How to determine if supplemental health care coverage is right for you

When Canadians seek medical attention for broken bones or emergency appendectomies, the country’s health care system allows most to head to the hospital and be looked after without the burden of a big bill.

But filling a prescription, seeing an optometrist or going to the dentist for a checkup all come with a price tag passed along to patients. While many have health insurance through employers, spouses or schools, plenty of people lack such a luxury because they are unemployed, self-employed or simply working for a company that doesn’t offer such benefits.

Jessica Moorhouse, a 33-year-old personal finance blogger, says those without additional health care coverage should educate themselves on what is and what isn’t provided by the government to identify gaps they might need to cover.

Then, work out what kind of health expenses you typically have and calculate how much it would cost to pay cash versus paying an insurance provider for that extra health care, Moorhouse says.

People who require pricey prescriptions or a high level of medical attention not covered by the government might find signing up for a health care plan is a better value than paying out of pocket, but the opposite might be true for people who have few medical needs.

“The past few years it’s made more sense for me to just save and pay cash, but in the future as I get older or start a family, my position and needs may change,” Moorhouse says.

“Health coverage beyond what’s included in Canada’s medical system may not be necessary for everyone, so you really need to look at your situation right now and also consider what you may require in the future in terms of health care.”

If you decide that a plan is right for you, Moorhouse recommends putting aside plenty of time for research. Alternatively, you could go via a broker who will find you the best price and policy.

If you’re a university or college student, most schools will offer plans at discounted rates. Some will auto-enrol every student in the plan, but if you already have coverage, you can apply to opt-out of it and receive your money back.

When seeking quotes, Moorhouse recommends people take a peek at some of the online calculators run by health insurance companies that will provide a free quote. Sun Life Financial and Blue Cross Canada are among the dozens of businesses offering such estimates.

“In the past when I’ve asked for quotes I’ve heard $100 to $150 per month just for a basic dental and vision plan is the norm, but again, it really depends on a number of variables,” says Moorhouse.

Keep an eye on restrictions and percentages of coverage too, she says.

“Just because you’re on an insurance plan does not mean you will be covered 100 per cent for that dentist visit,” she explains. “Usually you’ll be paying your insurance premiums plus 40 to 50 per cent of the cost of going to the dentist.”

Moorhouse says if you decide to forgo a plan, put aside some money for health care expenses instead.

According to her, the best way to figure out how much to save is to calculate the costs of the services you’ll need.

“Everyone’s needs are different,” says Moorhouse. “For myself, my needs are dental cleanings twice per year and an eye exam and possibly new glasses every two years…. I don’t need any prescriptions and I don’t have any health issues.”

Once you determine what it will cost for the services you need, you should put that money in a savings account along with some extra cash for unexpected charges or changes in prices, says Moorhouse.

You should be putting automatic contributions into the savings account so it becomes part of your regular budget and so you’re never left with an empty fund, she says.

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