I have never had Health and Dental Insurance before but now think I need it.
If you are 18 or over, a Canadian resident and are covered by your provincial health plan you can apply for a Health and Dental insurance. Some insurers, have age restrictions and will not consider you if you are over a certain age such as 70 or 75.
Though you get to decide on the type of coverage you want to apply for, the Insurer gets to decide whether or not to insure you. They do this by asking you to complete a health questionnaire. They get to decide whether or not to accept you for the plan you requested, offer to insure you with an exclusion for certain types of expenses, or to decline you. Chances are if you are declined they will still likely offer you an alternative plan which may or may not be what you really want to be insured for.
I have had Health and Dental Insurance before under a Group Plan but I lost it within the last 60 days.
Again, if you are 18 or over, are a Canadian resident and are covered by your provincial health plan you can apply for the same type of insurance plans as above. But in addition, you can choose not to complete a health questionnaire and apply under one of an Insurer’s “Guaranteed Acceptance plans”.
The coverages under these types of plans can be somewhat similar to what you had under your group plan but usually with significantly lower overall maximums. Costs at younger ages also tend to be much higher than plans which require you answer a health questionnaire.
No problem, there are plans that cover existing drugs, and they are known as “guaranteed acceptance plans”. You can get a quote here, but the catch is that they have drugs maximums anywhere between $1,000 and $2,000.
There is plenty of other coverage included in guaranteed acceptance plans… but due to the low drug maximum, you should carefully weigh the pros and cons of covering your existing drugs.
For someone who is not on any drugs, or even for someone who is taking some inexpensive prescriptions… we highly recommend taking a standard plan which provides up to $100,000 of drug coverage per year.
Trillium is a government funded health plan, designed for individuals who spend more than 4% of their household income on drug costs.
To find out if your prescriptions will be covered you can search the drug formulary here.
To qualify, you must:
1. Have a valid ohip card,
2. Spend more than 4% of your household income on prescription drugs,
3. Be under the age of 65
4. Not be enrolled in Ontario works
In Ontario, you qualify for Ontario Drug Benefit when you turn 65. Most drugs are covered but not all, you can search here.
You would think that many policyholders would cancel their plans, but that’s not necessarily the case. There is plenty of other coverage included on the plan that makes it worthwhile to hold on to.
Should I keep my plan after 65?
Yes! You will still have coverage for..
Drugs not covered by ODB
Dental Coverage
Chiropractor
Naturopath
Speech Therapist
Travel Health Insurance
Vision Care
Optometrist
Osteopath
Podiatrist
Semi Private Hospital
Masseuse
Acupuncturist
Psychologist
Chiropodist