Everything You Need to Know About Finding Affordable Ontario Health Care

Posted on April 12, 2019

The average Canadian household spent nearly $2,000 on health care in 2017. That figure represents direct costs that Canadians are paying out of pocket. It doesn’t include insurance premiums paid for supplemental health care.

Why are Canadian health care costs so high? Isn’t health care in Canada supposed to be free?

Most people actually pay quite a bit more than they realize for health care. The public system is paid for by taxes, which means every Canadian pays for the system.

Many Canadians have extra insurance. This can be through an employer or a private plan they buy themselves. This helps cover the gaps in the public program.

Even with public health care and private insurance, many Canadians end up paying out of pocket. Insurance may not cover some items. There are also deductibles and co-payments, which can add up.

What this means is you need to be selective when it comes to finding medical insurance. If you’re looking for affordable options for Ontario health care, this guide is for you.

The Costs of Public Ontario Health Care

Ontario spends over $53 billion on its health care system each year. The federal government provides some of the funds through grants for health care. Other funds are supplied from the province’s coffers.

Like other government programs, health care is funded by income taxes. Ontarians pay their OHIP premiums through their income taxes.

In turn, you don’t need to pay out of pocket when you visit the doctor or head to the ER. This is why many people think Canadian health care is “free.”

The cost of healthcare in Canada has been climbing. Ontario’s expenditures increased between 2016 and 2018.

Many factors have played a role in this. The most obvious was expansion of the Ontario health insurance plan. OHIP+, introduced in 2018, provided coverage for prescription medications to children and seniors.

OHIP+ has since been scaled back to keep costs in check. Another factor in rising costs is the number of people who need healthcare. As Ontarians grow older, they need more health services.

As the government looks to save money, health care is often a target for cutbacks. OHIP doesn’t cover every medical expense out there. The result is Ontarians end up paying more out of pocket for services.

The Importance of Supplemental Insurance

Since you pay for health care with income taxes, you may wonder why you should pay for private insurance.

When you look at the lengthy list of medical costs OHIP doesn’t cover, the answer becomes obvious. A great example is physiotherapy. If you need physiotherapy after a car accident, OHIP doesn’t cover it.

Prescription medications are another expensive medical item many Ontarians need. OHIP offers only limited coverage to certain groups of people. If you’re over 25, under 65, and have a job, you probably won’t qualify for coverage.

You end up paying out of pocket for prescriptions. The price tag on these medications can be quite high. If you have a chronic health condition, you’ll have to pay over and over again.

Supplemental insurance can relieve the financial burden of being ill. It also gives you the peace of mind that you’re covered if something does happen.

How to Get Supplemental Insurance

You have two options for getting supplemental insurance. The first is purchasing a private plan for yourself. You can go to almost any insurance or benefits provider and sign up for a health insurance policy.

Your employer may also offer health insurance as part of their employee benefits. If so, you’re legally obligated to take part in the program. You can still buy your own insurance on top of the employer-sponsored plan.

You can’t buy private insurance if your employer offers a plan and you choose not to enroll.

There are a few other organizations that offer insurance as well. Some universities, for example, offer group plans to students and alumni.

Employer-Sponsored Plans Can Cost

If you’re like most Canadians, you’d likely sign up for health insurance if your employer offered it to you. Many working Canadians have supplemental insurance provided by their employer. This benefit is part of what makes “good jobs.”

Many companies let their employees shoulder the cost of the plan. While employers get group discounts, they often opt to pay the minimum fee to qualify. That means employees are on the hook for the rest of the premium.

This adds up, especially if your employer provides a robust health insurance package. Worse, if there are benefits you’re not using, you could be paying a lot for them. It’s not unusual for employees to pay hundreds of dollars for employer-sponsored benefits.

Unfortunately, there’s not much you can do about this. If you don’t like the fees, you can opt out of the plan. You can’t go buy another private plan, though, so you’ll be without supplemental health insurance.

When to Buy Supplemental Health Insurance

There is some good news. One is that more Canadians are self-employed, thanks to the advent of the gig economy. Self-employed people are free to buy their own private health insurance plans.

If you’re taking disability or parental leave, you’re also allowed to buy your own private plan.

Finally, many employers are scaling back their employee benefits, including health insurance. While this looks like a bad thing at first glance, it could actually save you money in the long run. Your employer will cut costs, and you can seek out a more affordable plan to help fill the gaps in your coverage.

Even if your employer has a comprehensive insurance plan, you may not have enough coverage. If so, you can still buy a plan.

There are many situations in which it makes sense to invest in extra health insurance. The question is how you can find affordable insurance.

Finding Affordable Health Insurance

The first step to finding the right supplemental health insurance is to look at your needs. Review your OHIP coverage and any plans you may already be covered under. This could be an employer’s plan, a spouse’s plan, or a parent’s plan.

What medical expenses do you already have coverage for? What expenses aren’t covered? Are there types of expenses you could need more coverage for?

Once you identify the gaps, you can make a list of what you want your supplemental health policy to cover.

The next step is research. When it comes to medical insurance, Canada has no shortage of options. There are many different providers.

Find a few different providers, such as Manulife or Sun Life. Review the policies they have. Compare plans and coverage between providers.

Once you’ve finished this comparison, you should be able to identify a few plans that meet your needs. These may be with different providers. You may pick a couple of plans with the same provider to compare costs and coverage options.

Now you can begin gathering quotes. You can contact providers directly, but you may also want to work with brokers. They can help you find the best plan and the most affordable price.

Beware of Duplicate Coverage

A word of caution is in order when it comes to buying supplemental Ontario health insurance. You don’t want to duplicate coverage.

You may think it’s a great idea to buy prescription medication coverage from two different plans. Your employer-sponsored benefits offer some coverage. Then you have fallback coverage under another plan.

This can lead to situations where neither plan will cover the cost of medication. In essence, it makes it more difficult to use the coverage you have. In this situation, you end up paying twice over for coverage you may not even be able to use.

Ask about Deductibles and Other Fees

Another tip for finding affordable health insurance is to ask about deductibles and co-payments.

Some plans offer attractive premiums, but they come with high deductibles. This means you’ll end up paying out of pocket before your insurance kicks in. This could mean you pay $500, $1,000, or even $2,000 before you receive coverage.

Co-payments can also add up. Be sure to ask about other fees as well. Read lists of exclusions carefully, since the plan may not cover everything you think it does.

One easy way to think about this is to consider value. The lowest-priced plan may not provide you with the value you’re looking for. You could end up paying more out of pocket than if you bought a more expensive plan.

Ask for a Helping Hand

If you’re not sure where to start researching affordable plans for Ontario health care, get in touch with us. We can help you assess your needs and compare plans from different providers.

Don’t leave your health on the back burner. Find an affordable plan today for a better, healthier tomorrow.

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