Being without insurance during uncertain times can leave people feeling adrift. When employees face life changes, health insurance and other benefits can be a lifeline of stability. The insurance brokers at Group Enroll believe that no Canadian should be without health insurance during a time of need.
We present this guide to switching health insurance for employees at any stage in their career. It covers elements of the publicly-funded Canadian healthcare system, private supplemental insurance, and practical aspects of switching health insurance.
The Canadian Health Insurance System
Canadian law prohibits private insurance companies from covering some healthcare costs because government-funded provincial health insurance already covers them. However, about two-thirds of Canadians have supplemental health coverage through private insurance companies. This offers more expansive coverage to fill in any gaps that government-funded provincial health insurance doesn’t cover.
Comparing the Canadian and U.S. Health Insurance System
The health care system in the United States operates on an opt-in basis. The structure of the American Affordable Care Act allows people to enroll in health insurance even before they become sick.
Americans can usually enroll in a new plan only during a special enrollment period or if they have experienced qualifying events such as moving from one state to another or losing employer-based coverage.
Canadians have coverage through provincial and territorial health insurance plans that they become eligible for after a waiting period once they move permanently to a new province. They do not have to worry about the same enrollment restrictions that U.S. citizens do.
However, Canadians with private health insurance plans through their employers might have limited health insurance options. They would either have to switch employers and enroll in their new employer’s plan, pay for their policy, or ask their current employer for a different coverage option.
For Newcomers to Canada
Immigrants to Canada can apply for government health insurance, but there is a waiting period. The waiting period duration is different for each province, but it can be as long as 90 days. When you arrive in Canada, you should plan to get private insurance to cover medical expenses during the waiting period.
Applying for a Health Insurance Card
Each Canadian province has a health insurance plan with an application procedure and rules that govern coverage. Once you meet the eligibility requirements for health coverage, fill out and submit the application form with the appropriate documentation.
After Moving to a New Province Within Canada
You will only be able to apply for taxpayer-supported health care if you move to a new province long-term. If you are travelling for business or as a tourist to another province within Canada, you will not gain eligibility in that province.
Tourists and short-term visitors should apply for private travel insurance in their home province before travel. If you are travelling to another province because you are a member of the Canadian Armed forces or a family member of armed forces personnel, your status might affect your eligibility for health coverage. Consult the website for the health insurance plan in the province you are travelling to for the details.
Reasons to Enroll in Private Health Insurance
If you are among the one-third of Canadians who do not currently have private supplemental health insurance, you might wonder if you need private health coverage. You probably have many other responsibilities to take care of as you prepare for your move. However, the benefits of private health insurance might be worth your time.
Private health plans pay for the following medical products and services.
- Prescription drug coverage
- Mental health treatment
- Dental care
- Vision care
- Long-term care
Provincial and territorial health coverage often places considerable limitations on coverage outside your home province. Without private insurance, you might be in a position where you need to use telehealth to find affordable care in your former province. Private health cans also provide temporary coverage for many services during the waiting period once you move to a new province.
Private insurance might also transfer more easily from one province to another if your insurance carrier sells policies in multiple provinces. Private health insurance companies tailor their plans to offer the level of coverage that they can legally offer in a particular province. It is advantageous to reevaluate your private insurance policy when moving within Canada.
Reasons to Switch Your Current Private Health Insurance Policy
While many people switch health insurance plans because they move to a new province that offers different health insurance coverage, other life events might prompt you to reconsider your current health insurance coverage.
You Have a New Employer
Employers often provide private supplemental insurance as a benefit of employment. Many employees find that their employer's health insurance policies are not as well-suited to their needs.
If your new employer’s current health care offerings do not provide the coverage you need, speak with your employer’s human resources department about expanding or customizing health coverage options.
You Have a New Spouse
If you have recently married, consider adding your partner to your private supplemental insurance plan. Spousal coverage could save you money compared to having your spouse take out a separate policy.
If your current plan does not offer coverage that meets your spouse’s needs, switching health insurance policies might be a solution. If you have coverage through your employer, ask about the rules for changing your policy.
Some employers offer different levels of health coverage to different classes of employees with varying levels of responsibility. If your employer does so, ask about promotion opportunities and transfers within the organization that could lead to more comprehensive health coverage.
