Turning 25? Celebrate! Take a selfie, make a wish, and chase your dreams. Yes, age 25 is your year to thrive! And that means managing your health and staying active in your healthcare journey through life.
Sometimes life throws accidents and illness in our path – and not all healthcare in Canada is free of charge. It’s time to ensure you protect your health and your finances from unexpected healthcare costs.
How does your healthcare coverage change at 25?
Before you reach age 25, you may take your healthcare cost coverage for granted, but at age 25 your coverage likely changes.
Coverage from your government health plan
In Canada we are lucky to have Medicare, our publicly funded healthcare system that covers the full cost of medically necessary services to Canadians provided by hospitals, physicians, and dentists, when dental service must be performed in a hospital – regardless of your age.
Every province has their own unique provincial health plan – some cover other healthcare services.
In Ontario, you are covered by OHIP+ if you are 24 years and under, have OHIP coverage and are not covered by a private health plan.
OHIP+ coverage will stop on your 25th birthday. That means you are no longer covered for 5,000 drug products at no cost – and must pay out of pocket for your prescriptions (unless you have your own health insurance coverage).
Coverage under your parents’ health plan
In most group health insurance plans, children are covered up to age 21 if they’re not in school, or up to age 25 if they’re enrolled full time in a post-secondary program. Most health insurance plans cover costs for things like prescription drugs, dental care, therapy and more.
If you are still going to school after age 25 or have just graduated, you will no longer be covered under your parents’ plan. The good news is you have a ‘window of opportunity’ to transition to your own ‘post group’ individual health and/or dental insurance plan within 90 days.
So, what will your own health insurance plan cover?
An individual health insurance plan can cover prescription drug costs, dental care costs, or both and offers a variety of extended health benefits like
- vision care like glasses and contact lenses
- medical equipment like crutches and canes
- registered specialists and therapists including chiropractors, chiropodists, naturopaths, registered massage therapists, physiotherapists, acupuncturists for muscle and joint pain therapies
- homecare and nursing or personal support workers for recovery support
- ambulance and semi-private room hospital costs
- travel emergency medical insurance
- and more
Together, the range of benefits makes individual health and dental insurance a strong foundation for managing your healthcare expenses throughout your life. Instead of struggling to pay out of pocket for these healthcare costs, health and dental insurance will cover many of the costs of you, your spouse and your children’s medical care.
And don’t forget. Many plans include features to assist you in managing you and your family’s health, like virtual 24/7 access to healthcare practitioners online and mental health support tools.
All plans provide you with a health insurance benefit card that you can show your healthcare provider to confirm coverage for benefits like prescriptions or dental care — so you do not have to pay out of pocket for most of the costs.
How do you choose which plan to buy?
Many health insurance plans may ask for details regarding your medical history, and many do not. Here’s some tips on how to choose which coverage to apply for:
- If you are coming off of your parents’ health plan (or your own group health plan) apply for a special ‘No Medical’ guaranteed plan within 90 days of losing your coverage. With guaranteed plans, there’s no need to worry about sharing your medical history. This special type of health insurance plan is designed so that you do not lose access to coverage for medically necessary services or items. Your guaranteed issue health insurance plan can begin on the 1st of the month after you apply.
- If you want a more comprehensive health insurance plan, we recommend applying now, especially while you’re in excellent health. There are budget-options that can bridge the gap before you have employer health coverage to support you during your employment transitions. And you can continue the coverage for life by continuing to pay your premiums each month – so you have the peace of mind of always having the health insurance you need in place. Don’t worry about having two plans if you do get employer coverage – they can work together so you don’t have gaps in coverage, so you are spending less out-of-pocket on your healthcare.
- If you haven’t been covered by a health plan and have pre-existing medications, you are taking regularly – and want to have those covered by your new health insurance plan – speak to one of our specialists. We can help you find the right plan to fit your needs and budget.
Let us help you apply for health insurance coverage now
Now that you know you need health insurance, we can help if you find the terminology, options, and process confusing. You can talk with one of our professionals to get valuable help, for free. Or you can go online and get as many free health insurance quotes as you want. You will find full online plan details for the plan you choose, and we offer secure, online enrolment so you can get the health insurance you need, now.
