Filing a Health Insurance Claim

So you’ve decided on a health insurance plan that fits your needs, what now?

You will receive your ID card in the mail that has all of the information necessary that your health service provider will need to process your claim.

Individual claims must be submitted within 12 months of the service charge. Once the insurance company receives your claim it shouldn’t take more than 5 business days to process your claim and another 24hrs after processing to send out your re-imbursement. Make sure to include all necessary information including original receipts, for prompt processing and payment.

Many health care providers, hospitals, pharmacies dentists and optometrists most likely will bill your insurance provider right from the office, eliminating the process of having to fill out and send a claim form. If your health care provider does not bill your insurance provider directly, you are then required to pay the initial cost in full and then submit your claim yourself. You would then receive your re-imbursement by mail. You can use your receipts for tax purposes so make sure to retain the top portion of the cheque for verification.

Medical Marijuana Coverage

In June 2013 Health Canada introduced regulations to permit larger-scale medical marijuana production facilities. As a result, 15 companies are now fully authorized to produce and sell the product. Eight other companies are authorized to produce, but not to sell.

There is a very strict application process in which a company must meet Health Canada’s criteria in order to be considered. 

Consideration is given to the following:

• Storage
• Location
• Human Resources
• Pest Management
• Packaging/Inventory
• Record Keeping
• Sales and Marketing
• Quality Assurance

There are 3 steps when applying to Health Canada for an Authorization to Possess Marihuana for Medical Purposes and for a legal source of supply under the Marihuana Medical Access Program (MMAP):

Consult your Medical Practitioner

Before you apply to the MMAP your doctor must provide a letter declaring that other avenues of treatment have been used and have not been effective.  If you and your doctor agree you should apply to the MMAP to obtain marihuana for your condition and/or symptoms, you must choose a source of supply. As of March 31, 2014 you   would no longer be permitted to access Health Canada supply of medical marijuana, you will need to register with a licensed producer.

Is my medicine covered by my medical plan?

Because medicinal cannabis doesn’t at this time have a Drug Identification Number (DIN) it isn’t covered by any Federal, Provincial or private health insurance. If you are a veteran you may be covered by the Veterans Affairs of Canada or there is the option to declare it as a medical expense on your personal taxes providing you have valid receipts.

For any other questions about drug coverage go to http://www.caahealth.ca/

Retirement and Health Insurance

A great number of Canadians are working well past the age of their desired retirement and it’s not necessarily because they want to keep busy! Many people remain active in the work force for financial reasons, the like of which could be based on health issues that require the health insurance coverage they receive in the workplace. Under such circumstances, they find it worrisome to contemplate retirement.

People who are fortunate enough to have a health insurance plan at work must take into account the fact that they will lose that coverage once they retire. Aging Canadians, who suffer from chronic health conditions, understand the importance of health insurance as they deal with the costs of prescription medications and medical treatments. Some provinces subsidize certain expenses for those over 65, but not all medicines and treatments are covered.

Working Canadians must bear in mind the ‘what if’s’ when considering retirement. For those who are beginning to deal with health issues, one of their main concerns is this:  Will I be able to absorb the medical costs should I need a caregiver (a personal support assistant or nurse) when I retire? Home care expenses can run anywhere between $2,000 and $5,000 a month, depending on the level of care required. 

As we age, our body changes.  One can expect diminishing vision and increasing dental upkeep, and one should also be prepared in the event that the aid of medical devices might be required to help with mobility or hearing loss. 

There’s a way to alleviate your worries. CAA Health & Dental Insurance offers enhanced plans to early retirees and seniors that specifically address the needs of particular age groups. Health insurance companies - CAAhealth.ca - understand that every life stage has its own specific needs and for that reason, they offer customizable packages that fit the needs and the budget.

Obesity Puts a Strain on the Canadian Health Care System

In the last 25 years, the number of obese Canadians has tripled, bringing about additional strain on the country’s already fraught health-care system. At this rate, more than 1 in 5 Canadians will suffer from obesity in the near future. 

Statistics Canada has been keeping a record on obesity by means of surveys conducted over the last 26 years. The data reveals a 12% increase in the last 25 years.

Percentage of Obese Canadians

1985                6%

2011                18%

Yoni Freedhoff, medical director of the Bariatric Institute in Ottawa, stated “A flood of cheap, attractively packaged empty calories has washed over the grocery shelves and oversized plates of the nation in that time. I do not believe we’ve experienced an epidemic loss of willpower since 1980… I think the world around us has changed.”

Obesity Related Health Conditions

General health issues associated with obesity can include sleep apnea, gout, and osteoarthritis.  The top 5 obesity-related health conditions are:

• Heart disease and stroke
• High blood pressure
• Type 2 Diabetes
• Cancer
• Gallbladder disease and gallstones

Canadians Getting More Health Conscious

The Canadian government has begun to tackle the obesity problem by requiring schools to offer healthier food choices in school cafeterias, and limiting the supply of junk foods. Food labels and calorie counts are being made available in stores and in restaurants everywhere in Canada. Although we won’t see the effects from these efforts for a number of years, it is nevertheless a good start toward better nutrition.  In the meantime, more and more people suffering from health conditions due to obesity are requiring medical treatments, putting the annual costs for health care between $4.6 and $7.1 billion.

When the public health care system is overwhelmed you're looking at longer wait times in hospitals and for certain medical treatments as well. Private health insurance can make a difference and offer you more options in terms of the type of health care you receive. When it comes down to it....it pays to have options!

Aging Canadians and the Impact on Health Care Costs

In 2010, 4.8 million Canadians were seniors. Based on the established growth rate, that number will steadily climb to about 10.4 million in the next 20 years.

By 2031, all members of the baby boom generation will have reached the age of 65. The issue of whether or not Canada’s health care system will be able to meet their medical needs as time goes on is a significant concern. Canada’s health care system may very well have to change and adapt itself to adequately fulfill the needs of seniors.

Even though the elderly make up only 14% of the population, they incur about 45% of provincial and territorial health care expenditures. Today’s seniors are living longer than those of previous generations, a fact that has shifted the Canadian demography to an older population. Aging brings about limitations and chronic conditions that increase health care costs.

We need to think about how well we’ll do in the future under the existing public health care system. More and more seniors are relying on retirement savings and other income sources to help pay for medicines, treatments and/or services not covered by the government program.

Fortunately, there are health insurance plans available that focus on fulfilling the needs of baby boomers and seniors. Such policies include coverage for things like orthotics, home care, medical equipment, hearing aids, and hospital benefits.