Canadians have the benefit of public health care that covers basic services such as primary care physicians and hospitals. Some have access to private health insurance plans through their employer as part of their employee benefits plan. While many choose to rely on public health care or that provided as an employee benefits program, there are good reasons to consider individual health insurance as well.
Individual health insurance can help pay for services outside public health insurance coverage
Public health care in Canada makes basic health care affordable. If you want to see your primary care physician or need ward-level hospital care, the government likely has you covered. If you need prescription eye glasses, to see a dentist, or take prescription medication, however, you’re on your own with public health care.
Private individual health insurance is most commonly purchased as supplementary insurance to provide additional coverage for services that fall outside the realm of government pr employer-sponsored plans. Among supplementary individual health insurance, dental and extended health plans are the most common benefits bought. Other available benefits may include items such as:
- Optometrist services (e.g. eyeglasses and contact lenses)
- Prescription medications
- Special nursing services
- Ambulance services
- Wheel chairs and other equipment
- Semi- or fully-private hospital accommodations
- Medical expenses incurred outside of Canada
- Artificial limbs and prostheses
- Chiropractors
- Physical therapists
- Podiatrists
- Osteopaths
Dental services are often included under a separate individual health insurance plan. These plans often include basic preventative care such as checkups, cleanings, x-rays, fillings, and extractions, as well as more involved procedures such as root canals, scaling, and periodontal cleanings. Some plans even cover major restorative work, including procedures such as dentures and crowns.
Since coverage under public health insurance plans varies from province to province, the exact benefits and services offered in any given individual health insurance plan vary by plan. They can be purchased for a single individual or a family.
Individual health insurance may cost you less than your employer’s health plan.
As many as two-thirds of employees at companies offering 11 or more benefits would recommend their employer as a great place to work. The most commonly offered benefit is paid leave, which is made available to over three-quarters of employees. Employers know benefits sell; as such, many of them offer their employees private health benefits. Within the private sector, 70% of employees have access to employer-sponsored medical plans. However, only 51% choose to participate in them. Why? One good reason may be cost.
Like any product or service offered through the free market, health insurance plans differ in both quality and price. With employee group benefits, your employer gets to choose the provider and health care coverage options you have. You, as the employee, are then left to pay for it out of your paycheck. Depending on the services and coverage offered through your employer’s chosen plan, you could wind up paying out hundreds of dollars each month for benefits you neither want nor need.
That’s not to say all employer group health insurance plans are overpriced. All companies are required to contribute to their employee’s health plans so at least you know your employer is footing some of the bill. That contribution could be very low, however. Unless you’re one of the lucky ones whose company is offering an affordable health plan with good benefits, individual health insurance may prove to be more competitive in both cost and benefits. With individual health insurance, you get to choose the benefits you want and shop around for the price you like.
Individual health insurance can cover the things your employer health insurance doesn’t.
Continuing with the theme of individual health insurance putting the power in your hands, when you buy your own health insurance, you can gain access to a broader range of services and coverage options. Even if you have an affordable employer-sponsored plan, buying supplemental individual health insurance can ensure you get the coverage you need.
Companies can differ widely in the plans they provide. Large companies with more resources and employees can often purchase a more competitive plan for those employees. Smaller companies, however, may struggle to find a a plan that can provide all the benefits its employees want at an affordable price. Supplemental individual health insurance plans can step up to fill in the gaps when your employer coverage falls short.