Do I need supplementary health insurance?

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If you have read the article 5 important facts about your Manitoba Health Care coverage you will notice that there are some health services that are not covered. These services include dental; optical (for specific ages); ambulance, some drugs, medicines and vaccines; and others. If you, or your family members require such services, you need supplementary health insurance coverage.

What is supplementary health insurance?

This is a plan that insures you for health services that are not covered, or not fully covered, by government plans. They may be group plans sponsored by employers, unions and associations, or individual plans that you can buy for yourself and your family. These plans pay part or all of your expenses when you see a health care professional, when you are confined in a hospital, or need medicine or medical appliances/equipment. They prevent major out-of-pocket costs when you need health services.

What do these plans cover?

The coverage of supplementary plans vary. The most common types are extended health insurance plans which cover health-related expenses not covered by the Provincial health insurance such as:

• Prescription drugs/medicines
• Hospital accommodation
• Special nursing services
• Hospital/medical expenses incurred outside Canada
• Artificial limbs, prostheses and medical appliances
• Wheel chairs and other durable equipment
• Medical or paramedical services (e.g. optometrists, podiatrists, etc.)
• Vision care for ages not covered by Manitoba health care

Another type of supplementary plan is a dental plan. It covers expenses for basic preventive and maintenance services such as:

• regular dental check-ups or examinations
• cleaning
• fillings
• extractions
• x-rays
• root canals
• periodontal cleanings
• scaling
• major restorative work such as inlays and crowns, bridgework, dentures, and orthodontic treatments

Supplementary health plans are designed to answer certain needs and outline minimum and maximum benefits, eligibility, who is/are covered, conditions and requirements. It is crucial that you understand how these plans work to be able to maximize their benefits.

Other types of individual plans:

Aside from covering the most common health or medical expenses, there are other plans that you can purchase that provide benefits for specific needs. For instance:

Hospital cash plans – These plans pay you cash for each day you are confined in a hospital. The cash can be used for every day expenses, travel expenses, or for services (such as babysitting or housekeeping) that you may need.

Insurance for visitors or returning Canadians – This usually covers doctor’s services, hospital services and supplies only in emergency cases.

Disabliity insurance –This is designed to replace lost income while you are disabled and unable to work.

Critical illness plans – These may be group or individual plans that provide a lump sum benefit when you are diagnosed with a life-threatening illness such as cancer, heart disease requiring surgery, heart attack, stroke, and other critical illnesses.

Long-term care insurance – This pays for stays in nursing homes and chronic care facilities, or for the services of a caregiver in your home.

Travel insurance– Aside from covering trip cancellations and lost or damaged baggage, certain types of travel insurance help you if you need medical care when you are outside of the country. The plan can help you shoulder health care costs that may not be covered or only partially covered by your Manitoba health insurance. Travel insurance can also come in handy if you will be away for a long time and it is possible that your provincial coverage may lapse.

Considerations for purchasing supplementary health insurance

If you are thinking of availing supplementary health insurance, carefully consider your needs and resources. If you are employed, you should first check with your company’s HR about your group insurance plan coverage and its benefits. Some company plans may be flexible and allow you to tailor your coverage to closely meet your needs.

In Manitoba, individual and group plans are available from Blue Cross or Doctors Manitoba (an autonomous professional organization), or from insurance companies such as Great West Life, Manulife, Sunlife Financial and other private firms. These organizations and companies have plans that offer a variety of benefits. Do a bit of research to find out which plan is best for you. You can get useful information from insurance company websites or insights from family and friends who have experience about buying supplementary health insurance. You can also talk to a health insurance advisor or an agent from a reputable insurance company.

Sources: Manitoba Health, Healthy Living and Seniors, A guide to supplementary health insurance, Canadian Life and Health Insurance Association, Inc. (CLHIA).