Individual Health And Dental Plans - Think of health insurance as something that exists to protect your health and your budget. It covers the costs you incur for routine health care, routine dental care, illnesses and accidents that are not covered by your provincial or territorial health insurance.
Your specific needs and circumstances, as well as your budget, will help you determine the type and amount of coverage that's right for you. You can find flexible options that allow you to fully customize the health insurance that fits your needs. They are easy to buy and easy to manage and above all, easy to understand.
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There are two main types of supplemental health insurance you can choose from. They can help pay for expenses that regular insurance doesn't cover or share costs with other insurance plans you may have. If you're a gig worker, freelancer or self-employed — like about one in three Canadians today — you may have a special need for additional insurance. Depending on the type of coverage you are applying for, you may need to answer a medical questionnaire when you apply. Manulife's Flexcare
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If your situation is that you were previously covered by an employment policy but have lost benefits because you quit, lost your job or retired, then you may be eligible for a policy that essentially continues your coverage (though not necessarily with the same benefits). With these types of policies, like Manulife's FollowMe™ plans, you're guaranteed coverage and have no medical questions when you apply. You must apply for coverage and pay your first premium within a certain amount of time after you lose your job — with Manulife plans, that's 90 days.
There are certain requirements for health insurance. You must be over 18 years of age, a resident of Canada and already covered by a provincial or territorial health plan. You can also cover your spouse and dependent children who are under 21 and not working. You can't buy insurance for someone else, like your parents, but you can pay the premium for them if you want to.
Many expenses, some of which can be hundreds of dollars a year, can be covered by health and dental insurance. This includes things like:
You can tailor your coverage to your needs and budget. For example, you may need coverage for drugs but not dental work, or dental but not drugs—or you may want a plan that covers both. Typically, insurance companies offer several types of coverage in one plan. For example Manulife's Flexcare
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Combined plans offer drug, dental, vision and travel coverage, while Manulife FollowMe™ plans offer drug, vision, semi-private room hospital and advanced healthcare coverage. Some FollowMe™ plans also include dental, but travel insurance must be purchased separately. There are many options to choose from.
Plans often include accidental death and dismemberment (AD&D) coverage as well as survivor benefits. With AD&D, the insured receives a payout in the event of an accident. If an adult insured under the policy dies as a result of an accident, the survivor benefit provides continuous premium-free coverage for one year to the remaining persons covered by the policy. These types of plans can help protect the ones you love if something happens to you.
Some types of coverage can be purchased as stand-alone plans. For example, if your plan does not include travel, catastrophic drug coverage or hospital coverage, you can purchase them as separate plans. Catastrophic drug coverage offers unlimited drug coverage after you pay a certain amount for annual drug costs, while hospital coverage provides a semi-private or private room if you are hospitalized.
Many health policies provide more than just coverage – there are also non-insurance benefits. You can get telephone or virtual health services, for example, which provide 24/7 on-demand access to medical professionals who can provide services such as prescriptions, mental health care, diagnosis and referrals.
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Many insurers now offer wellness programs with their insurance plans – helping you and your family on a healthier path. For example, Manulife offers our Vitality program where you create a user profile and can track daily activities such as walking the dog or going to the gym. Or you can complete online nutrition courses to earn points that can be used toward rewards or even lower your premiums.
When determining which coverage is best for you, there are a few things to consider, such as:
You'll also need to balance your needs with your budget, so you'll want to learn about things like what percentage of health and dental costs are covered, the deductible amount (this is the amount you pay out of pocket before coverage begins), and the types of costs covered.
Life is full of ups and downs, so if your circumstances change, you may need to change your policy coverage. You can increase your coverage under your existing policy by submitting a written application with updated medical information. Or you can reduce your cover if you have covered for 12 consecutive months with existing benefits. If you're going through a major life change, like getting married or having a baby, you can add your spouse or child to your coverage.
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It is important to read and understand your policy and schedule of benefits so you know what is covered, what is not covered and the limits of coverage. Once you've met your annual out-of-pocket limit, you'll have to pay out-of-pocket until the next year. And some costs are subject to lifetime coverage, which is the maximum dollar amount your insurance company will pay for a health emergency during your lifetime, such as orthodontics or infertility treatment.
Note that many benefit years are policy anniversary years, not calendar years – so if you sign up for your policy in March, your benefits will continue for a year until the following March. This is important to remember in order to get the most out of your health insurance, especially preventive health benefits. Set reminders for regular doctor and dentist appointments, and make time to visit your massage therapist, chiropractor, or other health care providers. Consider enrolling in wellness programs and save time and hassle by using virtual health services.
It is also important to understand what happens when there are multiple policies. Although you cannot have more than one personal health policy from the same insurer, some of your costs may be covered by other sources, such as another health insurance policy, your spouse's policy, or your car insurance or credit card. In this case, the amount of eligible costs covered by the province or territory will be paid first, and payment of the remaining eligible costs will be coordinated among other insurers. Your policy will outline how this works - sometimes one insurer will pay the full amount and sometimes it will be split between your insurers.
In many cases, your pharmacist, dentist or health care provider will submit your claim directly for you, meaning there is no online form or paperwork for you. Otherwise, you can file your claim online or by mail within 12 months of your payment date and after you've paid any deductibles in your plan.
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You can apply for Manulife health and dental insurance online or by phone at 1-877-COVER-ME. You should have a list of your medications and, if you're applying for a plan that requires a medical questionnaire, ask questions about your medical history and doctor contact information. If you apply for FollowMe™, you will need details of your previous group benefits.
Health insurance can help give you peace of mind when it comes to expected and unexpected medical expenses and help you manage your budget for them. It can also improve your well-being and quality of daily life.
If you already have a plan with us and have any questions or want to file a complaint, you can call us: The difference between annual maximums and deductibles is perhaps the most important difference between a typical dental insurance plan and typical medical insurance. Plan, especially when it comes to your wallet.
It is important to note that many aspects of dental and medical coverage discussed in this article do not apply to Medicaid insurance. Medicaid insurance works differently (although in North Carolina it covers medical and dental services for children and adults). We will discuss Medicaid specifically in a future post.
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Furthermore, this blog post should not be taken as medical or dental advice. When considering personal care and the cost of that care, check with your provider and insurance company to make sure you fully understand all the costs associated with different treatment options.
A traditional health insurance plan usually includes what is known as a deductible. If
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