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Sun Life Health Insurance Review (2024)
Sun Life offers three flexible health insurance plans: Basic, Standard, and Enhanced, to suit diverse needs and budgets. It includes coverage for prescription drugs, dental, vision, and emergency travel, with up to 80% reimbursement on eligible medical expenses. Enhanced plans also cover orthodontics and restorative dental services. Dependents are eligible under specific conditions, and plans include semi-private hospital room options.
- What are the key features of health insurance from Sun Life?
- What are the different Sun Life health insurance plans I can choose from?
- What does Sun Life’s health insurance cover?
- Who is eligible for Sun Life’s health insurance plan?
- How much does Sun Life cover for prescriptions?
- How much does Sun Life cover for vision?
- What are the pros and cons of Sun Life’s health insurance plans?
- How can I get a quote from Sun Life?
- Frequently asked questions
When it comes to protecting your health and finances, having reliable health insurance can make all the difference. Sun Life offers a range of health insurance solutions designed to provide peace of mind and security, whether you’re looking for coverage for everyday medical needs or planning for the unexpected.
Their plans protect you from both your health and your finances, tailored to meet your specific needs. Their dental insurance plans help with costs for routine checkups, cleanings, and major dental work.
If you’re self-employed or retired, Sun Life offers flexible plans to keep you covered at every stage. Let’s explore why Sun Life’s health insurance plans are a great choice for securing your health.
What are the key features of health insurance from Sun Life?
Key features of Sun Life personal health insurance plans include coverage for three plan options (Basic, Standard, Enhanced), and pre-existing coverage has a 9-month waiting period. Coverage is available for dependents under 21, or 25 if in school.
Key features of Sun Life health insurance
| Feature | Details |
| Age | Up to age 69; renewable for those aged 70+ |
| Premiums | Guaranteed for one year from the policy’s effective date |
| Waiting period | – 1 year for restorative dental care and up to 2 years for orthodontic treatments
– Emergency travel medical: Coverage has a nine-month pre-existing condition limitation |
| Plans | 3 plans: Basic, Standard, Enhanced |
| Eligibility | Dependents must be under 21 or 25 if in school |
| PolicyAdvisor rating | 4.5/5 |
Call 1-888-601-9980 to speak to our licensed advisors right away, or book some time with them below.
What are the different Sun Life health insurance plans I can choose from?
Sun Life offers three health plans to choose from —Basic, Standard, and Enhanced. All plans allow for additional optional benefits such as semi-private hospital coverage and extended dental services. The Enhanced plan offers up to 80% reimbursement on medical expenses and includes extensive prescription drug coverage.
Below is a table highlighting the key features of each plan:
Sun Life personal health insurance plans
| Plan | Key Features | Ideal For |
| Basic | – Low-cost plan
– Covers basic medical and dental needs – Catastrophic drug and emergency travel medical coverage |
Those seeking affordable coverage |
| Standard | – Most popular plan
– Greater coverage for prescription drugs than Basic plan – Emergency medical coverage for travel – Optional preventive dental coverage |
Individuals who want moderate, well-rounded coverage |
| Enhanced | – Most comprehensive plan
– Highest level of prescription drug coverage – Catastrophic drug and emergency travel medical coverage – Optional dental coverage including restorative and orthodontic services |
Those needing extensive coverage and a broad range of services |
What does Sun Life’s health insurance cover?
Sun Life’s health insurance offers comprehensive coverage options, including up to 80% reimbursement for prescription drugs, $750 for preventive dental care, and up to $1 million for emergency travel medical expenses. Check out the table below for more coverage options in detail.
Sun Life personal health insurance coverage
| Coverage | Basic | Standard | Enhanced |
| Prescription drugs | 60% reimbursement, $750 max/year, no deductible, excludes fertility drugs & contraceptives | 70% reimbursement up to $7,000, then 100% to $100,000/year max; no deductible | 80% reimbursement up to $5,000, then 100% to $100,000/year max; includes oral contraceptives |
| Preventative dental | 60% reimbursement, $500/year max (optional) | 70% reimbursement, $750/year max (optional) | 80% reimbursement, $750/year max |
| Restorative dental | Not covered | Not covered | 50% reimbursement, $500/year max (optional) |
| Orthodontics | Not covered | Not covered | 60% reimbursement, $ 1,500-lifetime max (optional) |
| Supplemental health care | 60% reimbursement, alternative treatments up to $250/year per practitioner | 100% reimbursement, alternative treatments up to $300/year per practitioner | 100% reimbursement, alternative treatments up to $400/year per practitioner |
| Vision | Not covered | 100% reimbursement, $150 every 2 years | 100% reimbursement, $200 every 2 years |
| Emergency travel | Not covered | 100% reimbursement, 1st 60 days of trip, $1 million lifetime max | 100% reimbursement, 1st 60 days of trip, $1 million lifetime max |
| Semi-private hospital | 85% reimbursement, $180/day, $5,000 annual max (optional) | 85% reimbursement, $180/day, $5,000 annual max (optional) | 85% reimbursement, $180/day, $5,000 annual max (optional) |
Who is eligible for Sun Life’s health insurance plan?
To be eligible for Sun Life’s health insurance plan, you must be in Canada at the time of application and have Canadian residency with active provincial or territorial health and drug coverage.
For residents of Quebec, there is an additional requirement: maintaining group drug coverage through an employer, association, or the Régie de l’assurance maladie du Québec (RAMQ).
