Understanding Health Insurance: How to Choose the Right Plan for You

Posted on November 17, 2018

Canada's health care system is a source of pride for many Canadians. The fact of the matter is the system isn't always as great as we make it out to be.

All you need to do is compare Canada to other countries to see the issues. Canada spends about 10 percent of GDP on health care, the same as Britain. The UK manages to offer more services to its citizens.

Since the system has limits, Canadians end up paying out of pocket for uncovered services. The solution is to make sure you have great private insurance. Unfortunately, millions of Canadians don't have the coverage they need.

Understanding health insurance will help you find the right plan for you.

With our guide, you'll learn how to choose health insurance that fits your needs. We'll go over some of the key considerations when comparing plans. We'll also give you some tips to help you choose the right provider.

The Limits of the Public System

Almost everyone knows Canada has a public health care system. This provides Canadians with basic medical coverage. You can go to the hospital or visit your family doctor without worrying about getting a bill in the mail.

The public health care system has its limits. For example, most provinces don't offer coverage for dental care. Vision care, psychological services, and devices like hearing aids are often uncovered.

Most Canadians also have to pay out of pocket for prescriptions. Most provinces offer some limited assistance, but it's often not enough. Although there's talk of a national pharmacare program, it seems unlikely there will be one soon.

These gaps in the system show why it's so important for Canadians to have extra private health insurance.

Understanding Health Insurance Needs

Before you can select a health insurance plan, you should determine your needs. There are many different types of health insurance. What you need will depend on where you live, who you are, and more.

A young, single worker needs different health insurance than someone planning to retire. If you're married or have a family, your health insurance needs will be different.

Your needs may also vary based on where you live. Health care delivery is a provincial responsibility in Canada. Healthcare in British Columbia is different from the programs in Ontario.

At the very least, most Canadians will want to consider:

  • Dental insurance
  • Vision care insurance
  • Prescription drug coverage
  • Supplemental health insurance
  • Extended medical benefits

These insurance products work together with the coverage you already have under the Canadian health care system. The end result is you have better health benefits.

Extended Medical Benefits or Supplemental Health Coverage?

When you're looking for the best medical insurance, you might find some of the terms a little confusing. For example, you'll often find plans that are called extended medical benefits. Other plans may use the term supplemental health coverage.

What's the difference?

Extended medical benefits generally "extend" the benefits you already have. They may cover upgraded hospital rooms or provide more coverage for medical devices.

Supplemental health coverage generally adds new benefits to what you already have. Supplemental health insurance includes vision care and dental insurance. It might also include coverage for visits to specialists or services like physiotherapy.

Finding the Right Plan for You

Once you've reviewed your needs, you're ready to compare health insurance plans. There are many different providers, and most of them will offer similar plans.

Plans do differ between service levels and between providers. Always read plan descriptions carefully. You may find one provider includes more coverage in a lower-tier plan.

A plan may have almost all your desired benefits, but you'll need to upgrade to the next tier to get better dental.

Different Plans Have Different Levels of Coverage

Most health insurance providers offer several different plans, divided into zones or tiers. Each tier or zone offers slightly different coverage. More expensive plans include better coverage.

Plans in the lowest zone provide basic health insurance at an affordable price. Plans in higher tiers are usually more expensive, but they often provide better value.

Review your coverage needs again and compare out-of-pocket costs to the cost of a plan. You may be surprised to find a higher tier package is more affordable than you think.

Choosing the Right Provider

As we mentioned, plans are often comparable across providers. One might offer a lower-cost option while another provides great prescription drug coverage.

One deciding factor when it comes to insurance is the provider themselves. Some providers, like Green Shield Canada, are renowned for their customer service. Other providers tend to refuse claims or provide poorer coverage.

If all else is equal across select health plans, always bank on the provider's reputation. If you're not sure, get in touch and test the service you receive.

How Can You Save on Health Insurance?

Many Canadians choose to skip private health insurance because they believe the public system covers them. Others feel they can't afford private insurance.

There are ways to save on private health insurance in Canada. Some providers will allow you to customize prepackaged plans. Others will allow you to build your own from a menu of benefits.

Working with a broker can also help you save. So can switching health insurance providers every so often.

Another key to getting the best medical insurance is to be sure you learn the language. The more familiar you are with insurance terms, the more confident you can be about making good choices.

Take Action to Protect Your Health

Understanding health insurance in Canada is key to selecting the right health plan. Once you know the coverage you have and the coverage you need, you'll be more prepared to pick a great plan.

If you want to learn more about the health insurance options available to you, get in touch with a provider. They can help you assess your needs. They'll also help you compare plans and make the right choice for you.

Millions of Canadians still don't have the coverage they need. Don't be one of them. Start your journey to better health protection today.

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