If your spouse has group benefits through work - like Manulife, Sun Life, or Canada Life - you might assume you’re fully covered.

After all, they have a medical, dental, and hospitalization plan. But take a closer look, and you’ll likely find that coverage isn’t as comprehensive as it sounds.

In fact, most employer-sponsored plans come with limitations that leave employees (and their families) paying more than expected out of pocket.

‍And they're not free either.

Your spouse is almost certainly contributing part of the premium, deducted right from their paycheque.

‍This is where your Hiveworks HSA fills in the gaps.

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1. Many plans only cover 70% to 90% of costs

Whether it’s dental work, physio, or vision, employer plans don't always reimburse 100%

Example: your $200 dental visit is reimbursed at 80% - you’re still out $40.

Massage, chiropractic, and counselling often have similar partial coverage.

With an HSA, you can claim that leftover 10–30% and turn it into a tax-free reimbursement.

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2. Annual maximums are surprisingly low

Group plans cap how much they’ll reimburse each year. These caps can run out fast, especially when there are multiple people on the plan

• ‍Dental: $1,000–$1,500/year
• ‍Vision: $150–$250 every 2 years
• ‍Massage therapy, physio, chiro, counselling: $300 to $500/year per service

Once you hit the cap, you’re paying 100% out-of-pocket.

With an HSA, you can claim all amounts outside of these limits.

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3. Certain health expenses aren’t covered at all

Many common or necessary services aren’t included:

• Laser eye surgery
• Orthotics, orthopaedic shoes
• Fertility treatments
• Dietitians, naturopaths, acupuncture
• Acne treatments

If they’re eligible medical expenses under CRA rules, they’re reimbursable through your HSA - even if your spouse’s plan doesn’t cover them at all.

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4. Dependent coverage is limited

Spouses and children are often covered at reduced levels, or require an added premium.

Many plans don’t cover dependents' alternative or preventive care

Your HSA allows you to claim for your spouse and your children - even if they’re already covered under another plan.

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And here’s what CRA says about all of this:

If your spouse pays premiums for a health plan, that portion is a valid medical expense.

Premiums paid to private health services plans – including medical, dental, and hospitalization plans – can be claimed as a medical expense, as long as 90% or more of the premiums paid under the plan are for eligible medical expenses.

‍CRA – Eligible Medical Expenses

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That means you (as an incorporated individual) can use your Hiveworks HSA to:

• Reimburse the portion of premiums your spouse pays out-of-pocket
• Claim the uncovered amounts of any eligible medical, dental, or hospitalization expense
• Cover your own, your spouse’s, and your children’s leftover costs - tax-free

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What does “medical” mean, exactly?

“Medical” includes a wide range of health-related services - not just doctor visits. If your spouse’s group benefits cover any of the following, they fall under that “medical” category:

• Prescription drugs
• Eye exams and prescription glasses or contacts
• Mental health counselling and therapy
• Chiropractor, massage, physiotherapy, acupuncture
• Diabetes supplies and medical devices
• Orthotics, mobility aids, and other eligible items

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To Recap

You’re an incorporated individual, and your spouse has group benefits through their employer.

You might feel “covered” but in reality, you’re still paying out-of-pocket in ways that your Hiveworks HSA can absolutely help with.

1. Premiums paid for qualifying medical, dental, and hospitalization plans (like those from Manulife, Sun Life, etc.) if your spouse pays a portion of these through payroll deductions - can be submitted to your Hiveworks HSA
2. Out-of-pocket health spending - whether it's the leftover 20% from a dental visit, the full cost of a pair of prescription glasses, or a $150 therapy session not covered at all - can also be submitted through your Hiveworks HSA, for you, your spouse, and your dependents.

By using your Hiveworks HSA as an incorporated individual, you’re shifting health expenses from personal, after-tax dollars to pre-taxbusiness expenses.

‍Your HSA isn’t a replacement to your spouse’s benefits, it’s there to complete them. If you're paying out of pocket anyway, this is the smarter way to do it.

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