Dependent children can also be covered if they are under 25 years old, or between 21 and 24 and enrolled as full-time students. You are not eligible if you are diagnosed with certain specified illnesses or conditions, are awaiting medical tests or investigations recommended by a doctor, or have pending surgery.
How much does Sun Life cover for prescriptions?
Sun Life covers prescriptions under their health insurance plan with a coverage range from 60% to 80%, with annual maximums of $750 to $5,000, depending on the plan. Smoking cessation drugs are covered across plans, but contraceptives and fertility drugs are generally excluded.
Sun Life employs a pay-direct drug card system, allowing members to have their claims processed directly at the pharmacy, minimizing out-of-pocket expenses at the time of purchase.
This means that members only pay the remaining balance after the coverage is applied, making it easier to manage prescription costs.
Are glasses covered by Sun Life?
Yes, Sun Life’s personal insurance plans offer vision coverage under their Standard and Enhanced health plans. These plans cover up to $250 and $300 every two years, for prescription glasses, contact lenses, and prescription sunglasses.
Both plans include coverage of up to $50 for eye exams every two years. The Basic plan does not offer any vision coverage. There is also a one-year waiting period before vision benefits become active for new policyholders.
Is ambulance service covered by Sun Life?
Yes, Sun Life’s health insurance plans cover ground ambulance services in all three of their plan options (Basic, Standard, and Enhanced). Their Enhanced Plan additionally provides coverage for air ambulance services, with a maximum benefit of $5,000 per incident.
Coverage specifics may vary, so it’s best to consult the plan details or speak to a Sun Life advisor to ensure the plan meets all medical and emergency transportation needs.
Are dentures covered by Sun Life?
Yes, Sun Life dental insurance can help cover the costs of dental care such as oral exams, dental cleanings, fillings, extractions, crowns and bridges, dentures, dental implants, and more.
Coverage options vary based on your chosen Personal Health Insurance (PHI) plan—whether it’s a basic, standard, or enhanced option—allowing you to access a range of dental benefits. Coverage amounts differ by plan, with annual maximums starting from $500 for the Basic plan and lifetime maximums reaching up to $1,500 for the Enhanced plan.
How much does Sun Life cover for vision?
Sun Life covers up to 100% vision coverage for prescription glasses, contact lenses, prescription sunglasses, and laser eye surgery. Eye exams, under the Standard and Enhanced plans cover up to $50 every two years.
When it comes to eyeglasses and contact lenses, coverage can reach up to $250 under the Standard plan and $300 under the Enhanced plan, with both plans requiring a one-year waiting period before you can use the benefits.
Is breast pump covered by Sun Life?
Yes, Sun Life may cover breast pumps if deemed medically necessary with a doctor’s prescription. Coverage is typically up to $300, but this can vary by plan.
Claims generally need to be submitted under “medical equipment” or “prescription equipment,” and a doctor’s note is often essential for approval. You need to buy a pump from a designated medical supplier or reputable retailer.
What are the pros and cons of Sun Life’s health insurance plans?
Sun Life’s health insurance plans offer several benefits, such as a strong provider network, pre-existing condition coverage, and easy online management. However, some drawbacks include limited dental coverage on the Basic plan and waiting periods for certain benefits. Let’s explore the pros and cons of Sun Life health insurance below:
Pros and cons of Sun Life health insurance
| Pros | Cons |
| Sun Life has a strong network of healthcare providers across Canada | Dental benefits are not included in the Basic plan and are only available as paid add-ons in the Standard and Enhanced plans |
| It provides you the option of having a semi-private hospital room with all plans | All family members should enroll in the same plan, limiting customization based on individual health needs |
| The online portal and mobile app (mySun Life) allow easy access to policy management and claims submission | Certain treatments may require pre-approval or have coverage caps |
How can I get a quote from Sun Life?
You can quickly get a Sun Life health insurance quote from PolicyAdvisor. Get instant free quotes to see options customized for you in seconds. Plus, you’ll be able to compare Sun Life’s plans with other top Canadian health insurance providers.
If you’d prefer personal guidance, PolicyAdvisor also offers licensed advisors who can provide expert advice tailored to your needs. We also provide lifetime after-sales support to help you out with any future queries.
Frequently asked questions
What will happen if I stop paying my Sun Life insurance?
If you stop paying your premiums, your policy might lapse, ending your coverage and leaving your beneficiaries without a payout. Some policies offer options like a grace period, reduced benefits, or retained cash value. Check your policy details for any available alternatives.
How long does Sun Life take to process a claim?
Sun Life typically processes claims within 5–10 business days, depending on the claim type and required documents. Missing information or complex cases may take longer. For faster processing, submit your claim online or ensure all documents are complete. Contact Sun Life for specifics.
Are premiums for Sun Life plans guaranteed?
Sun Life personal health insurance plans do offer guaranteed premiums, but this guarantee is typically limited to one year from the policy’s effective date. After this period, premiums may be subject to change based on various factors, including the insurer’s policies, underwriting guidelines, and the overall health of the insured.
- Sun Life offers three plans—Basic, Standard, and Enhanced—with up to 80% coverage on certain medical expenses
- Prescription drug coverage ranges from 60% to 80% across plans, with annual maximums from $750 to $5,000
- One-year waiting period applies to some benefits, such as vision and orthodontics
- Semi-private hospital rooms are covered under all health insurance plans
- Dental and vision coverage are optional add-ons for Basic and Standard plan; included only in Enhanced plan
