This article provides information to Canadians about supplemental
Even though all citizens of Canada are provided with access to medical
care by the Canadian government’s federal and/or provincial programs,
these programs do not provide coverage for every health condition or situation.
Why should I buy supplemental health insurance?
Vision and dental coverage under the various provincial plans range from
comprehensive coverage to no coverage at all. Prescription drug costs
are usually covered up to a specified percentage, depending on the province
of residence. Children, seniors, and social assistance recipients are
provided with additional coverage by the government healthcare system
for health services such as vision and dental care, prescription drugs,
medical equipment, and treatment provided by specialized medical professionals.
Those individuals that are not part of these three groups must provide
for themselves. Additional coverage can be obtained by purchasing supplemental
coverage for the health services listed above vary by province/territory,
it is important that you determine what your government plan covers, what
it does not, and what types of coverage might be worth obtaining through
supplemental health insurance. Without supplemental health insurance to
offset the often high costs of health services not covered by the government
programs, you can end up with potential financial concerns.
What should I look for in a supplemental health insurance plan?
Most supplemental plans will pay from 40% to 80% of the cost of healthcare
needs such as dental and vision care, psychologists, podiatrists, chiropractors,
hearing aids, certain medical equipment, and health coverage while travelling
outside of Canada. When researching supplemental health insurance, asking
the right questions will ensure that you get the coverage your family
needs at a price you can afford.
Below are some pertinent questions you should ask a potential
- Can I obtain coverage for my children, and what is the cost per child?
- Is coverage available for family members with special needs, and
if so, what type of coverage is provided?
- Is coverage effective immediately upon approval of my application?
If not, how long is the waiting period?
- Will I be covered in the event of an emergency prior to my waiting
- Does the plan cover preexisting conditions, and what is considered
to be an existing condition?
- What exactly does the plan cover and what does it exclude?
- Does the plan provide coverage outside of Canada?
- Must I notify my insurance provider if I leave Canada for vacation
or business purposes?
- How does the plan provide coverage over and above the government
- How does my group health insurance coverage through my employer compare
to the coverage of supplemental health insurance?
- Does the plan cover visits to specialists or special procedures,
and what steps do I have to take prior to consulting with a specialist?
- Does the plan cover prescription eye glasses/contacts, and if so,
up to what amount?
- Does the plan cover dental care, and if so, what is the coverage?
- How do I file a claim, and how and when do I receive reimbursement
for my claims?
- What type of prescription drug coverage is provided by the plan, and
are there instances whereby a prescription drug would not be covered?
- What will be the monthly cost of the plan, and what methods of payment
- What happens if I accidentally miss a payment?
- Are there co-insurance or co-payments that I should be aware of?
- Is there a deductible that applies to the plan, and if so, how much
- How do I know when I have met the deductible?
While the process of researching and purchasing supplemental health insurance
may seem tedious and time-consuming, the effort is worthwhile. It will
ensure your family’s well-being and alleviate potential financial
difficulties in the event of serious illness or injury. It may be one
of the wisest decisions you will ever make.
About the Author:
Adriana Stefania is a freelance writer for Canada
Health Insurance. For more information on health insurance for Canadians
please visit www.canada-health-insurance.com.