Nearly 3.8 million Canadians are affected by asthma, according to Asthma Canada’s annual survey report. Asthma is a chronic lung disease which restricts the airflow into the lungs making it difficult to breathe. It is one of the most common chronic diseases in Canada.
If you have asthma, you may not think that you can get health insurance, but you do have options.
Purchasing health insurance when you have asthma
When you suffer from asthma you require regular medical checkups to ensure your condition is under control and treatments can be expensive – especially if you have to pay out of pocket. In the 2021 Asthma Canada report nearly (42%) of respondents indicated that their current drug coverage isn’t enough to control their asthma symptoms and feel that they need a little to a lot more support, even if they had partial drug coverage by their employer. One quarter (25%) of respondents indicated that they have skipped filling a prescribed asthma medication because they were not able to afford it.
Health insurance can help pay for the cost of prescriptions, helping you to stay on track with your medication management. You may be in a position where you’ve had the advantage of having group health insurance benefits provided by an employer and you didn’t have to worry about paying for your asthma medication. But can you qualify for coverage if you are not under an employer group plan?
Many Canadians are under the impression that individual health insurance is only for people with a spotless health record. This misconception adds up to a costly mistake for households. Individual health plans are not dependent on an employer – once you put a plan in place, it is yours for your lifetime regardless of changes in your employment or health. If you are coming off a group health plan, the good news is that you can apply within 90 days of leaving the group and qualify for a guaranteed acceptance individual health insurance policy if you have a medical condition that needs to be covered, like asthma.
What if you are not coming off a group plan? When you apply for health insurance coverage, your asthma is considered a pre-existing health condition. Health insurers may consider you ineligible for certain types of coverage, including coverage for your medications, allowing only for new medications to be covered.
The good news is that you can also choose from a wide variety of guaranteed issue plans and that you are eligible for even with your pre-existing asthma condition, and your current medications can be covered. These health plans are available to everyone regardless of their pre-existing conditions.
Health insurance helps with more than just prescription drug costs
Getting health insurance coverage for asthma can help cover the costs for corticosteroid inhalers, nebulisers, and prescription medications to keep you on track for better health management. But asthma also impacts other aspects of your health, and health insurance helps with that too:
Mental health support
The 2021 survey indicated that almost three-quarters of respondents felt anxiety and stress due to their asthma. Your health insurance plan can deliver many “built in” tools to help you learn new ways to deal with the expected and unexpected in life including motivational programs to help them focus and achieve their health as well as coverage for prescription medication that may help decrease your suffering.
Asthma can also put an emotional strain on your loved ones, and your plan can help cover expenses for both in-person and virtual therapy with marriage and family or addiction counsellors, reimbursing costs up to your plan’s maximums.
Better sleep and well-being support
“Having asthma can mean that you experience trouble sleeping. Some health insurance plans, like PRISM Health and Dental, offer access to mindfulness mental health support programs, which are like fitness programs for your mind and can help you rest.” Mindfulness is a proven practice that helps people approach stress, low mood and/or anxiety differently, so they can get more out of their day-to-day experiences and improve their well-being.
Easy access to medical professionals
To eliminate the obstacles of travel and waiting room time delays, helping you shorten the cycle between identifying a health problem and implementing a clinical solution, making taking care of your health more convenient and easier than ever, many health plans provide access to virtual health care providers.
Both for personal and family needs, virtual care enables consultations whenever and wherever you need them, including:
- Screening and assessments to detect potential health disorders or diseases
- New prescriptions or existing prescription refills
- Referrals for testing and diagnostic services, like blood work or specialist visits for further investigation
- text and video conversations to answer health questions.
With convenient apps you can also get access to recent articles on finding care, managing your health, and preventing illness, provincial health resources and search tools to find a health facility or community support group in your area.
Coverage for physical therapies
To help with your overall physical function and to release tension, your plan will cover costs for massage or working with a naturopath which is not covered by your government health plan; the dollar amount covered per visit (if there is one) and the annual combined maximum benefit will be outlined in your health insurance plan.
Rewards to keep you on track
You can get rewards for eating right, exercising, and learning about healthy choices, from premium discounts to gift cards depending on the health plan you choose. Plus, many plans provide online prescription services with at home delivery – helping you keep even more healthcare costs under control.
You can supplement your existing coverage
If you have an employer health plan that does not provide all of the coverage you need, benefits available in both your group and individual plan can be combined to provide higher coverage. A health insurance plan you purchase is always going to have different types of coverage or maximum visits per year, and the important thing to know is that the plans will work together to permit coverage of up to 100% of eligible expenses. Coordinating employer health benefits with your own supplemental plan is especially useful if someone in your family needs an expensive pair of glasses or additional therapy sessions.
Breathe easier by having health insurance in place
Choosing the health insurance benefits you think you will need may be overwhelming if you have asthma. At SBIS we can help with free expert advice, providing resources that educate you on features and plans and provide convenient on-line quotes so you can apply for best-in-class health insurance products. We offer a wide variety of options that will provide you with the benefits you need regardless of any prior health condition you have. Contact us at SBIS today at 1-800-667-0429 or 416-601-0429. Our business hours are Monday to Friday 8:45 a.m. – 4:45 p.m. eastern time.
