Where is Health Insurance on your List?

20% of Canadians don’t have any type of health insurance, be it group insurance, personal insurance or even personal savings put aside in the event of a health crisis. Many Canadian families feel overextended financially taking into account the general cost of living.

Between managing child care costs, mortgage and vehicle payments, utilities, investing in a retirement fund, as well as other common expenses, the idea of planning for potential future health care costs might be at the bottom of the list for many busy families.

The scary truth is that a serious health issue such as a heart attack, stroke, cancer, or other serious illness/accident can result in very high medical bills. Having health insurance coverage can help to absorb the costs. 

Health insurance can be customized to meet your needs. There are plans specifically designed for families with children, individuals, students, and seniors. It’s a matter of doing your homework and obtaining a plan that suits your particular needs and budget.

Canadians need to put health insurance higher on the list!

For more information about customized plans for CAA members, go to  CAAhealth.ca.

Waiting in Line for Medical Treatment

When I read an article online about the 64-year old Alberta man who has to live with a hole in his face for the next two-and-a-half years because of hospital wait times in his province, I was horrified as I’m sure many others were also. After having received chemotherapy for sinus cancer, this cancer survivor developed a hole between his right eye and nose. He has since been scheduled for about five surgeries to fix the gap in his face, but surgeries were cancelled due to more urgent cases. Alberta Health Services considers this procedure reconstructive or plastic surgery because it’s not a life threatening condition. Consequently, the patient must remain in this unfavourable condition for an indefinite period of time and has become increasingly frustrated.

Read the full article

While this is an extreme example, it does bring up the subject of public vs private health insurance. Private, or extended health insurance, can make a difference in your life as it allows you more options for treatment depending on the medical condition. 

How many times have you been in the doctor’s office and noticed that before he puts his pen to the prescription pad he asks the question: do you have private health insurance? His recommendations for care will often be based on whether or not you have any private coverage.

For questions about health insurance coverage visit CAAHealth & Dental Insurance.

Considering an Individual Health Insurance Plan?

If you’re looking for a supplemental health insurance plan you’ll find it under group insurance plans. This type of package covers members of a group and their eligible dependents. Some employers provide a group health insurance plan as part of an employee benefits program. Your eligibility would be determined by whether or not you are a full time employee and on how long you’ve worked for the company. In most cases, a worker must have been employed for at least one to three months, and part timers are not usually eligible.

If you don’t have a group insurance plan at work, you can purchase an individual insurance plan.  If you are part of an association such as a university or CAA you may get exclusive rates not available to the public by purchasing the plan sponsored by the association. 

Remember, when you are no longer an employee of the company, or you cease to be a part of the association, you no longer have coverage.

Filing a Health Insurance Claim

Although a health insurance claim is simple enough to file, the procedure varies with each plan.

One type of plan may require that you pay your health care provider up front and then submit your receipt by mail or electronically for a reimbursement.

Another type of plan may provide you with a drug or dental ID card that allows the bill to be submitted directly to the insurer electronically for payment.

Most insurance claims must be filed no later than one year from the date of the medical procedure, health service or appointment.

It usually takes a week or two to process a claim if it’s straightforward enough, and if you have completed the claim form correctly and completely.  However, it will take longer if the insurer has to contact you to clarify any of the details on the claim. A more complicated claim, such as one involving a disability, typically requires a lengthier time period to process.

Your insurance company may deposit payment directly into your bank account, or they may send you a cheque accompanied by a statement with the details of your claim.

Public VS Private Healthcare Debate

In 2005 Canada spent an estimated $142 billion on health care, which on average would be about $4,411 per person, according to Health Care in Canada.

The question is: Can this type of public health care system sustain itself, taking into account the fact that this amount is three times what Canada spent in 1975?

How many people have stories about long wait times in the emergency room of a hospital or health clinic; and how many are on the wait list for months before obtaining an appointment for a health service?

On June 9, 2005 The Supreme Court of Canada ruled on a case brought against Quebec Health Insurance by a patient (backed by his doctor) who had had to wait a year to get hip-replacement surgery. The ruling revealed that the majority of sufferers claim that long waiting lists for health care services cause patients to have to endure undue pain and/or be impaired for unreasonable lengths of time. As to this particular case, a 4 to 3 vote to invalidate the long-standing prohibition on private insurance for services covered under the Quebec public health care plan resulted.

Since 2006 Quebec has made modifications to its public health care system. For example, if a patient requires hip surgery (recommended by a specialist) and he or she has not been scheduled for surgery after 6 months by a government funded hospital, then Quebec will pay the costs for the patient to receive medical attention at an affiliated private clinic within the province. After nine months, the patient will be able to receive care at a private clinic outside Quebec, or Canada if need be.

A public opinion poll revealed that 43 percent of the public would like to have more control over management of their healthcare, while 54 percent believe that such measures would weaken a system that many people need to rely on.

Given that Canada’s public health care system is not perfect, there are many good reasons why it’s a smart decision to get a supplemental health insurance plan. Should you ever need immediate medical attention, having a supplemental health insurance plan in place can make all the difference in the world!

What does your province provide coverage for?