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Health & Dental Insurance
A foundational part of financial planning is ensuring you have comprehensive health coverage in place.
What is health insurance?
Health insurance in Canada plays a crucial role in managing both routine and unexpected health-related expenses. It covers a range of services, from paramedical treatments, dental and vision care, to significant costs like hospital stays and prescription medications.
As a Canadian citizen, your primary health coverage comes from the health insurance plan of the province where you reside. Each provincial plan offers a foundation of essential health services. However, there are often gaps in coverage, particularly for services like dental care, vision care, and certain prescription drugs. This is where private health insurance, offered by insurance companies, becomes vital. It acts as a supplement to your provincial health plan, filling in these gaps and providing broader health coverage. Consequently, in Canada, private health insurance is frequently referred to as an 'extended health care plan' because it extends the benefits of your government-provided health insurance.
In essence, a private health insurance plan in Canada is designed to alleviate the financial burden of those health and dental expenses not covered by your provincial government health care plan, ensuring a more comprehensive health safety net.
What does health insurance cover?
Health insurance plans cover a combination of routine expenses (i.e. planned predictable expenses), and unplanned expenses. Every plan will vary with regard to coverage amounts for each of these benefits.
- Prescription drugs
- Dental visits
- Paramedical services
- Vision care
- Ambulance (air / ground)
- Hospital accomodation
- Emergency travel medical
- Medical equipment
How do the types of health insurance plans compare?
There are three main types of health insurance plans; Medically Underwritten, Guaranteed Issue, and Guaranteed Acceptance. The appropriate plan for you depends on your circumstances. An advisor can assist in determining the appropriate plan for you.
- Medical questionnaire required
- Lowest relative cost
- Most benefits per dollar
- Excludes pre-existing conditions
- Can apply anytime, acceptance is subject to qualifying medically
- No medical questionnaire
- Moderate relative cost
- Moderate benefits per dollar
- Covers pre-existing conditions
- Must apply within 60-90 days of employee benefits terminating
- No medical questionnaire
- Highest relative cost
- Fewest benefits per dollar
- Covers pre-existing conditions
- Can apply anytime, acceptance is guaranteed
Get help with your health insurance planning.
Speak with a professional advisor who can help.
How much does health insurance cost?
There are a number of factors that can affect plan pricing, including:
Age
Generally, insurance cost less for younger age groups, and more for older age groups
Single, couple or family
Plan cost will vary depending on the number of people covered.
Province of residence
Plan cost can vary from one province/territory to the next.
Plan selection
Plans that include more benefits and higher coverage amounts come at a higher cost.
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.
Frequently asked questions
Answers to key questions about Health and Dental Insurance
People often consider applying for individual health insurance during life changes or transitions, such as aging out of a parent’s plan, losing employer group benefits, becoming self-employed, or when existing coverage no longer meets their needs. The appropriate timing depends on personal circumstances, health history, and the type of plan being considered.
Eligibility requirements for individual health insurance vary by insurer and by plan. In general, applicants are typically required to be Canadian residents and to have coverage under a provincial government health insurance plan. Age requirements, provincial rules, and other eligibility conditions can differ depending on the insurer and the type of plan.
The time required to obtain health insurance depends on the type of plan and the insurer’s application process. Some plans may become effective shortly after an application and payment are received, while others require review and approval before coverage begins. Timelines can vary if additional information is requested during the application process.
Medical underwriting is the process insurers use to assess an applicant’s health history and other factors when evaluating an application for coverage. Depending on the plan, this may involve completing a health questionnaire and, in some cases, the insurer may request additional medical information. The underwriting outcome can affect eligibility and the terms of coverage offered.
Many individual health and dental insurance plans do not require a physical medical exam. However, some plans involve medical questions as part of the application, and in certain cases insurers may request additional medical information. Requirements vary depending on the plan and insurer.
Still have questions?
Please contact our office and we'll be happy to address any questions you may have.
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