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Who needs private health insurance -- and
why?
The health-care system in Canada ensures that virtually everyone
living here has access to medical services in any part of the
country. You likely have a provincial health card that gets you
into doctors' visits, hospitals, covers various blood tests, X-rays,
and other medical procedures. As lauded as the Canadian system
is, it doesn't cover everything. With a few exceptions, provincial
plans don't cover dental care or pay for medications received
outside of a hospital. These plans also won't pay for glasses
or contact lenses. That's why many of us turn to private plans
purchased by our employers or, increasingly, to individual private
health-care plans.
Unlike the emergency health insurance you may consider buying
when you go out of the country on vacation, regular individual
health insurance is designed for the day-to-day troubles, surgeries,
and treatments that, while routine, can add up to big bills. Responding
in part to the changing workforce where more people are working
on short-term contracts or for themselves, insurers are offering
a variety of health-care packages to cover the needs of individuals
and their families. What started as a basic plan has become a
virtual buffet of services where consumers can choose which benefits
they want and need. If you work for a company that offers health-care
but not dental-care benefits, for instance, you can purchase your
own dental benefits. If you have prescription needs but can't
afford a full package, choose a basic health plan including a
drug plan, and skip the dental or vision portions. If you have
a growing family and want as much coverage as possible, order
the works. There are also some packages designed for health-care
catastrophes that would pay much more than the regular plans for
serious illnesses that would result in substantial drug or therapy
charges. The choices are improving and, for some people, the cost
of health insurance can be used as a tax deduction.
Of course, wanting insurance and getting it are two different
things. Insurers will have you think that everything is simple.
One brochure insists you can enroll in a plan in five easy steps
and in less than 10 minutes. Well, maybe it's that simple if you
are young, in excellent health, want very basic service, and have
no interest in the details. For the rest of us, it makes more
sense to pick up the phone and ask questions. Lots of them. You
won't want to be sorting out misunderstandings when you are sick.
Take care of it before you sign up and keep notes, so you will
remember your understanding of what you bought.
Who can apply?
Anyone can apply for health insurance, but there are restrictions
on who will be accepted and for what coverage. You must be a resident
of Canada and covered by a provincial health plan. If you have
a medical condition that requires regular medication, that particular
condition will most likely be excluded from coverage. The theory
is that you can't buy fire insurance while your house is burning,
so you can't insure against a medical condition that is already
evident. Of course, there are always exceptions, so it doesn't
hurt to inquire. A good example is pregnancy. Some companies will
offer limited health insurance to pregnant women if they apply
early in the pregnancy. If you are HIV positive or have MS, you
won't likely be offered health insurance at all. An insurer would
expect that your needs for expensive medications, therapies, and
treatments would be too high and almost a certainty. More times
than not, if one is offered after the medical underwriting process
a package with restrictions and exclusions it is still worth while
considering accepting the same. Keep in mind that if you have
the potential of formulating a group, a benefit program may be
available on a non-medical basis and it is best to consult your
representative at Wise Financial Group Inc. for advice.
This material is for information purposes only and should not
be construed as legal or tax advice. Every effort has been made
to ensure its accuracy, but errors and omissions are possible.
Individual circumstances may vary and specific legal and tax advice
is recommended.
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