Extended health insurance
Extended health insurance is an policy that provides coverage for eligible health expenses that are not covered under provincial health plans.[1] Some plans also cover vision related expenses as well. Extended health insurance is typically part of a company, union or association group benefit plan, although it can also be purchased by individuals who do not have group coverage.[1] In group plans offered by employers and unions, the plan sponsor typically pays part of, or all of, the insurance premiums.[1] Individual plans are purchased privately through an insurance agent, company or broker.[1]
Details of exactly what is covered, how much the plan pays, and what the deductible amounts are vary among plans. Dependents (spouses, partners, children) can be included in the coverage.
Coverages
Group plans
The following coverages can be part of a group extended health insurance policy:[1][2][3]
- hospital care
- prescription drugs
- medical services and equipment (private duty nursing, ambulances, crutches, hearing aids, ...)
- out-of-province emergency assistance
- vision care (eyeglasses and contact lenses)
- paramedical services (chiropractors, naturopaths, podiatrists, acupuncturists, massage therapists, speech therapists, psychologists, ...)
Individual plans
Individual plans can cover some of the same benefits as group plans, but pre-exiting conditions are commonly excluded.[1]
Prescription drugs
Canada is the only high-income country with a universal health insurance system that does not provide universal coverage of prescription drugs.[4] Instead, we have "a complex and largely uncoordinated mix of public and private insurance plans that differ in terms of eligibility, patient charges, and drugs covered".[4]
Extended health insurance plans typically include prescription drugs. If you don't have access to that, you may be required to, or have the option to, get coverage through a provincial program. For example, in Quebec, RAMQ's Prescription drug insurance is mandatory for those who don't have group coverage. Alberta and New Brunswick have optional programs for the general population.
Your province or territory may also have a prescription drug insurance program for groups such as seniors, people on social assistance, and individuals with diseases or conditions that are associated with high drug costs. See the list here.
Dental
Dental care plans are often separate from extended health policies.[1]
Tax credit
Premiums paid to an extended health plan, other than those paid by an employer, qualify as medical expenses for the medical expense tax credit.[5]
Questions and complains
Question and complaints about extended health insurance can be addressed to the OmbudService for Life & Health Insurance.
See also
References
- ^ a b c d e f g Canadian Life and Health Insurance Association (CLHIA, a trade association), A guide to supplementary health insurance, viewed April 9, 2020
- ^ Sunlife Financial (a large provider of group insurance), Health Care, viewed April 9, 2020
- ^ GroupBenefits.ca (a division of Park & Associates Insurance Agency Inc.), Extended Health Care, viewed April 9, 2020
- ^ a b Brandt J, Shearer B, Morgan SG (2018) Prescription drug coverage in Canada: a review of the economic, policy and political considerations for universal pharmacare. Journal of Pharmaceutical Policy and Practice 11: Article 28, viewed April 10, 2020
- ^ TaxTips.ca, Private Health Plan Premiums - Extended Health Benefit Costs, revised August 19, 2018, viewed April 11, 2020.
External links
- Why you should consider opting out of your employer’s health benefits, The Globe and Mail, 2018
