prescription costs. The catch: the deductible is roughly 4% of after-tax household income before anything is paid. On $80,000 net that is about $3,200 out of pocket first, every year, and it resets. Trillium is genuine catastrophic protection. It is not drug coverage in the sense an employee means when they ask whether their prescription is covered.

5. EI sickness benefits — federal, income replacement

What it does: replaces 55% of insurable earnings when illness or injury keeps someone off the job. The catch: capped at $729 a week and 26 weeks in 2026. A site supervisor on $110,000 receives roughly a third of his income, and it ends after six months. Nothing follows it unless the employer sponsors disability coverage. This is the single largest gap on the list, and the one employers are most surprised by.

• 55% of insurable earnings, subject to the weekly maximum
• $729 a week maximum in 2026
• 26 weeks maximum duration
• No automatic successor benefit — long-term disability is employer-sponsored or absent

6. WSIB — Ontario, workplace injury, employer-funded

What it does: covers lost income and treatment for injuries and illnesses caused by the work itself. Construction employers in Ontario already pay premiums for it. The catch: it only pays when the cause is work-related. The heart attack, the cancer diagnosis, the Saturday car accident, the back that finally gave out at home — none of those are WSIB claims. Employers who assume WSIB is their disability coverage are covered for one category of cause and uncovered for every other.

Related: WSIB premium rates for Ontario construction — What construction employers already pay, by classification.