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Guaranteed Acceptance Health Care Plans
Health and dental insurance for those who may not qualify medically for another plan.
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What is a guaranteed acceptance health care plan?
A guaranteed acceptance health and dental insurance plan is an appropriate choice for individuals who might face challenges in qualifying for a healthcare plan due to their medical history. This type of plan is designed to provide an insurance solution for those who may be ineligible for other types of health coverage.
The hallmark of a 'guaranteed acceptance' plan is its inclusive application process. Applicants are not required to complete a medical questionnaire, and the insurance company issues coverage without considering the applicant's health history. This means that coverage is assured regardless of your medical conditions or the timing of your application.
Like all health insurance plans, the primary goal of a guaranteed acceptance plan is to supplement your provincial government health care plan. It aims to reduce your out-of-pocket expenses by covering health and dental costs that are not included in your provincial coverage.
While guaranteed acceptance plans generally provide lower value in terms of benefits per dollar compared to other types of plans, they serve as a valuable potential solution. They are particularly beneficial for individuals with pre-existing conditions who might otherwise be unable to secure health insurance coverage.
This type of plan is an ideal fit for:
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.
- Individuals and families who have medical history that may preclude them from qualifying for a Medically Underwritten plan. Or, would result in too many exclusions.
- Individuals and families who have medical history and 'pre-existing conditions' that they want to ensure are covered.
- Individuals and families who are not covered by an employee group benefits plan and are outside the 60-90 day window to transition seamlessly to a Guaranteed Issue plan.
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
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.
Other types of health care plans
There are two other types of health insurance plans; 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.
Medically Underwritten
- Medical questionnaire required
- Apply anytime
- Lowest relative cost
- Highest benefits per dollar
- Excludes pre-existing conditions
Guaranteed Issue
- No medical questionnaire
- Apply within 60-90 days of employee group benefits terminating
- Moderate relative cost
- Moderate benefits per dollar
- Covers pre-existing conditions
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 Guaranteed Acceptance Health Care Plans
The key benefit of Guaranteed Acceptance extended heath care plans will cover any pre-existing medical conditions you may have, and you can apply at any time.
This is beneficial for those who have health history that may result in exclusions, or even potentially being declined for coverage if applying for a Medically Underwritten plan, as well as those who are outside the 60-90 day window for applying for a Guaranteed Issue plan.
The 'caveat' to a Guaranteed Acceptance plan, is that the insurer tends to assume that anyone applying for this type of plan is unable to qualify for the other plan types, and for that reason will design the plans (for both profitability and sustainability reasons) to offer lowest amounts of coverage at a higher relative cost.
Guaranteed Acceptance plans are a valuable option for those who can't otherwise get health care coverage, but from a best-practice standpoint are generally used once it's been determined that the other plan options aren't suitable.
It depends on the type of plan.
- For Guaranteed Issue and Guaranteed Acceptance plans, your coverage will be effective on the 1st of the next month after an application and payment is received.
- For Medically Underwritten plans, your coverage coverage will be effective on the 1st of the next month after an application has been approved (subject to qualifying medically) and payment is received.
- Medically Underwritten plans can sometimes take longer as the insurance company usually needs to obtain records from your attending physician(s). Average time to approval tends to be about 3-weeks. If the insurance company has difficulty obtaining the medical records from your attending physician(s) this may take additional time.
Still have questions?
Please contact our office and we'll be happy to address any questions you may have.
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