Sure you have Medicare, but does it cover everything you need it to?

Have you avoided going to the dentist because the cost of even regular checkups puts a strain on your finances? Are you squinting to read a road sign, or having trouble reading the newspaper but keep putting off going to get your eyes checked because you want to avoid paying for the cost of new glasses? Where your government health insurance may not cover these types of expenses, supplemental health insurance might.

Provincial government plans provide coverage of core health care services such as ward level hospital acute care and most physician services, however, it doesn't always cover everything. Medical expenses for things like prescriptions and glasses tend to creep up on you, which is why it is a wise choice to purchase individual health insurance which goes above and beyond basic government coverage.

Supplementary health insurance plans focus on non-core services that are not covered or not fully covered by government plans. Supplementary plans vary from province to province, as well as the type and level of insurance offered

The most common types of supplemental health insurance are extended health and dental plans.

Extended health plans could include any of the following:

  • prescriptions
  • semi-private or private hospital rooms
  • special nursing services
  • ambulance services
  • hospital and medical expenses incurred outside of Canada
  • artificial limbs, prostheses and medical applications
  • wheel chairs and other durable equipment
  • specialized medical care such as chiropractor, physiotherapist, registered massage therapist, etc.
  • vision care
Dental plans could cover:

  • basic regular visits for checkups, cleaning, fillings, extractions and x-rays
  • root canals, periodontal cleanings, and scaling
Depending on the dental insurance you choose you may also be able to cover:
  • restorative work
  • inlays and crowns
  • bridgework
  • dentures, and
  • orthodontic treatments

Individual health insurance plans for everyone

Despite its name, an individual health insurance plan doesn't necessarily cover only one person. An 'individual' plan could mean supplementary coverage for a family, single parent family, couple, or a single person. For more information on who might benefit from individual health insurance, take a look at the article, Who should have supplemental health insurance? on

Deductibles & maximums

Just like your auto insurance, supplemental health insurance plans typically have a deductible. You may have to pay a percentage of your expenses and those of any dependents, or a one-time charge when you go to submit a claim at the first of each plan year. This is called a deductible.

Most plans typically have a maximum on the amount that will be covered for certain services in a specific period. In some cases, this maximum applies to the total amount of coverage that will be paid during a year, or during a person's lifetime. Read your policy carefully so you understand what maximums apply to your eligible expenses before you purchase your coverage.

Think ahead

As Canadians, we're lucky to have universal health care coverage (Medicare), but too many Canadians fail to realize that this often doesn't cover many commonly needed things such as prescriptions, vision care and dental care to name just a few. It is because of these costly "extras" which you might not need at the moment, but mayl down the road, that you should consider buying supplemental heath insurance. Shop online now for the right health insurance for you and your family.

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