Comparatively speaking, we have it much better than our friends in the U.S., who don’t have universal health insurance. But while we do have coverage for some of the most expensive services, there are other things that aren’t covered by the provincial plans. Services like massage therapy, and items like glasses, for example, are often excluded from these plans.
There are many Canadians who have a private health insurance plan through their employer, or which they purchased themselves. The beauty of this is that there are mechanisms in place to help people offset the costs for health services or items. Without health insurance, you could potentially face financial hardship if you ever need treatment that isn’t covered.
You are likely wondering what kinds of plans are available, and how much do they cost? Health insurance is a very competitive field, so it’s no surprise that there are many plans to choose from. When choosing a policy, you have to think about what items or services you would like to have covered, and then you start thinking about monthly payments.
Do the Math
When figuring out what you wish to have covered and how much you would pay each month, consider that there are multiple levels of coverage. A plan that covers a plethora of services and has a large maximum for each service will most likely cost more in premiums. A plan that only covers basic services and a percentage of prescription drugs, for example, may be more affordable.
The trick is finding balance. You likely don’t want to pay too much for services or items you never use, just as you wouldn’t want to pay too little and have inadequate coverage. Again, it comes back to multiple levels of coverage.
Lower Level Pricing Plans
While we can’t give a definitive dollar amount, lower-level plans are obviously the most affordable and are attractive for those who don’t want to pay a lot of money for services they might need one day.
If you’re concerned about your provincial plan not covering enough and you want to have the peace of mind of having a “safety net,” this could be the right option for you, but be aware that many of these more basic plans have very limited coverage for prescription drugs.
The caveat with these plans is that they sometimes don’t cover enough. You have to look at what you’re paying for your policy, and the cost of things you need above and beyond that. It often happens that the extra expenditures cost more than a better plan would. Also, unexpected things like a broken tooth or prescriptions needed to treat an illness are harder to budget for.
Our website also offers a free quoting app to help you to calculate the costs of a health and/or dental plan.
Medium to High Level Pricing Plans
If you are in need of a plan that covers a little more but still within a certain budget, you can usually find something that is both affordable and fairly comprehensive. For instance, there are plans that will share the cost of prescription drugs and other treatments like physiotherapy.
There are plans that offer a lot of coverage as well, including prescription drugs, dental, massage therapy, medical equipment and much more, but expect to pay accordingly. If you need a lot of medical services, items or drugs, this may be the best option for you.
If you previously had a company group plan and wish to have an individual plan of your own, there are plans that will accept you, even with pre-existing conditions. You are guaranteed coverage if you apply within 60–90 days of losing your previous coverage.
The Times Keep Changing
It’s not realistic to think that health insurance pricing will remain the same forever. We live in a world that is constantly evolving, with shifting priorities and an ever-changing economy. The insurance industry is evolving along with everything else. With constant booms in inflation, it’s no wonder that the costs for health insurance are rising.
Health insurance providers have to stay competitive in order to sustain themselves. Prices are rising for just about everything, and while insurance is included, it’s our job to be there for you and to keep our prices reasonable.
One thing that’s out of the hands of the insurance providers is legislation. Recently, the Ontario Health Insurance Plan (OHIP) created a new pharmacare program that would cover some prescription medications for all Ontario residents aged 25 and under. (To learn more about OHIP+, see their webpage).
Other Cost Factors
Another factor to consider is that the provincial health insurance plans will cover certain services for people of a certain age. What this means is that only children within given age ranges (under 18 or under 25) have coverage for certain services. For example, if you have a dependent child in Ontario who just turned 18, they would no longer be eligible for free eye exams.
Your private health insurance plan would then consider the claim for the eye exam, provided you signed up for this provision. It’s advisable that you stay informed on what is or is not covered by your provincial plan. Keep track of items or services that are automatically paid for children, but may change when they reach a certain age. You may need to adjust your private insurance coverage accordingly.
Depending on your medical condition, there may be drug coverage for it, but this is determined on a case-by-case basis and will have a co-pay fee. If you apply for a plan and it’s determined that you are not eligible for drug coverage, a counter offer will be made to give you some coverage, or there may be specific exclusions to your plan.
It’s up to you whether you want to purchase the plan, but remember that these plans can help you in other ways, even if not for your specific condition. It’s never a bad idea to have insurance in place for the “just in case” scenarios.
Give Us a Call
If you want to know more about what types of plans you can purchase, call our office today and we can help you find a plan that is affordable and will keep you covered for the items and services you need the most. Our agents can go over each level of coverage and help you choose something that’s perfect for you and your family.