Understanding health insurance
Health insurance helps you pay for medical care. You usually pay a monthly fee to get insurance coverage. That fee is called a premium.
Provincial and territorial health plans in Canada cover most of your health care needs. Depending on where you live, they may cover hospital and doctor visits. It may not cover other health care or paramedical services.
Some workplace health care plans may cover services that your provincial or territorial health care plan doesn’t cover. For example, prescription drugs, dental care and vision care. If you don’t have a workplace health care plan, you may consider getting personal health insurance. Contact your financial institution or insurance company for personal health insurance options.
Who your health insurance policy covers
Your health insurance policy covers you if the policy is in your name. It may also cover your partner and children under 19 years old. Children over 19 who are still in school or disabled may be eligible.
Additional health insurance
Additional health insurance may help you:
- pay for services that your regular health care plan doesn’t cover. For example, special nursing services, ambulance services, wheelchairs and other equipment
- pay for your medical expenses if you become ill while travelling
- supplement your income if you suffer a major illness or severe injury
Before buying additional health insurance, check your workplace health care plan so you don't buy coverage you already have.
You should also check your policy to find out if:
- your insurer only covers a percentage of the claim
- your insurer only covers a maximum annual amount
Critical illness insurance
Critical illness insurance usually covers a one-time lump-sum payment if you're diagnosed with a critical illness. The payment may cover expenses such as daycare or renovations to make your home more accessible.
Critical illnesses may include:
- Alzheimer’s disease
- a heart attack
- a stroke
The amount you receive as a benefit will depend on the amount of coverage you choose. Your insurance company usually pays you the benefit after your diagnosis.
Insurance companies may differ in how they define critical illness and what conditions they cover.
Check with your licensed insurance agent to learn about which conditions your policy covers.
Read the policy carefully before signing. Make sure you understand what your policy does and does not cover.
Long-term care insurance
Long-term care insurance provides coverage if you become unable to care for yourself. It also provides coverage if you need assistance managing your daily activities. It may cover some of the costs of a care facility or a caregiver following an accident or illness.
Many long-term care facilities and home-care services receive public funding. However, most also charge extra fees for additional services that your insurer doesn’t cover under your long-term plan.
Travel health insurance
If you plan on travelling outside of Canada, you may want to get travel health insurance. It may help you pay for medical treatment while you’re in another country.
Your policy may not provide coverage for medical conditions you had before applying for insurance. Read your policy carefully.
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