What Happens at Age 65 - Manulife Engineers Canada Extended Health Care Prime Plan

Introduction

If you own a Manulife Engineers Canada Prime Plan Extended Health Care policy, this article is for you. As you approach age 65, it's important to understand the changes that will occur to your plan based on its current design. In this article, we'll cover what to expect when you turn 65 and provide insights on considerations to help you navigate these changes effectively.

What is the Manulife Engineers Canada Extended Health Care Prime Plan?

As a member of an eligible provincial engineering or geoscience association, you qualify for the Engineers Canada suite of sponsored and endorsed insurance benefit plans. Members of technician or technologist associations, and the Manitoba Association of Architects, are also eligible. Manulife is the insurance company that manages these plans on behalf of Engineers Canada and the respective provincial associations.

The suite of insurance benefits includes Life Insurance (Term Life), Disability, Critical Illness, Major Accident Protection, Dental, and Extended Health Care. Within the Extended Health Care category, there are four plan offerings to meet different needs:

• Prime Plan: A medically underwritten plan for those under the age of 65.
• Comprehensive Retiree Plan: A medically underwritten plan for those over the age of 65.
• Bridge Retiree Plan: A guaranteed issue plan for those transitioning from an employee group benefits plan, eligible within 60 days of termination.
• Base Retiree Plan: A guaranteed acceptance plan for those who may not qualify for other plans due to medical history.

This article focuses on the Prime Plan, the flagship extended health care plan within the Engineers Canada program. We will discuss the changes that occur once an insured person reaches age 65.

What Happens at Age 65 on the Prime Plan?

Upon reaching age 65, the following changes occur:

• Coverage within Canada: The lifetime maximum reduces from $1,000,000 to $50,000.
  • Annual Top-Up: The $50,000 amount is topped-up by $5,000 each year, automatically and in perpetuity.
• Coverage outside Canada (travel coverage): The lifetime maximum reduces from $5,000,000 to $25,000.

Annual Top-Up Explained:

The $50,000 lifetime maximum is replenished by $5,000 each year. This means that as long as an insured person uses $5,000 or less of extended health care benefits per year, the maximum coverage available remains at $50,000. If more than $5,000 is consistently used, the maximum coverage available will decrease over time. Should the maximum coverage decrease to zero, the coverage for that insured person would terminate.

Common Questions:

When do these changes become effective?

These changes become effective on the anniversary date of your policy following the insured person attaining age 65. For example, if you turn 65 on August 27, 2024, but your anniversary date is February 1, the changes would be effective February 1, 2025. If you have couple’s coverage, these changes occur independently for each insured person.

Does my coverage expire or terminate at age 65?

No. You can keep your existing coverage beyond age 65 as long as premiums continue to be paid.

Why keep my Health Care plan beyond age 65? Aren’t I eligible for Seniors Coverage Programs?

Even with provincial seniors' health coverage at 65, maintaining a private health insurance plan offers significant advantages. Private plans provide comprehensive coverage for services often excluded by provincial programs, such as extensive prescription medication coverage, vision and dental care, paramedical services, and medical equipment. They also typically offer emergency travel medical insurance, which is essential when traveling outside of Canada.

While seniors' programs do cover prescription drugs, their formularies typically include 4,500 to 5,500 of the most common medications (varying between provinces). In contrast, private health insurance plans offer a far more comprehensive list of prescription medications, often in the tens of thousands. This broader coverage ensures you have access to the medications you need, providing peace of mind and enhanced health security as you age.

What are my options for the Engineers Canada Prime Plan going forward (beyond 65)?

You have several choices, and Garrett Agencies is here to help:

1. Keep current plan: You can continue with the Prime Plan indefinitely. However, we recommend having more travel coverage than $25,000—more on this later.
2. Apply for a new plan: You can apply for a new extended health care plan, either within the Engineers Canada program or from a different insurance company. Garrett Agencies can assist with this.

Can Garrett Agencies assist me with the other available options in Canada?

Yes, Garrett Agencies can assist you with all plan options available in Canada, whether within the Engineers Canada program or from a different insurance company. As an independent brokerage, we work with all major insurance companies in Canada to provide a wide range of extended health care offerings. Our goal is to ensure you have a plan that best suits your lifestyle, health care needs, and budget in the long term.

What do most people choose to do after age 65 if they have the Engineers Canada Prime Plan?

Choices vary based on personal preference:

• Some prefer to remain on the Prime Plan due to appreciation of current premiums or coverage levels for certain benefits (e.g., $500 per practitioner per year for paramedical services). They often seek solutions for the travel coverage shortfall.
• Others transition to a new plan due to discomfort with the changes at 65, involving a review of available options and completing an application. Garrett Agencies assists with activating the new plan and terminating the old one concurrently.

As you approach age 65, it is a good opportunity to revisit your current coverage with a Garrett Agencies advisor who can assist with your options.

Travel Options if You Keep Your Prime Plan Beyond 65:

The lifetime maximum for travel coverage reduces from $5,000,000 to $25,000 at age 65. If you continue with the Prime Plan, consider the following options for travel coverage:

1. Single Trip Emergency Travel Medical Coverage: This option covers you for a specific date range (a ‘single trip’). Coverage expires once your trip is complete, and you would purchase this coverage on a per-trip basis as needed.
2. Annual Multi-Trip Emergency Travel Medical Coverage: This option covers you for an unlimited number of trips over the course of a year. Plans offer coverage for trips of up to 4, 7, 15, 30, or 60 consecutive days. You would purchase this coverage once per year, or as needed.
3. Multi-Year Emergency Travel Coverage: This option covers you for multiple years, often up to age 80, with unlimited trips per year (typically up to 30 consecutive days). You would apply for this coverage once and maintain it until age 80 without needing to reapply each year or for each trip.
4. A New Health Care Plan: Consider obtaining a new extended health care plan that includes travel coverage. Health care plans vary significantly in terms of travel coverage inclusion—some include travel coverage 'out-of-the-box,' while others offer it as an optional add-on. It’s important to discuss this with your advisor to ensure that any new plan includes the appropriate travel coverage.

Conclusion

Understanding the changes that occur to the Manulife Engineers Canada Prime Extended Health Care plan at age 65, and exploring your options, will help ensure you have the coverage you need. Whether you choose to retain your current plan or explore new options, it's essential to stay informed and proactive about your health care needs.

Consulting with a Garrett Agencies advisor can provide personalized guidance tailored to your unique situation, ensuring you make the best decision for your health and financial well-being.

Remember, maintaining comprehensive health care coverage is important and a foundational aspect of your health plan as you age, offering peace of mind and protection against unexpected medical expenses. Stay informed, stay covered, and enjoy the benefits of your extended health care plan well into your senior years.