Misconceptions about Health Insurance in Canada

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Canada’s government health insurance program is the envy of many countries around the world. Through coverage given by provincial health plans, Canadians receive medical care and treatment without ever having to consider the cost. This leads many to believe there are no healthcare expenses to worry about in Canada.Even with the availability of such comprehensive care to most residents of the country, there are many myths surrounding healthcare and health insurance.

Here are the five most common misconceptions about health insurance in Canada.

Healthy people don’t need supplemental health insurance

It’s true that those affected by chronic health conditions are more likely to have expenses over and above what is covered by the government. However, we’re all susceptible to illness, accidents and injuries. Hospitals and rehabilitation facilities are full of people who were sure a serious, life-changing injury couldn’t happen to them — until it did.

The last thing one needs when recovering from a serious illness or injury is to worry about how they are going to pay for necessary drugs, treatments and other health care services that will to aid in their recovery.

Private health insurance pays for the other services the government does not, delivering peace of mind at a terrible time.

That money can be put to better use elsewhere

Insurance premiums are rather like annual retirement savings. It is easy to think the money could be spent on things that are more fun, but when you really need it, you will never regret having health insurance. Something as simple as coverage for a semi-private or private room can make an unexpected hospital stay much more comfortable.

When it comes to the ongoing cost of prescription medications to manage a serious health condition, or the heavy burden of expensive dental treatments, it quickly becomes evident that health insurance premiums are an excellent value.

The government takes care of everything

Provincial health insurance plans take care of a lot of health needs, but not all of them. Things like prescription drugs, vision care, chiropractic care, dental health care, ambulance transportation, registered therapists, and medical equipment are not covered by government insurance plans for the majority of Canadians.

As governments change under new leadership and annual budgets, services covered are adjusted. Healthcare services today that are covered today may not be in the future.  The good news is that insurers quickly adjust their policies every year to help make sure you are covered.

You are covered everywhere in the country

When you travel to another province, your coverage is limited to what is known as “Physician and Hospital Services Only.” This means if a service is not covered in your own province, you won’t be reimbursed for it in the province you’re visiting, either. To add another layer of complication, if the clinic or healthcare facility is not equipped to bill another province directly, you will have pay out of pocket for your medical care and file for reimbursement when you return to your home province.

Furthermore, your home province will only reimburse you at the rate they would have paid if you were in your home province. If you visit a province that has more expensive services, you will be responsible for paying the difference.

This is why, even when travelling within Canada, a health and dental insurance policy that also offers travel insurance protection is strongly recommended. When you take the time to make sure your medical needs are covered everywhere you go, you can rest easy knowing you will be looked after in the event of an emergency.

You can always get insurance later

While you can usually apply for health insurance until the age of 80 or with some plans even older  , there are many reasons you should apply for health insurance right now. Firstly, you will be able to choose from a wider variety of health insurance plans and options when you are younger and healthier.

Once you have a pre-existing medical condition, any health insurance you want to purchase that is medically underwritten will limit benefits available for the existing condition (or exclude coverage for it altogether). It’s like trying to buy a repair warranty on your cell phone after you’ve accidentally left it in your jeans pocket and discovered it after the washing machine spin cycle is finished. You will be able to purchase guaranteed acceptance coverage, but it generally has lower coverage maximums.

If you are leaving an employer group benefit plan, you have the advantage of being able to purchase a wide variety of guaranteed acceptance plans – but only if you apply for coverage within the 60 or 90 day window of losing your group benefits.

Talk to an Insurance Broker

Ultimately, the decision to carry private health insurance coverage is a personal one. When weighing the costs of insurance premiums, it’s important to have a thorough understanding of what is and isn’t covered. This decision is likely to have long-term implications. Talking to an insurance broker about your current and projected health insurance needs is one way to make a sound, informed decision.

Contact us today to clear up any misconceptions about health insurance, and to discover what kind of policy will best suit your coverage needs.


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