How many supplemental health insurance policies are out there? According a recent industry report (p.15), individually purchased insurance contracts are helping to protect some 1.9 million Canadians from financial hardship.

With so many options available, comparing health insurance plans to find the one that is right for you and your family can be overwhelming. That’s why it’s essential to compare plans to determine the eligibility requirements and evaluate what is and is not covered. It’s also important to have a firm sense of your estimated out-of-pocket expenses.

With so many plans and coverage options to choose from, how can you tell which health insurance is right for you?

Eligibility

You may not be eligible for every supplemental health insurance plan available. Some plans offer guaranteed acceptance while others determine eligibility based on your medical history. This is not to say that everybody with a pre-existing health condition is automatically excluded from every type of health insurance coverage. However, your medical history will be a factor in the availability and rates for your coverage.

If you currently have coverage through a company group plan, you may qualify for different coverage packages. If you are changing jobs or retiring in the near future, you may be eligible for guaranteed coverage if you apply within 60 days of losing your group benefits.

Find out the requirements for each program to determine whether or not you qualify for coverage before you apply. If you unsure about your eligibility, an insurance broker can help you better understand the differences.

Coverage Level

The purpose of health insurance in Canada is to provide the coverage you need for routine and emergency medical care while reducing your out-of-pocket expenses. A typical plan pays a percentage of the cost associated with covered services, such as prescriptions, home care, medical equipment and more.

But all health insurance plans do not offer the same level of coverage for the same services. Some plans cover certain services, partially cover others, and exclude some altogether. It is important for you to review each plan to find out what is and is not covered, especially if you have a pre-existing condition.

Some health insurance plans will not cover the cost of treatment for pre-existing conditions. If you have a pre-existing condition, the prescription drugs to treat it may not be eligible for coverage, unless you are coming off a group plan and apply within 60 days of losing that coverage. Be sure to explore your options with an insurance broker.

Costs Above the Annual Premium

There is more to the cost of health insurance in Canada than just the monthly premiums you pay. Many plans also have deductibles, and some have copayments. What does that mean? Simply put:

• A deductible is an amount you must pay for services rendered before your health insurance plan will begin covering the cost of your treatment. For example, if you have a $500 deductible you must pay the total cost of your health care up to $500 before your insurance begins paying.
• After you have met your deductible, you may be responsible for paying a portion of your healthcare costs in the form of a copayment or coinsurance. For example, if you have a $20 copayment for registered therapists, you will have to pay $20 every time you visit a registered therapist.

The premium, deductible and copayment/coinsurance associated with each plan are all part of the expenses you will incur. Make sure you consider your total costs when comparing health insurance plans.

Annual Coverage Limits or Maximums

When selecting the right supplemental insurance coverage, it’s easy to focus on the annual premiums. After all, the total cost of the insurance policy will be a factor. However, when comparing prices, it is imperative to consider factors like the maximums.

Every medical insurance plan has a maximum dollar amount they will pay for products and services within a given time period. For example, Plan A may pay a maximum of $1,500 a year for medical equipment while Plan B pays a maximum of $5,000 a year for medical supplies and devices.

After the plan has paid the maximum amount allowed, you are responsible for any additional costs above that amount. Therefore, it may be worthwhile to select a policy with a higher premium that also has higher limits of coverage. Be sure to select a plan with maximums that meet your needs.

Choosing a Canada health insurance plan is an important decision. If you are still unsure about which plan is right for you and your family, you can contact a customer service agent for additional information and a health insurance quote.