Medically underwritten health care plans
Health and dental insurance for self-employed individuals or anyone not covered by a employee group plan.
What is a medically underwritten health care plan?
A medically underwritten health and dental insurance plan is often considered a 'standard' option in health insurance. The key feature of this plan is its 'medically underwritten' nature. This means that when you apply, you'll need to complete a medical questionnaire. Based on this information, the insurance company may also request your medical records from your physician to thoroughly assess your health status. This evaluation is a critical step in determining your eligibility and the terms of your coverage.
Like all health insurance plans, the primary purpose of a medically underwritten plan is to supplement your provincial government health care plan. It covers costs for health and dental services that are not included in your provincial coverage, thereby reducing your out-of-pocket expenses for these services.
Medically underwritten plans are often more cost-effective compared to other types of health insurance plans, offering more comprehensive benefits for each dollar spent. However, they typically exclude coverage for any pre-existing medical conditions. This exclusion is a significant consideration and underscores the advantage of obtaining such a plan earlier in life, when you are likely to have fewer health issues and a less extensive medical history. This proactive approach can ensure broader coverage and better value from your health insurance plan.
Medically underwritten health and dental plansMedically underwritten plans
What happens when you apply.
A medically underwritten plan asks about your health. In return it can offer broader coverage, but the insurer decides whether, and on what terms, to cover you.
Apply
Answer the health questions
Insurer reviews
About 3 weeks, mostly waiting for records from your doctors
- Offer: full coverageCovers you as applied for
- Offer: with exclusionsCovers you, except for a pre-existing condition
- DeclinedOther plans are still open to you
- Guaranteed-acceptance planApply any time
- Guaranteed-issue planWithin 60 to 90 days of leaving a group plan
You decide. Accept an offer and the insurer takes payment and finalizes your coverage. If not, we help you look at alternatives.
Recently left a group plan, with a health condition?
There’s a safer order that means you’re never left without coverage:
Secure a guaranteed-issue plan
Apply within 60 to 90 days of leaving your group plan, so you’re covered from day one.
Apply for medically underwritten
When you’re ready, with no rush. Your guaranteed-issue plan covers you meanwhile.
Switch, or stay
If the offer is good, we help you switch. If not, keep your guaranteed-issue plan as long as you like.
Illustration only. Insurers assess each application individually, and processing times and plan terms vary.
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.
- A self-employed individual who needs to provide health benefits for themselves and their family.
- An individual who has little to no health history (i.e. few if any 'pre-existing conditions')
- An individual who is comfortable with their existing health conditions (if any) being excluded, but wishes to have a robust plan for everything else.
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.
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
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 medically underwritten health and dental plan compared with other plans?
It usually gives you the most coverage for your money, and you can apply at any time. The trade-off is that you answer health questions, and the insurer can decline you or exclude a condition you already have. It suits people who are generally healthy, or comfortable with an existing condition being excluded.
What types of individual health and dental plans are there?
There are three. A medically underwritten plan asks health questions: it usually gives you the most coverage for your money, but the insurer can decline you or exclude a condition you already have. A guaranteed issue plan asks no health questions if you apply within the window after your group coverage through work ends, usually 60 days and sometimes up to 90. A guaranteed acceptance plan asks no health questions and you can apply at any time, but it gives you the least coverage for each dollar. See how the three plans differ.
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 medically underwritten plans
A question about your coverage? Ask us.
No obligation. We’ll tell you plainly what we think, including when you already have what you need.