Retiring? Here Are 3 Health Insurance Mistakes To Avoid

Retiring? Here Are 3 Health Insurance Mistakes To Avoid
Wisdom comes with age, so they say. But sometimes we all have things to learn – including facts about our health insurance, so we can avoid making mistakes that can impact our retirement plans.

According to an October 2022 survey by BDO Canada, 71% of Canadians found saving for retirement to be more challenging due to inflationary pressures. That poses the question: when its hard to save and costs are rising, is it a mistake to not consider health insurance when you retire?

To make your retirement health insurance decision easier, we’ve outlined three mistakes you should avoid.

Mistake 1: Believing you will still have coverage like your employer provides

Hammer and wrench

If you leave your job and retire, most employers do not offer continued health insurance coverage and if they do it is usually pared down quite a bit. That means you can’t rely on making claims on your group health coverage like you’ve depended on during your working years. When you are taken off your group insurance plan, you may no longer have coverage for healthcare services and items you may still need, like prescription drug coverage, physiotherapy or dental care.

It’s reasonable to expect that you may start to encounter health problems during your retirement as the years go by. If you don’t have a health insurance plan in place once your group plan ends, you could find yourself depleting your retirement savings faster than you’ve planned when you have to pay healthcare costs out of your own pocket.

What if your spouse becomes unexpectedly ill? What if you get injured? What if you can’t afford healthcare?

If you don’t have your own health insurance plan when you retire, you can find yourself in a sticky financial situation in the years to come. That’s a big mistake.

Health insurance can be there in case an accident, chronic illness or a serious health issue happens – as long as you take steps to put your own health plan in place. It is designed to be a safety net that prevents you from having to spend an inordinate amount of money on services to care for your health.

Mistake 2:  Believing the government takes care of all your health costs when you retire

When its tough to save for retirement, some people overlook the value of having health insurance in place because they believe the government takes care of everything when you get old. That’s mistake number two – the government doesn’t pay for everything.

It’s important to understand:

  • provincial healthcare programs such as OHIP for Ontario only provide coverage for things like hospital procedures and standard ward hospital stays and medically necessary visits to a doctor.
  • these provincial plans usually do not cover all prescription drug costs; seniors’ drug coverage under OHIP, for example, is guided by the Ontario Drug Benefit program which has a specific list of medications the province will pay for, which means some seniors won’t be able to access coverage for some of their prescriptions.

Your provincial coverage may cover eligible dental surgery in hospital and eligible optometry (eye-health services), but you can expect to pay out-of-pocket for

  • prescription glasses
  • regular dental care
  • some prescription medications
  • massage therapy
  • medical equipment.

Mistake 3:  Not putting enough health insurance coverage in place

When you retire, it is a mistake to postpone your health insurance decision. Why? You may not qualify for the health insurance plan you want if your have future health issues. By waiting to put coverage in place you could severely limit the options you have to choose from or in the worse case not be able to get coverage for your health issues.

Through Green Shield, Manulife and GMS, SBIS offers ‘post-group’ health and/or dental plans with guaranteed acceptance– regardless of your health status. Coverage is renewable year after year as long as premiums are paid.

Consider getting the highest level of coverage that you can afford, even if the benefits are higher than you may require at the time of enrolment, so you have peace of mind knowing you don’t need to go through underwriting to increase your coverage if your health changes – its important to have ‘enough’ coverage for your full retirement. You can always downgrade to another guarantee issued plan however you cannot upgrade.

You can transition from your group plan to your own guaranteed acceptance individual health insurance plan within 90 days to cover:

  • Prescription drugs for you retiree, your partner, and any dependent children
  • Dental care, including routine procedures like cleaning and fillings or emergency dental work required because of an accident
  • Vision care checkups, glasses, contact lenses and even laser eye surgery
  • Professional therapy services by a specialist like a massage therapist, psychologist, chiropractor, dietician, or acupuncturist
  • Transportation to the hospital
  • Home healthcare
  • Semi-private or private hospital accommodations
  • Emergency medical travel coverage

Take a good look at your ‘post-retirement’ health insurance plan options


Through our partnership with Green Shield, SBIS offers our exclusive Prism Continuum health care focused plans to employees who are coming off of a group plan. Plans include up to 15 days of travel health insurance protection, semi-private or private hospital coverage and the Change4Life online health tools and reward program.  You enjoy comprehensive coverage – even if you have a pre-existing health condition – that is the best choice to cover ongoing and unexpected health care expenses. No medical questionnaire is required.


Manulife Follow-Me is perfect for those who are coming off a company group insurance plan and need a new one. Acceptance is guaranteed, even with pre-existing conditions, if you apply within 90 days of leaving the group plan. FollowMe plans offer 24/7 access to Healthcare Online professionals with preferred pricing for their services. You’re can also enjoy up to 10% premium savings by adding the Vitality option and qualifying by actively maintaining good health. A surviving spouse has coverage continuously for one year if you die.


GMS Replacement Health plans include features like the GMS Prescription Drug Lookup Tool to find out which drugs are covered under your plan. And like Continuum and FollowMe plans, you can enjoy the convenience of a pay-direct card to present at participating pharmacies, dentists, massage and physiotherapists, psychologists, and more, so your plan is billed directly for covered costs. No need to pay out of pocket!

If these ‘retiree’ plans are not the right fit SBIS also offer a wide range of fully underwritten plans to choose from.

Don’t make a mistake. Let SBIS help you with your retirement health insurance.

SBIS is a professional insurance broker, expert in the complex world of health insurance. Working with SBIS means that you will receive:

  • free online resources to learn about retiree health insurance
  • free telephone consultation for sound guidance to help you figure out what coverage you do need
  • over 40 different health and dental insurance plan options comparable to your employee health plan
  • access to many plans that do not jeopardize your coverage if you have a pre-existing health condition
  • free, no-obligation quotes to help you determine how much to set aside in their post-retirement budget
  • buy online options to shop, compare, and apply for a plan when it is convenient
  • free assistance in actually signing up for the new plan
  • help with updating personal information like an address change, upgrading, or downgrading coverage or updating premium payment information like a bank account change
  • assistance throughout the claims process and advocating to help you get the most out of their insurance coverage.

Ready to get started? Give us a call today at 416.601.0429 or 1.800.667.0429 toll-free.


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