When you’re shopping for health and dental insurance, you may find yourself with questions. How much coverage is enough ? Why should you choose 1 plan over another? Are you paying for benefits you’ll never actually use?
To help simplify this process, we’ve run through some of the most common things you’ll need to consider as you look for the best health insurance for your situation.
Figure out what coverage you already have
Before you buy extra coverage, make sure those health needs aren’t already covered by insurance you already have. This could include:
Provincial or territorial health insurance
If you’re eligible, government healthcare covers many common medical services and supplies. What’s covered can vary depending on your age, income, and where you live, so be sure to check out the specifics for your province or territory.
A workplace benefits plan
Some employers offer health and dental benefits to their employees as part of an overall compensation package. You may also be eligible for coverage through your spouse’s workplace benefits plan if you don’t have 1 yourself. If you have Canada Life benefits, sign in to check your coverage.
Take stock of your specific situation
Are you getting older, and anticipating future health needs as you age? Do you have kids that might need braces? Are you self-employed and do a physical job that means you may frequently need to see a chiropractor? The specifics of your current – and future – situation play a major part in selecting the right plan for you and your family.
If you’re retiring, consider:
- A plan that has higher coverage for prescription drugs
- A plan with coverage for medical supplies like hearing aids and mobility devices
- A plan with home care options like home health aides
- A plan that allows you to add emergency travel medical insurance
- A plan that covers pre-existing medical conditions
If you’ve got a family, consider:
- A plan that covers services not included in your kids’ government health care, like speech therapy or mental health services
- A plan that helps cover any glasses or contact lenses they might need, even if their eye doctor visits are covered by their government plan
- A plan with dental coverage
If you’re a freelancer or a contractor:
- A plan that includes paramedical services like massage therapy or chiropractor, especially if your job is physical or you’re hunched over a computer all day
- A plan with accidental death and dismemberment insurance, particularly if you have a partner or dependants who rely on your income
- A plan that could cover you if your health changes in the future, even if you’re young and healthy now
Decide which coverage you need
Individual health insurance plans can offer different levels of coverage and may allow you to exclude or include coverage for specific services or supplies and select between different coverage amounts within that decision.
When you’re choosing a plan, consider:
Do you need dental coverage?
Dental coverage can include routine dental check ups and cleaning, but can also help cover major dental expenses like crowns.
Do you need vision coverage?
This coverage can include eye exams for adults, but may also extend to the cost of frames and contacts or laser eye surgery.
Do you need prescription drug coverage?
While government healthcare covers medication you need when you’re in hospital, many Canadians have to pay-out-of-pocket for prescription drugs you may need to treat an illness or manage chronic conditions. FYI: Some plans will cover pre-existing conditions but others may not.
Do you need coverage for paramedical services?
Depending on the plan, this coverage could help cover the cost of mental health services like psychologists or social workers, massage therapy, physiotherapy and specialists like naturopaths or speech therapists.
Do you want to add any extras?
Many plans give you the option to add some optional coverage, at an additional cost, to your plan. This could include:
- Emergency travel medical insurance
- Hospital accommodation, which can upgrade you to a private or semi-private room
- Hospital cash, which can cover expenses like parking or childcare while you’re admitted
- Accidental death and dismemberment insurance
- Major dental coverage, which can cover needs like crowns or dentures
Determine how much coverage you need
Many individual health plans have different levels of coverage you can select from.
For example, Canada Life’s Freedom to Choose™ health and dental insurance , Select, Select Plus and Select elite plans all can be tailored to include dental coverage, but each plan has different coverage levels.
Routine dental care & Diagnostic services, preventative services, minor restorative services, endodontic and periodontal services, denture maintenance, oral surgery or adjunctive services
- Select: 70% coverage up to $350 per person each calendar year
- Select plus: 80% coverage up to $750 per person each calendar year
- Select elite: 80% coverage up to $1,000 per person each calendar year
Major restorative dental care & Dentures, bridgework, crowns, posts, onlays and inlays
- Select: No coverage (but can be added as optional coverage)
- Select plus: No coverage (but can be added as optional coverage)
- Select elite: 50% coverage up to $750 per person each calendar year
- Select: 100% coverage
- Select plus: 100% coverage
- Select elite: 100% coverage
The more your plan covers, the more your monthly premiums are likely to be. If you’re on a budget, it may be worth sitting down and figuring out whether the amount you spend on a plan each month makes financial sense when compared to the out-of-pocket cost of services you’ll actually use. Balance this, of course, with the fact that you can’t predict the future, and unexpected health needs can arise at any time.
Supplemental vs continuing coverage
There are 2 kinds of individual health insurance: Supplemental and continuing insurance.
Supplemental refers to plans for people who don’t currently have any non-government coverage at all, while continuing insurance is for people who are currently with (or have just left) another insurance plan, often workplace benefits.
These distinctions matter because continuing a workplace benefits plan may allow you to keep your coverage for pre-existing conditions, while supplemental insurance may exclude those conditions from coverage.
Crunch the numbers
Cost can be a major deciding factor when you’re choosing the right plan for you. To find out how much different plans with different coverage levels might cost you, get a quote using our questionnaire.
What is underwriting?
Underwriting is how an insurer determines your monthly premiums or if you’ll have any exclusions on your plan. Underwriting is a risk assessment exercise – basically, how likely is it that they will have to pay out for the coverage you’re purchasing – so things like pre-existing conditions and your age will be a factor in how much your individual health insurance costs.
Apply for coverage
In many cases, you will be able to buy your private health insurance online or by calling to speak with a company’s sales representatives. Most private health insurance plans require you to apply first, meaning someone from the company’s team will take a look at your application before approving you for coverage.
This could involve a medical exam, although some plans – including Canada Life’s Freedom to Choose health and dental insurance – do not require a medical exam for coverage. However, you may have to answer some medical questions for underwriting purposes. While you may not be denied coverage entirely, you may be offered a different plan (potential with a pre-existing condition excluded) or at a higher monthly premium than you may have been initially quoted.
While this sounds complicated, applying for health and dental insurance online is often quick and easy – answer some questions, fill out some personal information, choose your preferred billing method – and might just end up being way less of a hassle than you think.