You Have Divorced
If you received supplemental health insurance through your former spouse's plan, you might need to enroll in health insurance for yourself. Many people who receive health care benefits through their spouse's employer do not have experience choosing and evaluating individual healthcare policies.
You Have Children
Having a child through birth or adoption introduces the need for more expansive health coverage. With the change in your family status, assessing whether your current plan offers enough coverage to provide for your new child is prudent. Consider the implications of your current plan for:
- Prenatal care
- Hospitalization and delivery costs
- Health coverage for your child
In addition to reevaluating your health coverage, consider applying for a life insurance policy to provide for your family in the event of an illness.
You or a Family Member Have Changing Health Care Needs
Many policyholders need additional health coverage when they take on the role of caregiver for a parent, an aging spouse, or a friend or family member with a chronic illness or special needs. Consider switching your health insurance to a more comprehensive policy to cover.
- Physical therapy or rehabilitation for a dependent
- Hospitalization
- Prescription drug care
- Preventative health care
- Mental health care
Travel to the United States from Canada
What if I am travelling to the United States? Provincial and territorial health insurance provides some coverage to eligible Canadians who travel to the United States and other countries. However, the degree of coverage varies from province to province. Buy travel insurance before your trip to avoid unexpected medical bills while travelling.
Finding a New Plan
Many health insurance providers offer private health insurance policies. There is typically nothing preventing you from buying a policy for a province in which you reside. Many people have trouble figuring out where to start.
Getting Private Insurance Through Your Employer
If you are switching health insurance plans because you have changed employers, your new employer might offer benefits comparable to your old plan. Talk with your human resources department during the onboarding process or at any point before any deadline your employer might set for enrollment in their employer-supported plan.
Many insurance companies offer rate quotes on their websites. Before submitting rate requests to individual companies, consider some difficulties you might face.
- The process of requesting quotes from insurance companies can take time, especially if you are submitting requests to multiple companies
- Insurance policies are often complex and challenging to compare one-to-one
- You might not be aware of all the health insurance options in your province
An insurance broker depends on a longstanding relationship with the Canadian health insurance industry. Brokers use their understanding of patients and insurance companies to connect the right applicant to the right company. Insurance companies offer low rates to brokers because they know the applicants are a good fit for their policies.
Cancelling Your Current Health Insurance Plan
It is typically straightforward to cancel your current insurance plan by contacting your insurance provider. Wait until you have set up your new insurance plan before cancelling your old insurance to avoid any gaps in coverage.
Enrolling in a New Health Insurance Plan
Enrolling in a new plan typically involves several crucial steps:
- Investigating plans and comparing between them
- Getting quotes from health insurance companies
- Filling out an application for the insurance policy that you prefer
Deciding which plan is best for you can take some time. Start comparing plans before you anticipate needing the insurance coverage so that you can make an informed choice.
Things to Consider When Enrolling in Your New Plan
Even though enrolling in a new plan is usually straightforward, choosing the right one can be challenging. As you evaluate any insurance plan, keep the following questions in mind:
- Is it easy to understand the benefits that the plan offers?
- Does the plan offer the coverage that I anticipate needing?
- Is the plan flexible if you need coverage in an emergency?
- Is the insurance provider easy to work with when you have questions or want to file a claim?
These questions can seem daunting at first. Fortunately, you don’t have to navigate the Canadian private health care market yourself. Insurance brokers are companies that connect insurance companies that offer innovative and competitive health insurance products.
Request Your Custom Rate Quote Today
If your health insurance plan doesn't work for you, start looking for a new one today. Switching health insurance doesn't have to be complicated. If you need to choose the health insurance plan that is perfect for you, Insurdinary is your source for the best quote.
Insurdinary is an insurance broker that partners with policy insurance companies throughout Canada. We provide quotes for custom health insurance policies to Canadians as an alternative to employer-based group private insurance systems.
Fill out the enrollment form at the Insurdinary and tell us a bit about yourself to obtain a custom insurance quote. If you have any questions, feel free to contact us on our website. We'll get to know you and your health coverage needs before contacting health insurance companies on your behalf.
