Guaranteed issue health care plans
Health and dental insurance for those retiring or losing their employee group benefits.
What is a guaranteed issue health care plan?
A guaranteed issue health and dental insurance plan is an ideal choice for individuals transitioning from an employee group benefits plan, especially those who have recently lost such benefits (within the last 60-90 days). This type of plan is particularly beneficial for ensuring continuous health coverage during such transitions.
The defining characteristic of a 'guaranteed issue' plan is its straightforward application process. Applicants are not required to complete a medical questionnaire. Instead, the insurance company provides coverage on a guaranteed basis, provided you apply within 60-90 days after your employee group benefits end. This feature makes it a hassle-free option for maintaining health insurance coverage.
Similar to other health insurance plans, the primary function of a guaranteed issue plan is to cover health and dental costs not included in your provincial government health care plan. This helps in reducing your out-of-pocket expenses for these essential services.
While guaranteed issue plans generally offer moderate value in terms of benefits per dollar compared to other plan types, their significant advantage lies in covering pre-existing conditions. This aspect makes them a valuable option for individuals with existing health issues who are seeking comprehensive coverage without the need for extensive medical underwriting.
Guaranteed-issue health and dental plansGuaranteed-issue health plans
Leaving a group plan? Timing matters.
When group coverage through work ends, many insurers offer a health and dental plan you can join without medical questions, but only if you apply within a set time.
Group plan through work
Group coverage ends
Apply with no medical questionsusually within 60 days
Window closes
- Applied in time: accepted, with no medical questions
- Applied too late: medical questions, and coverage may be limited or declined
Common reasons group coverage ends:
- Leaving a job
- Retiring
- Starting your own business
- Aging off a parent’s plan
Most insurers allow 60 days after group coverage ends, and some allow up to 90. Applying within 60 days keeps the most options open. Plan terms vary by insurer.
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 is currently covered by an employee group benefits plan, or has recently lost their benefits (within last 60-90 days).
- Individuals and families who have recently lost their employee group benefits (within last 60-90 days).
- Individuals and families who have medical history and 'pre-existing conditions' that they want to ensure are covered.
- Individuals and families who want/need a 'bridging' solution to avoid gaps in coverage while they shop for a Medically Underwritten 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
Cost
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 acceptance
- No medical questionnaire
- Apply anytime
- Highest relative cost
- Lowest benefits per dollar
- Covers pre-existing conditions
Frequently asked questions
All questionsWhat is the benefit of a guaranteed issue health and dental plan compared with other plans?
If you apply within the window after your group coverage through work ends, usually 60 days and sometimes up to 90, you’re accepted with no health questions, and conditions you already have are covered. It costs more than a medically underwritten plan for the same coverage, so if you’re healthy, it’s worth checking both before your window closes.
How long does it take to get health and dental insurance?
It depends on the type of plan. A medically underwritten plan usually takes about three weeks, mostly waiting for records from your doctors. Guaranteed issue and guaranteed acceptance plans ask no health questions, so they usually start on the first of the month after your application is approved.
Related to guaranteed issue plans
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