If you are an Ontario resident, you are covered by OHIP, Ontario’s beloved public health insurance plan that covers most of our medical needs. But did you know that there are situations where having private health insurance can be a game-changer? Let’s dive into the world of private health insurance in Ontario and figure out who needs it and why, and who can skip it without worry.
Who needs private health insurance in Ontario?
Frequent travelers
If you’re a jet-setter who loves to explore the globe, private health insurance is your best friend. While OHIP covers you in Ontario, it’s not much help when you’re sipping margaritas in Mexico or skiing in Switzerland. Private health insurance ensures you’re covered for medical emergencies and unexpected illnesses or injuries while traveling abroad, giving you peace of mind wherever you roam.
Self-employed folks
As a self-employed individual, you’re the boss of your own destiny (and your own health insurance). While OHIP has your back for basic medical services, private health insurance can fill in the gaps by covering prescription drugs, dental care, vision care, and other services that aren’t included in OHIP’s coverage. Plus, having private health insurance means you won’t have to dip into your business funds to cover unexpected medical expenses.
Families with kids
Family plans cover all family members under one insurance policy and are in demand due to the benefits they offer. A comprehensive health insurance plan can not only take care of your physical health during a medical emergency but your financial health as well. You have to think about what your family needs to choose a plan that is suitable for them. Generally speaking, the way you go about selecting a family health insurance plan will depend on whether you’re an employee or self-employed.
Retirees and snowbirds
Ah, retirement—the time to kick back, relax, and enjoy life to the fullest. But as we get older, our healthcare needs tend to increase. Private health insurance can provide extra coverage for prescription drugs, dental care, and vision care that may not be fully covered by OHIP. And for those lucky snowbirds who escape the Canadian winter for warmer climates, private health insurance ensures you’re covered for medical emergencies while basking in the sun down south.
Who doesn’t need private health insurance?
Employees with group benefits
If you’re lucky enough to have a job with group benefits, you may not need private health insurance. Many employers offer comprehensive health insurance plans that cover prescription drugs, dental care, vision care, and other services not covered by OHIP. Just be sure to review your plan carefully to understand what’s included and any limitations or restrictions.
Low-income individuals
For low-income individuals and families, the Ontario government offers programs like the Trillium Drug Program and the Ontario Drug Benefit Program to help cover the cost of prescription drugs. These programs are designed to ensure that everyone has access to essential medications, regardless of their income level. Plus, OHIP provides coverage for basic medical services, so low-income individuals may not need additional private health insurance.
People happy with OHIP
Hey, if you’re perfectly content with OHIP and don’t feel the need for extra bells and whistles, more power to you! Ontario’s public health insurance plan provides coverage for most medical services, including doctor visits, hospital stays, and some diagnostic tests. If you’re in good health and don’t anticipate needing additional services, private health insurance might just be an unnecessary expense.
What types of private health insurance are there in Ontario?
In Ontario, private health insurance comes in various forms, each tailored to meet specific healthcare needs and preferences. Here are some common types of private health insurance available in the province:
- Extended health insurance: Extended health benefits plans provide coverage for services not covered by OHIP, such as prescription drugs, dental care, vision care, paramedical services (e.g., physiotherapy, chiropractic care, massage therapy), and medical equipment and supplies. These plans are often offered as part of employee benefits packages or can be purchased individually from insurance providers.
- Travel health insurance: Travel health insurance provides coverage for medical emergencies and expenses incurred while traveling outside of Canada. This type of insurance is essential for Ontarians who frequently travel abroad for business or leisure, as it ensures they have access to medical care and financial assistance in the event of illness, injury, or other emergencies while abroad.
- Critical illness insurance: Critical illness insurance provides a lump sum payment if the insured individual is diagnosed with a serious illness covered by the policy, such as cancer, heart attack, stroke, or organ failure. The lump sum payment can be used to cover medical expenses, mortgage payments, household bills, or any other financial needs during the recovery period.
- Disability insurance: Disability insurance provides income replacement if the insured individual becomes unable to work due to injury or illness. It ensures a steady stream of income to cover living expenses, mortgage payments, and other financial obligations during the period of disability. Disability insurance can be particularly valuable for self-employed individuals and those without access to employer-sponsored benefits.
- Dental insurance: Dental insurance provides coverage for routine dental care, including check-ups, cleanings, fillings, and other dental procedures. This type of insurance helps offset the cost of dental services, which can be significant, especially for more complex procedures like root canals or crowns.
- Vision Insurance: Vision insurance covers the cost of eye exams, prescription glasses, contact lenses, and other vision-related expenses. It helps individuals maintain their eye health and vision by providing financial assistance for routine eye care and corrective lenses.
- Drug insurance: Drug insurance, also known as prescription drug coverage, helps cover the cost of prescription medications. It ensures individuals have access to necessary medications without facing high out-of-pocket expenses. Drug insurance plans may vary in coverage, with some providing comprehensive coverage for a wide range of medications and others offering more limited coverage.
These are just a few examples of the types of private health insurance available in Ontario. Depending on individual needs and preferences, Ontarians can choose from a variety of insurance options to ensure they have access to the healthcare services and financial protection they need. It’s essential to carefully review and compare insurance plans to find the coverage that best meets your specific healthcare needs and budget.
NEW! 3 Accident Insurance options at $7 per month each!
These plans are great and affordable for everyone. No medical exam required. Tax-free benefits. They pay regardless of your age or gender. The enrolment is quick and easy. Based on the coverages you choose, you could receive monthly payments to cover a period of disability, a lump sum in case of a fracture, or reimbursement for your medical expenses after an accident.
3 coverage options at $7 per month each:
- Disability in case of accident: income replacement of $700 or $1,400 per month
- Accidental fracture: a lump-sum payment of up to $14,000; payable in 7 days
- Extended medical care further to an accident: the lifetime maximum of $100,000
To learn more visit https://insurancestoronto.ca/
Final thoughts:
Private health insurance in Ontario can be a valuable asset for those who need extra coverage beyond what OHIP provides. Whether you’re a frequent traveler, self-employed entrepreneur, or retiree enjoying the golden years, private health insurance can offer peace of mind and financial protection when you need it most. But for those who are covered by group benefits, government assistance programs, or are perfectly happy with OHIP, skipping private health insurance might be the way to go. At the end of the day, it’s all about finding the right balance of coverage and cost that works for you and your unique healthcare needs.
