What do I Need to Know Before I Purchase Health Insurance?

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Although all legal Canadian residents have access to Canada health insurance through the government system, many services are not covered under the provincial plans.  Because of this, many Canadian residents purchase supplemental insurance to fill in the gaps and ensure they have adequate coverage for routine and emergency medical care.  Supplemental insurance can protect you and your family from the financial impact of an unexpected illness or injury, but choosing the right plan isn't always easy.  Here's what you need to know before you purchase a Canadian health insurance plan.

What is Covered?

Health insurance plans offer varying levels of coverage for different products and services, such as prescription drugs, vision care, extended healthcare, treatment by specialists and more.  However, all products and services are not covered by all plans.  Before you purchase health insurance, you need to find out what is and is not covered and make sure the plan you choose meets your needs.  This is especially important if you have a pre-existing condition(s).  Some plans do not cover the cost of care associated with conditions that existed previously.

Is Coverage Guaranteed?

Some health insurance plans offer guaranteed acceptance regardless of your current health status or your medical history.  However, others require you to have a medical exam and/or fill out a health questionnaire before they decide if you are eligible for insurance coverage.  In some cases, if you have a pre-existing condition, the insurance carrier may still grant you coverage if you agree to accept certain exclusions.  This occurs frequently when the applicant has a pre-existing condition.

How Much Does it Cost?

Figuring out how much a health insurance plan costs may not be as easy as you think.  There are a variety of costs associated with most insurance plans, including:

  • Premiums.  This is the amount you must pay to purchase health insurance in Canada.
  • Deductibles.  This is the amount you must pay for services rendered before the insurance company will pay.
  • Co-insurance and co-payments.  This is the portion of the bill you are responsible for paying for each product or service you use.

It is important to take all of these costs into consideration when choosing a health insurance plan.  For example, some plans have higher premiums than others, but if the deductible and co-insurance/co-payments are low, the overall cost may actually be lower than a plan with a low premium.

How do I Choose?

Choosing the right health insurance plan is a big decision.  With so many factors to consider, you may want to speak with a customer service agent who can help assess your current and future needs, compare plans and give you a health insurance quote, so you can choose the plan that is right for you.


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