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Health Insurance

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Frequently asked questions related to Health Insurance

Do I need a medical exam to get health care coverage?

No, there typically is no physical or other medical exam required to qualify for any health or dental care plan.

Medical exams (including blood and urine samples) are common for other forms of insurance, such as Life, Disability, Critical Illness etc.

For Medically Underwritten health care plans, there will be medical questions on the application, and the insurer may write to your physician (and compensate them) to produce a summary of your medical history. This is usually all that is required, though the insurer can request additional information as needed.

What is medical underwriting?

Medical underwriting is a process used by insurance companies to evaluate an individual's health risks based on their medical history, age, and lifestyle. This assessment helps determine the terms of the insurance coverage, including premium costs and any exclusions. The outcome influences the affordability and extent of coverage offered to the individual. In some cases, coverage may be declined if an individual's risk is deemed too high.

During underwriting, the insurer may request medical records from the insured person's physician, require health examinations, and ask the applicant to complete a health questionnaire as part of the application. This information provides a comprehensive view of the applicant's health.

How long does it take to get health insurance?

It depends on the type of plan.

  • For Guaranteed Issue and Guaranteed Acceptance plans, your coverage will be effective on the 1st of the next month after an application and payment is received.
  • For Medically Underwritten plans, your coverage coverage will be effective on the 1st of the next month after an application has been approved (subject to qualifying medically) and payment is received.
  • Medically Underwritten plans can sometimes take longer as the insurance company usually needs to obtain records from your attending physician(s). Average time to approval tends to be about 3-weeks. If the insurance company has difficulty obtaining the medical records from your attending physician(s) this may take additional time.
What do you need to get health insurance?

To be eligible for an individual health insurance plan, you must meet the following requirements (regardless of insurance company):

  • Be a resident of Canada
  • Have coverage under your government health insurance plan
  • Be at least 18 years of age on the date of application for the  policy, except for children of an insured person.
  • Quebec residents must also be registered under the RAMQ Prescription Drug Insurance Plan or have equivalent coverage under a group plan.

Note: If the plan is Medically Underwritten it will require a medical questionnaire, and you will need to qualify medically. If you do not qualify due to your health history there are alternative options (e.g. Guaranteed Acceptance plan) available.

When should I apply for health insurance?

One should consider applying for Health Insurance in the following cases:

  1. Ideally, when you are young and have relatively little health history.
  2. When you turn age 21, and are no longer a 'dependent' under your parents plan. This could be turning age 25 if you were a full-time student attending post-secondary (depending on which plan your parents have).
  3. When you become a Canadian citizen and are covered by a provincial government health care plan.
  4. When you leave your employer and lose your employee group benefits (applying within 60-days is best).
  5. When you separate from a spouse and need to find your own plan.
  6. When you are going self-employed.
  7. When your employee group benefits are underwhelming and you wish to supplement with your own plan.

Still have questions?

Please contact our office and we'll be happy to address any questions you may have.

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