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ConsumerInfo on Health Insurance


Who needs private health insurance -- and why?

The health-care system in Canada ensures that virtually everyone living here has access to medical services in any part of the country. You likely have a provincial health card that gets you into doctors' visits and hospital, and covers various blood tests, X-rays, and other medical procedures. As lauded as the Canadian system is, however, it doesn't cover everything. With a few exceptions, provincial plans don't cover dental care or pay for medications. They also won't pay for glasses or contact lenses. That's why many of us turn to private plans purchased by our employers or, increasingly, to individual private health-care plans.

Unlike the emergency health insurance you may consider buying when you go out of the country on vacation, regular individual health insurance is designed for the day-to-day troubles, surgeries, and treatments that, while routine, can add up to big bills. Responding in part to the changing workforce where more people are working on short-term contracts or for themselves, insurers are offering a variety of health-care packages to cover the needs of individuals. What started as a basic plan has become a virtual buffet of services where consumers can choose which benefits they want and need. If you work for a company that offers health-care but not dental-care benefits, for instance, you can purchase your own dental benefits. If you have prescription needs but can't afford a full package, choose a basic health plan including a drug plan, and skip the dental or vision portions. If you have a growing family and want as much coverage as possible, order the works. There are also some packages designed for health-care catastrophes that would pay much more than the regular plans for serious illnesses that would result in substantial drug or therapy charges. The choices are improving and, for some people, the cost of health insurance can be used as a tax deduction.

Of course, wanting insurance and getting it are two different things. Insurers will have you think that everything is simple. One brochure insists you can enroll in a plan in five easy steps and less than 10 minutes. Well, maybe it's that simple if you are young, in excellent health, want very basic service, and have no interest in the details. For the rest of us, it makes more sense to pick up the phone and ask questions. Lots of them. You won't want to be sorting out misunderstandings when you are sick. Take care of it before you sign up and keep notes, so you will remember your understanding of what you bought.

[ Excerpted from The Insurance Book: what Canadians really need to know before buying insurance, by Sally Praskey and Helena Moncrieff (the book is now out-of-print)]



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