Employee Benefits After Age 65 in Ontario

Current as of October 2026. Government programs, tax rules and prices change. Check the official sources listed at the end of this page before making a decision, and confirm details with a licensed advisor.

Why age 65 matters for group benefits

For decades, 65 was the age when group coverage was built to wind down. Disability benefits were designed to replace income until retirement, life insurance amounts often stepped down, and health and dental coverage sometimes ended altogether. Today plenty of people keep working past 65, like a bookkeeper who loves her job or a site supervisor mentoring apprentices.

That leaves employers with practical questions: does the plan still cover a 66-year-old's dental cleaning, and what happens to their prescriptions once the province steps in? The answers depend on your insurance contract, Ontario law and the government programs that begin at 65.

What Ontario law says (as of October 2026)

Ontario's Employment Standards Act, 2000 prohibits age discrimination in benefit plans, but for that purpose it defines age as 18 or older and under 65. The Ontario Human Rights Code was amended so that benefit, pension and group insurance plans that comply with the ESA and its regulations do not infringe the right to equal treatment on the basis of age. Together, these rules have historically allowed plans to reduce or end some coverage at 65.

That picture became less settled in 2018. In Talos v. Grand Erie District School Board, the Human Rights Tribunal of Ontario found that the Code provision permitting age-based distinctions in benefits, along with related ESA provisions, amounted to age discrimination contrary to the Canadian Charter of Rights and Freedoms. The Ontario Human Rights Commission, which intervened, said employers may need to revise group health, dental and life insurance benefits that give reduced or no coverage to workers 65 and over, and that age-based distinctions should be based on accepted insurance practice and credible actuarial data. Other decision makers have reached different conclusions in specific cases, particularly for long-term disability.

The takeaway, as of October 2026: if your plan cuts off health, dental or life coverage at 65, it is worth reviewing with an employment lawyer and your benefits advisor rather than assuming it is fine. GroupBenefitPlans.ca does not give legal advice, and how these rules apply to your workplace depends on your facts, contracts and any collective agreement.

Health and prescription drug coverage after 65

Extended health coverage (massage, physio, hearing aids, glasses) may continue past 65, continue in a modified form, or end, depending on the contract. Some plans adjust maximums or drop features such as out-of-country travel medical. Your plan booklet and contract are the only reliable answer.

Prescription drugs are where things change most, because the province steps in. As of October 2026, Ontario residents with OHIP are automatically enrolled in the Ontario Drug Benefit program on the first day of the month after they turn 65. Seniors pay a $100 annual deductible and up to $6.11 per prescription filled or refilled after the deductible, and lower-income seniors can apply to the Seniors Co-Payment Program to remove the deductible and reduce the co-payment to up to $2.

How a group plan interacts with ODB varies by insurer and contract. Some plans are designed to work alongside the provincial program, for example by covering drugs that ODB does not list, or helping with the deductible and co-payments. Ask an advisor to explain exactly how your prescription drug benefit treats members 65 and over so employees are not surprised at the pharmacy counter.

OHIP itself continues as usual at 65, with one helpful addition: as of October 2026, people 65 and older are covered for one major eye exam every 18 months plus two follow-up minor assessments. Glasses and contact lenses are still not covered, which is one reason vision benefits stay valuable.

Dental coverage after 65

Cleanings, fillings, crowns and dentures do not get cheaper with age, so dental coverage is often what older employees value most. Whether your group dental plan continues past 65 is again a contract question, and it is worth confirming before an employee's birthday rather than after a claim is declined.

Government dental programs have their own rules about other coverage, as of October 2026:

• Canadian Dental Care Plan (CDCP): one of the requirements is having no access to dental insurance, including through your work or pension plan or a family member's plan, and adjusted family net income must be under $90,000. Having employer dental coverage, even unused, generally makes someone ineligible. There is a limited exception for some retirees who opted out of a work or pension dental plan before December 11, 2023 and cannot re-enrol.
• Ontario Seniors Dental Care Program: for people 65 and older with annual net income of $25,480 or less (single) or a combined $42,290 or less (couples) who do not have private insurance or dental coverage under another government program. CDCP coverage does not disqualify someone.
• Because both programs depend on not having other dental coverage, ending or keeping group dental for an older employee can affect what public help they qualify for. Encourage employees to check the official program pages before making decisions.

Life insurance and disability coverage at 65

Group life insurance is the benefit most often designed to reduce with age. Many contracts include an age-based reduction or a termination age. Make sure the policy schedule matches what your employee handbook or any collective agreement promises; where those documents disagree, employers can end up responsible for the difference.

Disability coverage is different. Long-term disability is designed to replace income during working years, and many LTD contracts end coverage or benefit payments around age 65. Public programs follow the same logic: CPP disability benefits are for people over 18 and under 65. The 2018 Talos decision expressly did not apply to LTD, and arbitrators have upheld LTD age cut-offs in some cases. Short-term disability terms vary by contract, so check yours.

Practical options for employers

If you have, or expect to have, team members working past 65, a few approaches are worth discussing with a licensed advisor:

• Ask your insurer what age-related terms apply to each benefit: health, drugs, dental, vision, life, AD&D, STD and LTD.
• Explore whether health and dental can continue for employees 65 and over, possibly with plan design adjustments and pricing based on actuarial data.
• Consider adding a health spending account, which can help cover deductibles, co-payments and services the main plan does not.
• Make sure your plan booklet, offer letters and handbook all describe age-related changes the same way.
• Tell employees well before 65 what will change, and point them to ODB and other official program information.

Getting help with your plan

Benefits after 65 sit where contracts, employment law and government programs overlap. Get matched with a licensed benefits advisor who can walk through your current contract, explain options for older employees, and help you communicate changes clearly. For legal questions about age and benefits, speak with an employment lawyer.

Common questions

Can an Ontario employer stop benefits when an employee turns 65?

Ontario's Employment Standards Act limits its age discrimination protection in benefit plans to employees under 65, and the Human Rights Code has a related exception. However, a 2018 Human Rights Tribunal of Ontario decision (Talos) found that exception breached the Charter as applied to health, dental and life insurance benefits in that case. As of October 2026, employers who end coverage at 65 should review the practice with an employment lawyer.

Does the Ontario Drug Benefit replace my group drug plan at 65?

ODB starts automatically for OHIP-covered residents on the first day of the month after they turn 65, but it does not cover every drug and it has a deductible and co-payments (as of October 2026). How a group plan works alongside ODB depends on the contract, so check with your plan administrator or insurer.

Will having work dental coverage affect the Canadian Dental Care Plan?

Yes. As of October 2026, CDCP requires that you have no access to dental insurance, including through an employer or pension plan or a family member's plan. Having employer dental coverage generally makes you ineligible, even if you do not use it. A limited exception exists for some retirees who opted out of a work or pension dental plan before December 11, 2023.

Does long-term disability coverage continue after 65?

Many LTD contracts end coverage or payments around age 65 because they are designed to replace income during working years. The exact terms are in your policy, so check the contract or ask your insurer.

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