Prince Edward Island provincial health care plan (PEI Health)

Eligibility and coverage details for Prince Edward Island

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GHIP

Who is covered by the Prince Edward Island provincial government health care plan?

The PEI Health Plan covers all Prince Edward Island residents. It provides basic healthcare services, including doctor and hospital care. Residents must register to receive coverage.

GHIP

Are you eligible?

To qualify for PEI Health, you must be a resident of Prince Edward Island for at least 3 months. You can apply as soon as you arrive in the province. Certain exceptions apply.

What's covered

Coverage details for the Prince Edward Island provincial Health Care Plan (PEI Health)

Benefit
Coverage details
Prescription Drugs

PEI Health acts as the payer of last resort, providing drug coverage only when no other insurance options are available. Residents aged 65 and older qualify for the Seniors’ Drug Program, which requires a co-payment and a professional pharmacy fee for eligible prescription drugs. Coverage may also be available for residents with specific medical conditions who meet certain criteria. PEI’s Biosimilars Initiative ensures that only biosimilar versions of eligible drugs are covered under the provincial drug program.

Ambulance

Residents of Prince Edward Island are required to pay a flat fee for land ambulance services. The fee applies regardless of the medical necessity or urgency of the situation. Air ambulance services are generally not covered under the provincial plan. Learn more about ambulance billing and coverage on the island.

Dental benefits

Routine dental services are not covered for individuals aged 18 and over. However, limited coverage is available for residents between the ages of 3 and 17 who do not have private dental insurance. Long-term care residents may also be eligible for certain dental benefits under provincial programs.

Vision care

There is no coverage for eye exams, glasses, or contact lenses under the PEI Health Plan. However, children in Kindergarten are eligible for a free eye exam and free glasses if needed. Learn more about eye exam coverage.

Hospital

PEI residents with a valid health card are covered for standard ward room accommodations and medically necessary hospital services. If a ward room is unavailable, private or semi-private rooms may be covered, though they are not covered by default. Learn more about hospital stays.

Paramedicals

There is no coverage available for paramedical services under the Prince Edward Island health plan. Residents are responsible for covering the costs of services like chiropractic care, acupuncture, or physiotherapy through private insurance or out-of-pocket payments.

Hearing aids

Some coverage for hearing aids is available through Audiology Services for residents up to the age of 21. Residents over the age of 21 will need to explore private insurance options or government assistance programs for hearing aid coverage.

Medical equipment & supplies

The Insulin Pump Program in Prince Edward Island provides coverage for insulin pumps and associated supplies for residents under 25 with type 1 diabetes. Additionally, residents may qualify for coverage of ostomy supplies through the Ostomy Supplies Program, depending on medical need and eligibility.

Paramedicals

There is no coverage available for paramedical services under the Prince Edward Island health plan. Residents are responsible for covering the costs of services like chiropractic care, acupuncture, or physiotherapy through private insurance or out-of-pocket payments.

Nursing benefits and home care

The Home Care Program in PEI provides access to various health and support services, including nursing care, personal support, and rehabilitation. Coverage is available for those who qualify, allowing residents to receive necessary medical care in their homes or communities.

Accidental death and dismemberment

There is no coverage for accidental death and dismemberment under the PEI health plan. Residents will need to look into private insurance for such coverage.

Out of country

PEI residents may be eligible for limited coverage for emergency medical services received outside of the country. The level of coverage is determined on a case-by-case basis, and residents may be responsible for costs beyond what is covered by the province.

Disclaimer

The information provided on this page is intended for general informational purposes only and may be subject to change. While every effort is made to ensure accuracy, provincial and territorial health coverage details can vary and are regularly updated. We recommend contacting your respective GHIP or consulting a legal, tax, or insurance advisor for advice tailored to your specific situation.

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Extended Health Care

How Personal Health & Dental Insurance Complements Your Provincial Plan

While your provincial or territorial health plan covers many essential medical services, there are important areas where personal health insurance can help extend your coverage, giving you broader protection and peace of mind.

Bridge the Gaps in Coverage

Provincial health plans often leave gaps, such as prescription drugs, dental visits, and vision care. Personal health insurance can bridge these gaps by covering expenses your government plan doesn’t, ensuring you’re not left with unexpected out-of-pocket costs.

Be Ready for Life’s Health Changes

Even with your government health coverage, there are still costs that can catch you off guard, like prescription drugs, dental care, and vision expenses. A personal health plan can step in to cover these out-of-pocket expenses, making sure you’re protected from financial surprises.

Secure Your Health & Financial Future

Investing in personal health insurance today can save you from paying high costs for treatments or services down the road. By taking a proactive approach, you can ensure you get the care you need now, avoiding bigger health issues—and bigger bills—later on.

Get in touch

Talk to an advisor who can understand your situation, answer your questions and help you build an insurance plan appropriate for you and your family.

How to contact your GHIP

For more information on the latest coverage details, please contact the Prince Edward Island provincial health care plan directly at:

Health PEI
16 Garfield Street
P.O. Box 2000
Charlottetown, PE C1A 7N8
Phone: 902-368-6130
Email: [email protected]

Website: Health PEI