Tips for choosing the right coverage
The importance of health insurance for your family
Ensuring that you and your family have high-quality health insurance is a priority for most Canadians. Even though the government supplies basic medical care and emergency services, if anyone in your family becomes ill or requires extra care, you could be faced with a situation needing to pay out of pocket for prescriptions and additional health services – not an ideal position, regardless of your financial situation.
If you have group health insurance through your employer, you likely won’t have to pay for extra medical expenses. But, for many Canadians, private health insurance is an effective option to help pay for additional costs of health care that are not covered through by the government.
Understanding your family’s health insurance needs
As with any other form of insurance, it’s important for you to take your time and explore your options to find health insurance that addresses all the medical needs of your family. Choosing health insurance is not a decision that should be rushed. Policies can vary widely, and you need to ensure you include the health coverage your family needs and will use.
Perhaps the first thing to consider is what is covered by OHIP and/or your employer (if applicable). You can use this as a basis for understanding what medical coverage your family needs outside the scope of health insurance that the province provides. Ask yourself:
- If you required the services of a physiotherapist or massage therapist, do you have coverage?
- If you required prescription medication, would you have to pay out of pocket?
- Are there certain types of treatment that would be beneficial for your family or a particular member of your family?
Are you keeping in mind your future needs and that of your family?
Answering these questions will help you better understand the type of policy that makes the most sense for your family.
Key considerations for health insurance for a family of 4
While some invest in private health insurance coverage in an effort to be proactive and ensure they have coverage when they need it, others explore their health insurance options because it does not make financial sense to pay for medical treatment out of pocket. Regardless of your reason for exploring your options, here are some important considerations that should be part of your decision:
- Existing conditions: Does anyone in your family have a pre-existing medical condition? If so, what is it? What are their medical needs? Restrictions may apply for pre-existing medical conditions, but some plans are guaranteed-issue. This is just one reason to purchase insurance coverage when you are healthy.
- Policy use: Consider how much you will actually use the policy. If you anticipate to use it only occasionally, then a lower premium policy may make more sense. Remember that if you find your coverage level is too low, you can always apply to increase it to meet your health care needs as they change over time.
- Cost vs. coverage: The balancing act between health insurance cost and coverage is perhaps the biggest challenge for families as they consider their options. Determining how much you can afford to pay for your monthly premium and the amount of coverage you will receive is an important distinction to make. Avoid choosing a policy based on premium cost alone. In general, lower premiums are associated with less coverage, meaning that you may have to pay for some services out of pocket. Higher premiums offer more extensive coverage, requiring you to pay less out of pocket.
- Coverage limits: Every health insurance policy outlines coverage limits. Make sure you are aware of these limits and how they can impact your family. For example, if you or a family member requires extensive dental work, a basic policy may not provide you with enough dental care coverage. Balance your coverage needs, limits and pricing to ensure all family members have access to the coverage they need, which will minimize your out-of-pocket expenses.
- Customization: A final consideration is your ability to customize policy elements to meet your family’s specific health care needs. Make sure that you inquire about your ability to personalize your plan.
Keep in mind that health insurance needs for a single person will vary significantly compared to health insurance for a family of four. Factor all of the above into your decision to find the right level of coverage for everyone in your family.