Individual Insurance in Ontario

Anyone without group coverage who wants help with costs OHIP does not cover, such as prescriptions, dental and paramedical care. That includes self-employed people, retirees and people between jobs.

Premiums depend on your age, the plan and whether it is medically underwritten. Basic guaranteed acceptance plans are usually the least expensive, while comprehensive plans cost more.

Medically underwritten plans can decline applicants or exclude conditions. Guaranteed acceptance plans and plans for people leaving a group plan do not ask medical questions.

OHIP generally does not pay for routine dental care, eyeglasses for most adults, many paramedical services such as massage therapy, or most prescription drugs taken outside hospital for working-age adults. Ontario has drug programs for some groups, such as people aged 65 and over. Individual health and dental plans are designed to help fill these gaps.

Disability insurance typically pays a monthly benefit to replace part of your income if illness or injury stops you from working. Critical illness insurance pays a one-time lump sum if you are diagnosed with a covered condition, whether or not you can keep working. Many people consider both because they respond to different situations.

Many group plans offer a conversion option or access to a plan for people leaving group coverage, often without medical questions. These options usually have a short deadline after your group coverage ends, so it is worth acting quickly. An advisor can compare a conversion plan with other individual options.

Guaranteed acceptance plans can usually be arranged faster because there are no medical questions. Medically underwritten health, disability, critical illness and life plans take longer because the insurer reviews your health history and may request more information. A licensed advisor follows up within 24 hours to get the process started.

Expect to share the ages of everyone to be covered, the types of coverage you want, your budget and, for underwritten plans, your health history and current medications. For disability insurance, your occupation and income also matter. If you are leaving a group plan, have your coverage end date handy.

They may be. Premiums you pay for a private health services plan can generally be claimed as an eligible medical expense for the medical expense tax credit, subject to Canada Revenue Agency rules. Self-employed people may have other options, such as a deduction or a health spending account through their business. A tax professional can confirm what applies to you.