March 4, 2022
8 mins

Understanding Supplementary Health Insurance in Canada

At last count, Canadian spending on medical expenses equals $8,019 per citizen. You must be familiar with Canada's universal health care system and other available insurance. Supplementary health insurance in Canada is one way to avoid excessive medical bills.

In Canada, you benefit from a universal healthcare system that takes outstanding care of its citizens. However, you must pay for some medicines and services in some instances. Supplementary health insurance can help.

Keep reading to learn more about supplementary health insurance in Canada.

An Overview of Health Insurance in Canada

Canada has a free and public health care system. The system is quite generous for its citizens and permanent residents.

The public funds the decentralized Canadian health system: officially, it's called Canadian Medicare. People sometimes refer to it as universal healthcare.

The 13 provinces and territories of Canada administer and fund their healthcare programs. Each region has its insurance plan and receives related federal assistance based on its population.

However, Canadian medical services are free up until a point. You must pay for excluded services. These services might include dental care and outpatient prescription drugs. Still, the various provinces and territories offer extended coverage to select groups.

The Real-World Experience of Health Insurance in Canada

Taxpayers pay for Canadian Medicare, and the system works rather well. The Canadian healthcare system ranks high internationally.

There is, however, one primary grievance citizens have about the Canadian health system. When seeking treatment, they can face long wait times. Canadian consumers might indeed wait longer for medical services compared to other countries.

What Is Supplementary Health Insurance in Canada?

Supplementary health insurance covers services not covered by universal healthcare in Canada. These services might include:

  • Chiropractic services

  • Dental hygiene

  • Massage therapy

  • Physiotherapy

  • Podiatry

  • Prescription drugs

  • Private hospital rooms

  • Vision care

Furthermore, there are many other services not covered by universal health insurance. Conversely, supplemental dental insurance might cover services like braces and dental cleaning.

You may wish to understand better what's covered by supplemental health insurance. If so, you can visit your provincial government website to find more information. For instance, if you live in Ontario, you can visit the Financial Services Commission of Ontario website.

How Supplementary Insurance Works

Supplementary health and dental insurance work just like any other kind of insurance. It spreads the financial risk of insurance services among many people. That group of people pays into a fund.

Just as you'd save to prepare for the holidays, you'd use health insurance to stay prepared for medical emergencies. In this way, insurance minimizes the costs associated with unexpected events like healthcare treatments.

For example, you may have employee-sponsored supplementary health or dental insurance. In that case, your employer will pay the premiums, and you'll realize the benefits.

Can I Buy My Own Insurance?

If you're a Canadian resident, you can't wholly replace universal healthcare. Yet, you can buy supplemental health insurance to cover expenses not covered by Canadian Medicare.

Suppose you've recently settled in Canada. Alternatively, you may have returned to Canada after a long absence.

In these instances, it will take some time before you can qualify for universal health care coverage. If so, you may consider investing in supplemental health insurance in Canada until you're eligible for universal benefits. Usually, it will take about three months of permanent residence for you to become eligible.

Does Supplemental Health Insurance in Canada Cover All Expenses?

Supplementary health insurance can't cover all your medical expenses on its own. For instance, you'll most likely have to pay a deductible at the beginning of the year. An insurer might require that you pay for the first $2,000 for services out-of-pocket to cover your deductible.

You may also have to pay a percentage of your medical expenses in addition to your deductible. Insurers call this payment co-insurance. You can check your provincial guideline website to learn more about deductibles and co-insurance for supplemental insurance in your region.

Do I Need Supplementary Insurance if I’m Covered Through Work?

If you have employer-sponsored health insurance, you might wonder, “Should I buy my own health insurance?”

Well, that depends on your needs. It helps to know exactly what your employer's insurance covers.

Otherwise, you may have special medical needs not covered by universal health care and your work insurance combined. For instance, a work health plan may only cover a percentage of your chiropractic visits. In that case, you may want to speak to an insurance agent about buying supplementary health or dental insurance.

Group Plans Explained

Usually, an employer will provide you with health insurance through a group plan. Alternatively, you could access group health insurance through a professional association.

If you have employer-sponsored insurance, your employer will most likely pay the premiums. However, if you get your insurance through an association, you'll most likely pay the premiums on your own.

In either case, everyone in a group plan receives the same basic coverage. However, if you purchase your health insurance, you can choose what features will best serve your needs.

Questions to Ask About Group Health Insurance in Canada

If your employer offers group health insurance, you should ask a few questions. You'd direct the questions to your human resources department.

For example, you should know how much coverage you have and exactly what your group insurance covers. You should also ask for a group benefits booklet if you haven't received one.

It's also vital to determine what insurance company provides your healthcare coverage. You should also ask if the group insurance covers pre-existing conditions.

Furthermore, you must find out if you must have a medical exam to prove that you're insurable. Otherwise, you should find out exactly when your insurance starts and ends.

Coordinating Spousal Benefits

If you have spousal coverage, it's essential to carefully check your partner's health insurance plan. You must understand what coverage you have.

After reviewing your spousal coverage, you may feel you need more than the plan offers. In that case, you may want to speak with an insurance agent.

In this instance, an insurance agent can help you choose an appropriate supplementary plan. Moreover, they can show you how to coordinate your benefits. The agent will also explain which plan will cover your medical treatment first.

Assessing Your Insurance Needs

You may have excellent health. In that case, you might wonder whether you need supplementary health insurance. But, again, the decision to purchase additional health insurance is highly personal.

Universal health coverage is excellent for most of your basic medical needs. Yet, there are many things that it doesn't cover.

If you need medical services not covered by Canadian Medicare, you must pay for them out-of-pocket. The expenses for the services can become quite burdensome. It's not in your best interest to find yourself in a position where you must pay for uninsured medical expenses.

Insurance and Age

You may also wonder if your age affects your additional health insurance premiums. Supplementary health insurance is much more affordable when you're younger. As a result, you'll have lower premiums.

The insurance company views younger policyholders as less of a risk. As a result, they'll charge less for coverage.

How to Choose a Policy

You may have employer-sponsored health insurance. Alternatively, you may have purchased insurance on your own from an insurance company. You may have even purchased your healthcare insurance from an agent.

When choosing supplementary health insurance, it's vital to choose the right plan for your needs. In addition, it helps to ask friends and family members for recommendations and referrals.

You could also speak with a trusted advisor like your family lawyer or accountant. It's also helpful to review annual insurance company reports to find the best supplementary health insurance policy you can.

Concerning Your Coverage

Any insurance coverage can prove confusing. For example, you may have employer-sponsored insurance. In that case, again, you can find out more information about it from your human resources department representative.

Alternatively, you may have an individual plan. In that case, call your insurance agent or the insurance company to find out more information.

An insurance agent or company representative should provide you with answers in plain language. In this way, they can help you understand your insurance coverage better.

Learn More About Securing Your Future

Hopefully, you now have a better understanding of supplementary health insurance in Canada. Now that you know more about supplemental health coverage, please feel free to check out our article about better managing your finances.

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