How to Compare Private Health Insurance Plans in Canada

Posted on April 20, 2019

The Canadian public healthcare system pays for around 70 percent of health costs. The other 30 percent comes out of the pockets of individual Canadians.

How are Canadians handling their share of healthcare costs? Some people have health insurance through their workplace. Others may be supported by a parent or spouse.

Many others have to pay out of pocket for medical costs the public system won’t cover. Given this, private health insurance is a great idea for most Canadians.

If you want a private plan, you may feel overwhelmed by the options. Learn to compare private health insurance plans with this essential guide. With its tips in hand, you’ll be able to find the best plan for you.

Assess Your Needs

The first step when you compare private health insurance plans in Canada is looking at your situation. What do you need in a private health insurance plan?

Every Canadian has different needs. If you’re a senior citizen, you may want help paying for dentures or your glasses. Younger Canadians may be more interested in coverage for prescription medications.

Always be sure to review the coverage you have under your provincial plan. A private plan shouldn’t duplicate coverage you already have.

Pick the Coverage You Want

Here are some of the most popular types of coverage for private health insurance in Canada:

  • Prescription medications
  • Vision care, including prescription glasses and contact lenses
  • Dental care, including routine care, braces, and more
  • Coverage for medical equipment, such as walkers and wheelchairs
  • Supplementary medical service coverage, including physiotherapy and massage therapy

Another popular health benefit is emergency medical services while abroad. As more Canadians travel, they need more coverage than provincial plans have.

You might also choose a plan that provides coverage for wellness initiatives. Other plans offer coverage for mental health conditions. In 2018, some private insurers even introduced coverage for medical cannabis.

You likely need some types of coverage more than you need others. If you don’t travel much, you may not see the need for emergency medical coverage. If you wear glasses, you may see great value in getting a plan with vision coverage.

You should also think about your budget. How much can you afford to pay for insurance? How much would you need to spend to get a plan that covered all your current medical expenses?

Compare Private Health Insurance Providers

The next thing you should consider is the different health insurance providers. Some companies are Canada-wide. Others may provide insurance in one or two provinces.

Before you begin assessing their specific plans, think about each provider themselves. Some companies have an excellent reputation, while others may be lesser-known.

You can use review sites and customer reviews to compare insurance providers. You’ll want to know how each company performs on some key aspects. Ask the following questions:

  • Does the company offer extras, like 24-hour medical advice or a mobile app?
  • How many different plans do they provide?
  • What are the premiums like?
  • How fast do they provide service?

Some companies will provide excellent service, but their rates may be higher. Other providers will have lower premiums. They may not offer convenient tools like an app or an online claims process.

Compare a Provider’s Private Health Insurance Plans

Now you likely have an idea of which companies rank high in customer service, which has the best rates, and so on.

It’s time to start comparing plans. Pick a few of your preferred providers and look at the plans they offer.

Most companies have more than one plan, and many have special plans for certain groups. For example, an insurance provider may offer a special plan for people aged 55 and over. This plan takes into consideration this demographic’s unique health needs.

Know Plans Inside Out

As you compare the provider’s plans, take note of the ones that offer the coverage you need. You can pick a few plans that meet most of your needs.

The most obvious thing to compare is what type of coverage is included in the plan. Some plans will cover almost everything under the sun, while others will be much more limited.

Annual maximums are also important. A basic plan may cover prescriptions, but only up to $300 or $400. Another plan may provide thousands of dollars’ worth of coverage.

When you compare plans, always ask the following questions:

  • Is there a deductible? If so, how high is it?
  • Does the plan have a co-payment? If so, how much is it?
  • What are the premiums like?
  • Are there any extra fees?
  • What are the restrictions on coverage?
  • Are there restrictions on age or location?

Knowing the answers will help you assess the costs of each plan. A plan with low premiums and a high deductible could cost more in the end, even if it looks like an affordable choice.

As you look at different plans from a provider, one or two leading choices should present themselves.

Repeat this process for a few different providers, picking plans that meet your needs. Then you’re ready for the next step.

Compare Health Insurance Plans between Providers

Once you’ve compared plans for a single provider, you can compare between providers.

Why not compare plans between providers first? You want to be sure you’re comparing similar plans when you look at different providers.

A top-tier insurance plan may have very high premiums compared to a basic plan with a high deductible. If you haven’t reviewed all the terms of the plan, you may think the basic plan provides much better value.

In this case, though, you’re comparing apples and oranges. The coverage provided by the basic plan won’t be the same as the top-level plan. You should compare one provider’s basic plan with basic plans from other providers.

This gives you a better idea of what each different provider is offering. One provider may offer 24/7 support with their basic plan. Others may only provide this service with their high-value plans.

The same is true of coverage. Two basic plans from different providers may not provide the same coverage. One provider may provide better dental, while another offers more for prescription medications.

Putting it All Together

Now you’ve assessed three major factors:

  • Your needs
  • Different health insurance providers
  • Different health insurance plans

It’s time to consider everything together. Which plans best fit your needs? One provider’s plan may be slightly above your budget, but it provides more of the coverage you need.

Keep the provider’s reputation in mind as you finish this assessment. You might think about a plan that doesn't quite fit your needs because the provider has great support.

Similarly, a low-priced plan may fit your budget, but if it’s from a provider you’re unsure of, it might not be the right fit.

Don’t Forget about Brokers

It’s easy to visit the websites of many different insurance companies and compare plans. You may not need to talk to anyone, and getting a quote can take just a few minutes.

You may think you’re getting the best pricing or plan options by going direct to the insurance company. After all, cutting out the middleman often lowers the price.

When you’re shopping for health insurance plans, that “middleman” could help you get the right plan and a great price.

Brokers Get Great Prices

Insurance brokers help individuals like you access group plan pricing. They work on your behalf to get better coverage and pricing from the insurance companies. Since they have many clients, the insurance provider gives them a group discount.

This is exactly how employer-sponsored health insurance works. Your employer enrolls a group of employees. The insurer gives them group plan pricing, which is usually better than what you can get as an individual.

An insurance broker also enrolls a group. Since the risk is broken up over many accounts, the insurer can offer lower premiums. The broker may also be able to access group plans or more policies for a lower price.

Compare Plans with a Broker

You may want to start your research by talking to a broker. They work with most major insurance companies, so they can help compare providers and plans easily.

Their expertise and insight could help you determine your needs. They can also help you pick the right plan.

Get Covered Today

It can take a lot of work to compare private health insurance plans, but the effort is worth it. When it comes to your health, you want to be sure you have the right coverage when you need it.

If you need some help getting started, get in touch with us today. We can help you assess your private health insurance needs. We can even offer plan comparisons.

With the right coverage, you can enjoy the peace of mind that comes with private health insurance.

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