Top Tips on Health Insurance

Health Insurance Tips

Date published: March 18, 2014

The brokers here at InsuranceSoEasy have been in the Canadian health insurance business since 1981: that is more than 30 years! This experience gives us superb insight into the health insurance industry, and we would like to pass on to you the most important things that we have learned.

Tip #1: Get Health Insurance While Healthy

This is the most important advice that we can give you! We regularly hear from Canadians who are now shopping for health insurance because of current medical bills (e.g. prescription drugs, therapy not covered by provincial healthcare, etc.). Unfortunately, trying to buy health insurance after a serious health/medical condition is diagnosed is more difficult than getting coverage while you are healthy.

Keep in mind that most health plans are “medically underwritten”, which means that there is a medical questionnaire. In addition the insurance company investigates each applicant’s medical history.

To put it in a nutshell: if you are not insured at work via employee benefits then it is a smart move to leverage your good health now and get health insurance.

Tip #2: Consider Guaranteed Health Insurance for Pre-Existing Conditions

There are people who are diagnosed with a medical condition and do not have any health insurance. If this applies to yourself or someone you know there are two options:

 There are instances where a guaranteed health insurance plan makes a great deal of sense. An example of this is uninsured people that are diagnosed with diabetes. A guaranteed issue plan such as Flexcare ComboPlus Starter covers the costs of most of the durable medical equipment that a diabetic uses, thereby partially paying for itself. Add in the dental and prescription drug coverage and the ComboPlus Starter plan is a virtual "no brainer" for diabetics.

Tip #3: Provincial Healthcare Plans are Slowly Decreasing Coverage

The current, long-term trend with most provincial healthcare plans (e.g. AHCIP for Albertan s, OHIP for Ontarians, etc.) is a gradual decrease in coverage. This means that more and more Canadians will be paying for treatments or medications that used to be paid for by the province.

For example, as of January 1, 2013, OHIP will no longer cover annual physical checkups (they are being replaced by the less frequent "Periodic Health Exams").

What does this mean for Canadians? If you do not have health insurance coverage then you’ll be covering more and more medical costs out of pocket.

Tip #4: Prescription Drug Costs Can Hurt You Financially

Occasionally we are contacted by people who do not have drug coverage and are paying out large sums of money for prescription drug coverage.

Generally speaking, prescription drugs are only covered by provincial health plans if administered while in a hospital, or if the person in question is 65 years of age or older. (Note: each province has different public healthcare plans that determine what is covered and how much coverage there is).

A guaranteed issue health plan offers drug coverage, but in these cases the amount of coverage does not begin to cover the costs of some prescription drugs. For example, consider Kalydeco, a drug for treating cystic fibrosis that costs up to $300,000 a year.

Low-income families (in Ontario only) may qualify for prescription drug coverage via the Trillium Drug Program if the cost of the drugs is high compared to the family income. Click here for more information.

Tip #5: Know What Health Insurance Plans Cover

Before shopping for a health insurance plan it’s a good idea to know what a typical plan consists of.

Generally speaking the average Canadian private health insurance plan consists of:

Decide if you are not interested in dental or drug coverage. If this is the case know that there are health insurance plans that don’t offer dental and/or prescription drug coverage. Don’t pay for what you do not want!


We hope you found these health insurance tips helpful. If you have any questions at all please call us toll-free at 1-800- todo . We are licensed, experienced Canadian insurance brokers, and we are here to help.

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