Health Insurance Myths

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Believe it or not, health insurance isn’t just designed for unhealthy people —it’s meant to be for everyone. Whether you are in the prime of your life, or find yourself on the receiving end of medical care, it’s still in your best interest to purchase a plan and protect yourself.

It simply isn’t worth the risk of getting sick and not having insurance. If you experience a medical emergency, it’s important that you already have coverage in place to ensure access to care, and to protect yourself from out-of-pocket expenses.

It costs less to insure someone who is healthy, so what’s stopping you? Nobody plans to get sick or injured. There’s no such thing as an optimal time to get hurt, but it certainly helps to have insurance beforehand.

A pre-existing condition will affect your eligibility to some plans, but don’t lose heart. If you have a condition, there are many plans available that are guaranteed issue. Some require you to be coming off a group plan while others may not.

Below, we’ll talk about some common myths and misunderstandings regarding supplemental health insurance.

You Don’t Need Health Insurance if You Are Young

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This myth is particularly troubling. Even young children can become very ill or have an accident. It’s risky to assume that just because someone is young, they will never need insurance. In the case of an accident, your insurance may cover services or equipment that the province doesn’t pay for. Generally, yes, younger people are healthier than older people; however, that doesn’t mean they don’t need insurance too.

You Can’t Get Health Insurance if You Have a Pre-Existing Condition

As mentioned before, having a pre-existing condition this shouldn’t hinder you from purchasing a plan. There are many programs available that offer guaranteed acceptance, qualifying you for coverage regardless of your medical history. As long as you meet the plan’s eligibility requirements, you should be good to go.

It may also be possible to get acceptance from a plan that does not provide guaranteed approval. Depending on your medical history and the pre-existing condition, you may qualify for modified coverage with the condition excluded. Don’t let your past stop you from looking after your future. Ask!

Your Provincial Plan Covers You When You Travel

This myth is often mistaken for fact. Many people think their provincial insurance plan provides the same amount of coverage outside the country as it does when they receive care in Canada. This is simply not the case.

Yes, the government will cover out-of-country expenses, but only a minuscule amount, and only for emergencies. For example, the Ontario Health Insurance Plan (OHIP) will only pay a limited amount. If you have an accident outside of Canada, you will wish you had purchased extra coverage. Remember, everything right down to the cost of bandages will be billed, and a hospital visit is very expensive. It’s not worth hundreds of thousands of dollars for you to risk going without travel insurance!

You Can’t Afford Health Insurance

Many people incorrectly assume that health insurance is unaffordable. The truth is having insurance is cheaper than NOT having it. Every year, the government de-lists programs and services that they once paid for, meaning you are now responsible for the costs of those services if should you need them.

Depending on the level of coverage you need, you have many affordable supplemental insurance options. Consider your monthly premiums, deductibles, co-payments and co-insurance payments when determining the costs. You’ll find that it’s not that much, compared, for example, to the costs of prescription drugs due to an unexpected injury. Being prepared is in your best interest!

Everything Under the Sun is Covered

This myth is a little bit different than the others, but it’s still a popular one. Many people believe that whatever plan they purchase will cover whatever services they want. Imagine someone going to get cosmetic Botox injections, and then demanding that their insurance reimburse them. This happens more often than you’d think!

This can also happen for treatments that your doctor prescribed to you. If your doctor feels you would benefit from a type of service, you are welcome to submit the claim, but if it’s not covered, you won’t get paid. Even with a doctor’s note, you cannot receive reimbursement for excluded services. In cases such as these, it’s a good idea to consult with your insurance provider and find out if something is eligible before you receive these services.

As Soon As You Buy Insurance, You’re Covered

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Some insurance plans have a waiting period before your coverage kicks in. If you purchase a plan and then get a massage treatment the next day, that visit might not be eligible for reimbursement if it does not fall under the available dates of coverage. Before purchasing anything or receiving any treatment that you’re not prepared to pay for out of pocket, find out when exactly you will be eligible under your plan.

We hear a lot of myths and rumours when it comes to insurance. Don’t fall victim to false information. If you have questions, get answers! Call the Special Benefits Insurance Services office today and find out more about health insurance plans, so you can understand your coverage.


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