Get Your Health Pan: A Step-By-Step Guide

Health insurance helps you pay for medical care, and you usually pay a monthly fee, called a premium, to get insurance coverage. In Canada, provincial and territorial health plans cover most health care needs, including hospital and doctor visits, but they don't cover everything. If you don't have a workplace health care plan, you may want to consider getting personal health insurance. This can help cover expenses such as prescription drugs, dental care, and vision care. Personal health insurance is also useful if you're self-employed, retired, or want to top up your employer's coverage. You can get a quote and apply online for personal health insurance or contact an insurance broker to find the best plan for you.

Provincial and territorial health plans

Canada has a universal healthcare system that is designed to ensure all Canadian residents have reasonable access to health and dental care. However, Canada does not have a single national plan. Instead, there are 13 separate provincial and territorial health care insurance plans. These plans are administered by the provincial and territorial governments, which are responsible for insuring or covering "medically required" services and certain hospital services if they are "medically necessary".

The specific services covered by each plan vary depending on the province or territory, but generally include visits to the hospital or doctor. For example, in Ontario, the government administers the Ontario Health Insurance Plan (OHIP), which covers visits to general practitioners and specialists, basic hospital costs for medically necessary procedures, certain dental surgery done in hospitals, and ambulance services under certain conditions. Other provinces and territories, such as Newfoundland and Labrador, Prince Edward Island, Nova Scotia, New Brunswick, Quebec, Manitoba, Saskatchewan, Alberta, British Columbia, Yukon, the Northwest Territories, and Nunavut, also have their own health care plans and insurance programs.

To be eligible for health coverage in Ontario, individuals must meet certain criteria, including being physically present in the province for a minimum number of days and making Ontario their primary place of residence. Additionally, they must meet at least one of the following criteria: being a Canadian citizen, an Indigenous person, a permanent resident, or having applied for permanent residence. Similar eligibility criteria may apply in other provinces and territories, but it is important to check the specific requirements for each region.

While the provincial and territorial health plans provide basic coverage, they may not cover all healthcare needs. Individuals may also have coverage through their workplace benefits or private insurance plans, which can help fill the gaps in coverage. It is important for individuals to understand their coverage options and ensure they have the necessary insurance to meet their healthcare needs.

Personal health insurance

In Canada, provincial and territorial health plans cover most health care needs, including hospital and doctor visits. However, if you don't have a workplace health care plan, you may need to consider personal health insurance to cover services that your provincial or territorial plan doesn't, such as prescription drugs, dental care, and vision care. You can contact your financial institution or insurance company to discuss personal health insurance options.

In the United States, the Affordable Care Act (ACA), also known as Obamacare, ensures that all Americans have access to affordable health insurance. The ACA offers financial help or subsidies based on your income to reduce healthcare costs. Individual health insurance plans are classified into five categories based on the percentage of healthcare costs they cover: Platinum, Gold, Silver, Bronze, and Catastrophic. Platinum plans have the highest monthly payments but the lowest deductibles, while Bronze and Catastrophic plans have lower monthly payments and higher deductibles.

When choosing a personal health insurance plan, it's important to consider factors such as provider eligibility and choice, medication eligibility, premiums vs. out-of-pocket costs, and the strength of the provider's customer service. Individual plans offer more control, flexibility, and choice of insurers compared to group plans, but they often come with higher costs as they are not partially paid for by employers.

Critical illness insurance

Before purchasing critical illness insurance, it is important to check your existing health insurance plan and workplace healthcare plan to ensure you are not paying for coverage you already have. You should also carefully read the policy to understand what is and is not covered and consult a licensed insurance agent to learn about which conditions are covered by the policy.

Long-term care insurance

There are several options for long-term care insurance:

• Traditional long-term care insurance: These policies work like auto or home insurance, where you pay premiums (often for as long as the policy is in effect) and make claims if you need the covered services. Premiums can rise over time, and if you stop paying, you usually lose coverage.
• Hybrid policies: These policies combine long-term care coverage with another benefit, usually life insurance or an annuity. You may pay a lump sum or a fixed amount of annual payments, eliminating the risk of rising premiums. In return, you get long-term care coverage along with some amount of life insurance that will go to your heirs if you don't use the long-term care benefits.
• Federal Long Term Care Insurance Program (FLTCIP): This program provides long-term care insurance to help pay for costs when enrollees need assistance with daily activities or have a severe cognitive impairment. Most federal and U.S. Postal Service employees, active and retired members of the uniformed services, and their qualified relatives are eligible to apply when the program is not suspended.

When considering long-term care insurance, it's important to understand the coverage provided, the types of benefits and policies available, and how benefits will be paid or reimbursed. Additionally, factors such as your budget, assets, overall financial condition, and ultimate financial goals should be taken into account when deciding whether to purchase long-term care insurance.

Disability insurance

There are two main types of disability insurance: short-term and long-term. Short-term disability insurance provides benefits for a limited period, such as a few weeks or months. Payments usually start after a short waiting period of around one or two weeks. This type of insurance is typically available through an employer and covers temporary medical conditions or injuries that prevent someone from working.

Long-term disability insurance, on the other hand, provides benefits for a longer period, sometimes even until the disabled person reaches retirement age or is able to return to work. This type of insurance can help maintain your lifestyle if a more serious or permanent disability prevents you from earning an income for several years.

Anyone who relies on their income to support themselves or their family should consider disability insurance. While many people receive coverage from their employer, self-employed individuals and business owners should also look into getting a policy to protect their income and the viability of their business.

In the United States, there are also government-provided disability benefits such as Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSDI is tied to your work history and pays benefits to you and certain members of your family if you have a disability and have worked enough years to qualify, paying Social Security taxes during those years. SSI, on the other hand, does not require a work history and provides money to cover basics like food, clothing, and housing for those who are 65 or older or have a disability.

Frequently asked questions