What Does It Take to Get Guaranteed Health Insurance in Canada?

Posted on June 16, 2019

Do you keep hitting roadblocks in your search for health insurance?

Do you find that your medical history or age is preventing you from getting covered?

Some insurance plans may exclude people because they are older or have certain long-term health conditions. People who fall into these categories may be more likely to need health care. Unfortunately, they also find it more difficult to get insurance coverage.

Health insurance companies cover health care costs. When people get a lot of medical support, the insurance companies will have to pay out more to cover those people's expenses.

When a company thinks that it will need to pay out a lot to cover a person's health care costs, that person is less likely to get accepted for insurance coverage.

Wouldn't it be nice if you could get health insurance without disclosing your medical history to the insurance company?

You may be surprised to learn that you can!

If guaranteed health insurance coverage sounds like the perfect solution to your insurance worries, read on.

What is Guaranteed Health Insurance?

If you have a pre-existing condition that's keeping you from getting insurance coverage, guaranteed health insurance coverage could be the answer.

You might be asking: What is guaranteed health insurance? Simply put, guaranteed health insurance is a plan where you can be certain of your approval, as long as you meet basic eligibility criteria.

Sometimes guaranteed health insurance is also called "no medical" insurance. You won't need to undergo a medical exam or disclose your medical history to apply for coverage.

Maybe you're wondering how to find guaranteed health insurance plans. To help you out, we've put together a useful guide on what to consider when searching for guaranteed health insurance coverage.

Accessing Canadian Health Services: A Crash Course

If you live in Canada, you probably know that there is a strong system of public health insurance.

Registering for this public insurance is fairly straightforward. The first step is to apply for health care coverage in the province where you live. After that, you'll get your Health Card, which gives you access to health services.

The Canadian health care system is based on equality of access for all residents. Sometimes, though, certain types of health care, medications, or medical equipment are not covered under public insurance systems.

This can create problems for people with long-term conditions. If you have diabetes, for example, you'll need to monitor your blood sugar daily. You may find, though, that all the equipment you need is not covered under your public health insurance.

Whether or not a certain type of care or medication is covered under public insurance all depends on whether it is considered "medically necessary."

There is no set definition of what is "medically necessary" within Canadian health care law. Generally, procedures that get designated "medically necessary" are those that are provided by a doctor or other hospital staff.

The services that are considered medically necessary vary between provinces and territories. It is up to each provincial and territorial health insurance plan to determine which types of care they will cover.

Public insurance often does not cover dental care, vision services, and many medications.

This can create serious problems for people with long-term conditions.

Think About What You Need from a Private Health Insurance Plan

There are many restrictions on which medical procedures are considered "medically necessary." In addition, paying for medical expenses without insurance tends to be very expensive.

Medication costs in Canada have been rising quickly in the last few years. When averaged across the whole population, Canadians are spending $1086 per person on drug costs alone. This is equivalent to 16.4% of total health care costs.

This is where private insurance comes in.

Approximately two-thirds of Canadians purchase private insurance to supplement their public insurance plans. Private insurance can make a real difference to personal finances, especially for people who take a lot of medications.

Unfortunately, many of the people who need private insurance to cover medical costs also face the most issues in applying for private insurance.

These are the people who benefit most from guaranteed health insurance plans.

When you're choosing a guaranteed health insurance plan, it's important to consider which types of service are most important to you.

You might want to start by asking yourself a few basic questions:

  • What is the maximum amount of coverage that you will need?
  • Will you need coverage for medications and medical equipment?
  • Will you need coverage for dental and vision services?
  • Do you think you'll use basic services, or will you need more specialist support?

Once you've established your guidelines for the insurance search, it's time to start researching insurance plans.

Shop Around for Policies

There are lots of private health insurance plans out there. You'll want to make sure that you do your research to make sure you get the best possible coverage for you and your family.

Insurance plans can vary quite a bit in the maximum medical expenses they cover. Some might cover expenses up to $500,000. Others are capped at $25,000.

If you expect to receive a lot of medical care, you'll want to choose a plan with a higher maximum coverage amount.

For people with serious health conditions, some insurance companies offer to cover expenses related to home care.

Different plans also provide different levels of vision and dental support. You'll need to think about how often you plan to use a certain service and how much you expect your treatment to cost.

Think, for example, about going to the dentist. Do you expect to go for regular check-ups every six months? Or will you need crowns or root canals?

Different procedures will be covered at different rates. Some specialist procedures might not be covered at all. You'll want to make sure you have full information about rates of coverage before choosing a policy.

You wouldn't want to go in for an expensive treatment, only to find that your insurance plan covers just 60% of costs.

You'll also want to make sure that your coverage is for life, and not for a fixed period of time. On a related note, it's important to make sure that your chosen insurance company protect will not unexpectedly raise your premiums.

Finally, if you and your family travel regularly, you'll want to think about whether your insurance will cover you in other countries.

Making Your Application for Guaranteed Health Insurance

Let's say you've done all your research, and you've decided that a guaranteed health insurance plan is right for you.

With all the different factors to consider, it can be confusing to decide what to do next.

First, make sure you meet the basic eligibility requirements. Some guaranteed health insurance plans are only available to people of certain ages. Most plans also require you to live in Canada full-time.

You'll also want to think about whether you want a plan just to cover your medical expenses, or whether you want family members covered under your plan as well.

Some companies give you the option of building an insurance plan based on your specific needs. For example, you can opt to be covered just for dental expenses and prescription drugs, but not for vision coverage.

This mix-and-match option can be good for people with specific health concerns.

There are also insurance plans that are just for emergencies and hospitalization. These can be good for people who don't expect to need regular medical care.

Whatever plan you choose, you're going to want to make sure that you choose an insurance provider with a good reputation. You can do this by talking to family and friends, or by reading online reviews.

But if health insurance is very important to you, you might want to get help from a professional.

Getting Help from an Insurance Agent

Even when you know what you want out of a health insurance plan, all the information on different types of coverage can leave your head spinning!

Luckily, there are services out there that specialize in helping you find the best insurance plans for your needs.

A professional insurance agent can help match your specific needs with insurance plans. They can help you prioritize the different types of coverage and help you pick the one that gives you the most value for money.

Whatever your needs, there's an insurance agent out there who can support you.

Navigating the Private Insurance System

Hopefully, you now have a better understanding of guaranteed health insurance, and you know what to look out for when choosing a private insurance plan.

The insurance system is complicated, though, and you might have more questions along the way.

Lucky for you, our simple search tool allows you to easily find insurance agents and compare quotes for all different types of insurance.

Maybe you're still on your journey of gathering information about your best insurance options. Check out our blog for our top tips on getting private insurance in Canada!

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