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How Does Health Insurance Enrollment in Canada Work?

on 21 Dec, 2018

$253.5 billion — that’s how much Canada expects to spend on healthcare this 2018. That’s an expenditure of more than $6,800 per person. In total, that’s about 11.3% of the nation’s gross domestic product.

The good news is, some of that cost will come from the government. After all, that’s the reason the Canadian healthcare system – known as Medicare – exists. Thanks to this system, folks in the country have lower healthcare out-of-pocket costs.

But this only applies to people who’ve gone through health insurance enrollment. In short, only those enrolled in the system can get access to these free healthcare services.

Don’t worry though. It’s not as complicated as it sounds, so long as you take the time to get to know it. We’ll give you the basics in this post, so be sure to keep reading!

Getting in Touch with Your Provincial or Territorial Ministry of Health

There are 13 provincial and territorial ministries of health. They manage, organize, and deliver health care services to their residents. Each also has their own “version” of public health insurance.

That said, the first step to enrolling in Canadian health insurance is to know your ministry. For instance, if you live in British Columbia, you have the B.C. Ministry of Health. They overlook the publicly-funded health insurance known as the Medical Services Plan (MSP).

Whereas Alberta residents can qualify for the Alberta Health Care Insurance Plan (AHCIP). Ontarians have OHIP or the Ontario Health Insurance Plan. Then, there’s Manitoba’s version, which is the Manitoba Health.

What’s important is to apply with the Ministry of Health in your particular area. Also, keep in mind that in some provinces, like Ontario, you have to wait for three months to get the insurance. That’s why as early as now, you should determine if you qualify.

Qualifications for Canada Health Insurance Enrollment

In essence, all residents of each Canadian province can qualify for health insurance. Under the Canada Health Act, a “resident” is someone with legal entitlement to be, stay, and live in Canada. But they should also be “ordinarily present” in these provinces.

That said, residents don’t include tourists, visitors, and transients. There are, however, travel insurance programs that they can get while in Canada.

In any case, the first qualification you need to meet is residency. Each province’s or territory’s Ministry of Health has their own residence requirements.

For example, your MoH may require you to be in the province or territory for at least 183 days every year. You may also need to prove you’ll return to your residence to qualify for the health insurance.

Make sure you check with your province’s or territory’s MoH for the full requirement list. This way, you can determine if you’re eligible, and if so, what coverage you’ll get.

Getting Started with Your Application

In some places, new residents can get – and use – their public health insurance right away. But in other areas, like Ontario, B.C., and Quebec, the three-month waiting period applies. You can apply for your Canada health care card right away though.

The waiting period is for the processing of your application and your card. That’s why you’d want to apply as soon as you can.

Note that during this time, you’re still uninsured, since you don’t have a card yet. In this case, private health insurance can serve as a buffer as you wait.

Most Ministries of Health allow you to apply for health insurance online. Aside from being convenient, the online application only takes 15 minutes! If you can’t do it online, you can do so by mail.

Quebec is one of the places where online application isn’t available though. You’d have to visit a Régie office to get a registration form. If you can, take all the needed documents with you, so that you can complete the application during the visit.

Documents include proof of identification (for yourself and your dependents) and Canadian citizenship. If you’re married, make sure you upload or bring your marriage certificate too. In case you’re divorced, don’t forget to prepare the decree.

Getting Extra Health Insurance from a Private Insurer

There’s no doubt that the Canada health care system is a great help to the nation’s people. In fact, almost 90% of Canadians say that without it, Canada wouldn’t be Canada. But that doesn’t mean it already provides everything you need.

Yes, it covers a lot of healthcare services, such as visits to doctors and hospital stays. It also pays for some eye- and foot-health services. Ambulance services are also included in the list.

In essence, it covers anything considered “medically necessary”. If the treatment or service you need doesn’t meet that description, you’d have to pay using your own money.

One of the biggest issues here is that it doesn’t cover prescription drugs. Of comparable countries with universal health insurance, only Canada has this “flaw.” It’s one of the reasons behind the limitation of Canada’s public health insurance.

It also doesn’t provide coverage for preventative healthcare services. Getting restorative dental services (like dental fillings, crowns, etc.) also mean out-of-pocket expenses. The bottom line is, there’s a lot that public health insurance leaves uncovered.

No wonder that two-thirds of Canadians have extra health insurance. They own policies with private insurers, to bridge those “gaps” left by Medicare.

If you believe and know that you need more coverage, consider getting extra insurance. You may have to shell out money for it every month, but it’ll be far lower than remaining underinsured.

Making Private Health Insurance Easier on Your Pocket

While completing your public health insurance enrollment, make sure you review your coverage. This’ll give you an idea on which areas you need more coverage for. From there, you’ll know what your priorities are when getting private health insurance.

Let us help you find the best private health insurance in Canada. You only need to make a request for a quote, and we’ll find the best rates for you.

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