Under the Canada Health Act, all Canadian residents, including children, have access to medically necessary treatment through their province or territory’s health insurance plan. In certain provinces and territories, some children may enjoy more comprehensive benefits than adults. Because of this additional coverage, you may think you don’t need to purchase an individual insurance plan for your family—but that kind of thinking could end up costing you a lot of money.
Children tend to get sick more often than adults, and they can have special healthcare considerations. There may be many products and services that are not covered under your provincial plan that your child may need, leaving your family vulnerable to the financial impact of an unexpected illness or injury.
When deciding whether or not to purchase a supplemental health insurance plan for your family, it is important to carefully review the benefits available under your provincial plan to identify any gaps in coverage that might exist. You should also assess the needs of your children to determine the amount of coverage that is necessary. After weighing these two factors, you can make a decision about whether or not you need to purchase a Canada health insurance plan for your family.
Here are some things to consider:
While some provinces provide pharmacare programs for children and youth, the number of drugs covered is limited. Private health insurance plans can cover thousands more drugs than those offered under provincial plans.
Dental insurance helps offset the cost of your child’s oral care. A regular check-up can cost hundreds of dollars (and specialized care may cost thousands), but with insurance you would only be paying a small portion of the total. It’s also a great way to keep track of how often you need to see a dentist; you can schedule your appointments according to what your dental plan dictates. Your dental insurance plan will have a yearly maximum, but by monitoring your child’s oral health regularly, your costs will likely stay well within that amount.
While most provinces cover the cost of eye exams for children, the cost of prescription glasses or lenses is not covered. Health insurance can help families with eyewear costs.
Alternative and complementary therapies
For various health problems some children may benefit from massage, physiotherapy or chiropractic care. Speech therapy or mental health counselling may be needed. Over the years, these can amount to thousands of dollars.
The cost of maintaining your children’s good health can add up quickly. If you have kids, purchasing a supplemental insurance policy can help protect you from these out-of-pocket expenses.
If you had a plan before your children came along, call your insurance provider and have them add your kids to it.
While they may still be your babies, most individual health insurance plans consider your child an adult at the age of 21, though there may be some exceptions for those with mental or physical disabilities. To find out if these exceptions apply to your family, you must contact your insurance broker or carrier.
If your kids attend college or university as a full-time student after age 21, they need health coverage. Some coverage might be available through their school. In fact, health and dental insurance may already be included in their student activity fees. However, your son or daughter can probably opt out of the school’s coverage (and get their money back!) if they are still covered under your group plan. Make sure they review their student benefits carefully. Think of this as just one more piece of life advice you can give them before they branch out on their own.
If you do decide that obtaining an individual health insurance plan is the right decision for you and your family, you’ll want to make sure you choose one that meets your needs. Just as coverage varies by province, it also varies by insurance plan. It is important to find out what products and services are covered, as well as what is excluded. If your child has a pre-existing condition, you need to know whether or not treatment associated with it will be covered. Don’t forget to consider all the costs of the plan you purchase, including premiums, deductibles and co-payments.
With so many things to think about, choosing the right plan may seem overwhelming, but a customer service representative can help. A knowledgeable insurance professional at SBIS can assess your individual situation and help you review the options available to you, so you can make an informed decision about a plan that is right for you and your family.