You may not have been paying much attention while you were studying at school, but have you learned that public health insurance in Canada does not cover every health service and product you need? If you want to visit the dentist, pick up a prescription or get a massage… you will have to pay out of pocket, unless you can depend on the financial help provided by health insurance.
When you finish going to school, whether that is when you are 18 or up to age 25, it is important for you to look at your options. Here are 3 ways you can get the health insurance coverage you need:
Source #1: Employer health benefits
Lucky enough to get employment straight out of school? If you are working in contract or part-time positions, your compensation generally doesn’t include health benefits.
If you are employed full-time, your employer may provide health insurance coverage as part of your compensation package (not all employers do). Your health benefits will start only after a waiting period which is typically 30 to 90 days (often matching your probation period).
An employer provided health insurance plan will help you handle the costs of medical treatments for yourself and your spouse or children when they are needed. It also gives you access to preventative healthcare tools to help you lead a healthier lifestyle.
Your health plan may cover prescription drug costs, dental care costs or both and offer a variety of extended health benefits like
- Vision
- Accidental Dental
- Ambulance Transportation
- Hearing Aids
- Home Support Services
- Medical Items
- Medical Services
- Registered Therapists
- Travel
- Hospital Accommodation
You may find there are gaps in the coverage – like no dental benefits. Or this may not be your ‘forever full-time employer’, so you will be faced with losing this coverage when your employment ends.
At this early stage of your working life, consider purchasing a supplemental health insurance policy of your own that will:
- serve as a financial cushion when prescription drug costs add up because of a chronic issue, or provide dental coverage
- cover any ‘gaps’ between times you have group health insurance through an employer and times that you don’t.
Source #2: Your spouse’s health plan
Does your significant other have health insurance? Before you are common-law or married, your spouse may have health coverage through their employer. Once you are together, you can be eligible to be added as a spouse, changing to a family plan. This new plan will likely cost more per month, but then you would have the same health coverage as your spouse.
One thing to consider is that if you also purchase a supplemental plan of your own, it might improve your coverage. Where applicable, you may be able to claim expenses under your spouse’s plan and later claim the remaining amount on your own plan. This process is called “coordination of benefits” and may allow you to have full coverage for services that are covered under both plans. Group plans always pay first, then the individual plan will reimburse afterwards. Remember, as soon as you marry, be sure to inform your insurance provider of the change in marital status.
Going in an opposite direction, if you separate or divorce, you may be removed from your spouse’s plan. Any coverage you have for yourself under an individual (supplemental) plan can stay with you (for lifetime) as long as you continue paying your premium.
Source # 3: Taking advantage of a ‘transition window’ from your parents’ plan
In most group health insurance plans, children are covered up to age 21 if they’re not in school, or up to age 25 if they’re enrolled in a post-secondary program. If you’ve been covered under your parent’s health plan, once you graduate you have a ‘window of opportunity’ to transition to your own ‘post group’ individual health and/or dental insurance plan within 60 to 90 days. Guaranteed acceptance is dependent only on your first premium payment. Coverage is renewable year after year as long as premiums are paid.
As a young person just out of school, you are likely on a tight budget. You’ll learn that there are many options when it comes to health insurance that are very affordable. But remember, cheaper is not always better — look at the “maximum out-of-pocket” amount for any plan you’re considering.
Remember, the easiest time to apply for health insurance is when you are young and healthy
As a new graduate you have a lot to celebrate, and you need to be prepared to face the changing road ahead. If you are in good health and do not have any pre-existing conditions (health conditions that existed prior to applying for coverage) the best option is to purchase an underwritten individual health insurance plan of your own. Applications for medically underwritten health plans ask questions about your medical history like what prescriptions you currently take, any past illnesses or injuries when you received medical care or stayed in the hospital, or if you have a current medical condition. Instead, you can choose a guaranteed plan that does not require you to answer those questions, but remember, the amount of coverage, especially prescription drug coverage, offered by guaranteed plans is less than medically underwritten plans. Either way, as long as pay your premiums you will have health insurance coverage your entire life, whether you are working or not, married, or single. If you want to learn more, go online or call us. At SBIS we are ready to help.
