The provincial healthcare plans provide some degree of health insurance for nearly all children living in Canada. Most large cities in Canada have hospitals that are dedicated to treating children. Although children’s parents or guardians are not responsible for paying fees for their children to receive treatment at such hospitals, health coverage varies widely from province to province. Vision and dental coverage across the provincial plans range from comprehensive coverage to no coverage at all. Prescription drug costs are usually covered up to a specified percentage of the cost, depending on the province.
Children, seniors, and social assistance recipients are three groups of people that are provided with coverage for health services that the public healthcare system does not typically provide coverage for. These additional health benefits include vision, dental, prescription drugs, medical equipment, and services provided by specialists. The type and amount of coverage for these additional health benefits varies in accordance with the province/territory of residence.
Supplemental Child Health Insurance
It is crucial that you determine what your federal/provincial plan covers, what it does not, and what types of coverage might be worth obtaining through supplemental child health insurance. If your child does not qualify for the coverage of hearing aids, prescription lenses, prescription drugs, dental care, medical equipment, or various other health care services under the governments’ programs, supplemental child health insurance is worth considering as many of these services can result in unexpected, significantly high expenses. Without supplemental coverage to offset such costs, you and your family may eventually experience financial concerns. While obtaining supplemental child health insurance may appear complicated and time-consuming, it is worth the effort. You can purchase extra coverage for additional benefits through individual health insurance plans, or company group health insurance programs, which are often offered by employers.
A Guide to Choosing Child Health Insurance
When shopping for supplemental child health insurance, asking the potential insurance provider the right questions ensures that you will get the coverage your children need, at a cost that meets your budget.
Below are some sample questions you can ask the insurance provider:
What is the cost of coverage for one child and/or to cover additional children? What type of coverage is provided by the plan for children with special needs? Does the plan cover preexisting conditions? What does the plan consider to be an existing condition? Is there a waiting period before the plan becomes active? What is covered under the plan? Does the plan provide coverage outside of Canada? Do I need to notify my provider if the child leaves Canada? What are the plan’s exclusions? What coverage does the plan offer over and above the government plan? How does my workplace’s health insurance coverage compare to the coverage of supplemental insurance? Does the plan cover special procedures or visits to specialists? What do I have to do if I want to schedule an appointment with a specialist? Does the plan cover glasses/contacts, and if so, up to what amount? Does the plan cover dental care, and if so, what services are covered? How do I file a claim and how do I receive reimbursement for claims under the plan? What type of prescription drug coverage is provided by the plan? Are there particular instances or exceptions whereby a prescription drug would not be covered? What will be the monthly cost of the plan, what methods of payment are accepted? What happens if I miss a payment? Are there co-insurance or co-payments that I should be aware of? Is there a deductible that applies to the plan? How much is the deductible and how does it affect my coverage? How will I know when I have met the deductible?
