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Medical Insurance in Canada

MEDICAL INSURANCE PLANS IN CANADA

Medical costs are on the rise, and if you do not have proper insurance, an illness or injury can have a devastating financial impact. Some people do not have group insurance or provincial health insurance such as OHIP. Those that do, may find having group insurance and provincial health insurance may not be enough in some circumstances.

OHIP AND PERSONAL INSURANCE

When purchasing coverage, it is important to buy the right type of health insurance to suit your situation. For instance, if you are a Canadian traveling abroad for an extended period of time, some travel insurance plans become void if you are not covered by OHIP or another provincial health insurance plan for the full duration of your absence from Canada. An expatriate policy may be more appropriate for you.

Health and dental plans similarly require you to be covered by your provincial health plan because they are a supplement to it, not a substitute for it. A knowledgeable benefits advisor will ask what your status is regarding provincial health coverage when you are buying insurance, and then recommend the correct type of health insurance for you.

If you are a visitor, a returning Canadian or a new resident of Canada, then the category of medical insurance most suitable for you is "Visitors-to-Canada" medical insurance. This type of medical insurance is for someone who is not covered by a provincial health insurance.

Some medical insurance plans have deductibles and copayments. This means you are required to pay part of the expense incurred. This can be a way to keep the cost of your plan lower while still providing you with valuable protection against catastropic financial loss. Some travel insurance policies allow the insured to choose from a range of deductibles, and offer a discount on the premium depending upon which one is selected.

COVERAGE FOR PRE-EXISTING CONDITIONS

If your search for a health and dental plan has been prompted by increasing costs of prescriptions you regularly take, you should first be aware that individual health and dental plans fall into 2 groups - "medically evaluated" plans and "guaranteed coverage" plans.

Medically evaluated plans require you to complete a medical questionnaire which is reviewed by an underwriter to determine your eligibility. Any current conditions and medication will be excluded by the plan.

Guaranteed coverage plans are available for someone who has just left a group plan behind, but you must apply for coverage before 60 days of when you were last covered by the group plan. These plans will cover a pre-existing condition.

LOW COST STARTER PLANS

If you are not not leaving behind a group plan, then there are still a few basic plans with a modest maximum for drug benefits. Their value should be measured by looking at the overall benefits provided, not just a comparison of the drug benefit maximum. They also provide you with benefits for dental, hospitalization, home nursing, paraprofessionals, ambulance, medical equipment, and sometimes also travel insurance.