Easy Group Benefits is dedicated to boosting the health and wellness of your staff, even if you are the only staff member. Self-employed contractors with no employees need health and dental coverage too.
Of course, there is strength in numbers, and your options applying as an individual are more restricted. This article will go over some of the differences between group and individual health insurance, and reveal a few options on the individual side that come Easy Group Benefits recommended.
Medical Underwriting Required
Unlike group benefits plans most individual health plans require the completion of a medical questionnaire. Don't worry, it is not like life insurance underwriting where a full medical is often required.
The insurance company reviews the medical questionnaire and has the option to deny coverage, charge more due to your medical risk, or exclude pre-existing conditions. This can be annoying as you are likely trying to get insurance because you have a recurring medical issue. Unlike a group benefits plan through your work, where no medical underwriting is required, you can't buy insurance after your house has burned down (so to speak).
Luckily, most dental-only plans will require no medical underwriting and are sold on a guaranteed acceptance basis. Remember, dental expenses are not covered under provincial health care plans and even regular dental work can get very expensive if you don't have insurance!
Insurance of any kind isn't purchased for issues that have already happened, or to protect from things you know are going to happen. You purchase insurance to protect yourself from the unexpected. Health and dental insurance are no different.
Individual Plans Come As A Package Deal
When purchasing an individual health plan, you don't have as much room to pick and choose. Carriers will offer different packages geared either towards amounts of coverage or specific types of coverage. For example, a carrier might offer a plan that has the same categories of coverage as a package but different options for the amount covered. Other carriers might offer category-specific plans like dental-only plans, or prescription drug plans.
You are going to want to look under the hood and see what these packages really include. Two health plans may both have dental coverage but one is for white fillings and the other for silver fillings only. Or two plans may offer paramedical coverage but one has acupuncture and the other doesn't.
It is important to keep in mind what you are looking for. Easy Group Benefits is knowledgeable about all carriers and is experienced in finding the best individual health solutions tailored to specific needs. We recommend different companies for dental only plans then we would for drug plans or plans geared towards health practitioner coverage. Make sure you talk to us, or another licensed agent you trust before purchasing!
You Can't Get As Much Coverage
This is especially true in the extended health/ paramedical practitioner category. You will see in our recommendations that there are still a few good options out there but they are hard to find.
Some benefits plans offered through a company of 2 or more employees can include unlimited coverage for dental and drugs, and coverage for paramedical practitioners of $1000 per each (RMT, Acupuncture, Chiro etc...) per year. This kind of coverage is not available to individuals but the reason actually ends up proving to be helpful to the individual.
On the group side, insurance companies evaluate the plan each year and offer a new price based on how much the company used the plan. On the individual side, the price increases are only related to age brackets, and cost of living adjustments.
One thing you really need to look out for if you are exploring individual health plans is per visit maximums. A per visit maximum is the maximum dollar amount an insurance company will pay for each visit. Personally, this is my biggest issue with most individual health plans. A lot of Easy Group Benefits clients are looking to get coverage for extended health practitioners but on the individual side, almost all plans will come with a per visit maximum.
This means the individual health plan might provide coverage for $500 for each practitioner per year but only cover $20 per visit! Not very useful!
The Best Individual Health Plan
Now that we have discussed some of the ins and outs of the individual health and dental market let's explore some of Easy Group Benefits' favourite options.
Manulife Association Health And Dental Plan
Why we like it:
This plan has hands down the best coverage available if you are looking for extended health practitioners. It rivals the coverage level of what would be available through a company benefits plan. Up to $600 per practitioner with no per visit maximums is available on their gold plan.
On top of the outstanding paramedical coverage, it is a really comprehensive package at an affordable price.
Sunlife Personal Health Insurance
Why we like it:
Much like the Manulife plan mentioned above, you can get very good coverage for extended health practitioners with their most comprehensive plan offering $400 per practitioner with no per visit maximum.
They may be a bit lower in paramedical coverage but they make it up for it in a strong base plan. Even the standard plan offers $100K of prescription drug coverage and includes 60 days travel insurance. Sunlife's pricing is very good as well, especially in certain age brackets.
Blue Cross Dental Only
Why We Like It
People looking solely for dental coverage may be having a hard time finding a plan. Look no further. Blue Cross offers an excellent, cost effective dental only plan. Don't get pressured or up-sold into paying for benefits you don't want.
The plan increases in coverage over time, after year 2 you are covered $1000 a year at 80%. The dental only plans start at a mere $26 a month!
Green Shield Health Assist Zone
Why We Like It
Green Shield is a non-profit insurance organization that is able to provide a wide array of health insurance options for individuals and companies. The Health Assist Zone Plans are comprehensive package plans that provide coverage for absolutely everything. Honestly, they don't offer anything specifically impressive but they do offer comprehensive packages at affordable rates. If you are looking to get coverage for a bit of everything this may be the way to go.
Now you know about some of the best individual health plans on the market, and a few things you need to look out for. The insurance world is ever changing and complex so please, don't hesitate to reach out and let with Easy Group Benefits hook you up with the best health and dental plan for you!
Questions?
Talk to the author!
Benjamin Bondar
ben@easygroupbenefits.ca
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