How much do you know?
Does OHIP cover all of your health and medical expenses in Ontario?
CORRECT ANSWER: NO.
The Ontario Health Insurance Plan (OHIP), only partially covers some health services you may need.
Take this checklist along with you when you speak with your employer, human resources representative, insurance agent or company about supplementary health and/or dental insurance.
Questions to Ask Your Employer/HR Representative
□ How much coverage do I have? What exactly is covered?
□ Is there a group benefit booklet available that summarizes my coverage?
□ Which insurance company is our plan with?
□ Is my pre-existing condition covered?
□ Do I need to have a medical exam to provide evidence of insurability?
□ When does my coverage take effect? When does it end?
□ Can I extend coverage to other family members?
□ Is it possible to increase any of my coverage? How much will it cost me? Is there a deadline?
□ What happens to my coverage if I take a leave of absence, maternity leave, etc.?
□ What happens to my coverage if I am laid off?
□ What happens to my coverage if I retire?
□ What are my
□ Are there any exclusions of which I need to be aware?
□ Can I coordinate benefits with my spouse/partner’s plan?
□ How do I file a claim?
Questions to Ask Your Insurance Agent or Company
You have the right to work with an agent or company you trust. FSCO regulates insurance agents and companies in Ontario.
In FSCO’s database you can find:
Licensed Agents in Ontario and
Licensed Insurance Companies in Ontario.
To help you find a supplementary health and/or dental insurance policy that fits your needs, the insurance agent or company you choose will probably ask personal questions about your family, health, and budget. They need this information to understand how much coverage you need. You might want to ask these questions before settling on a particular type of policy.
□ How long have you been in business?
□ Do you have any references I could review or contact?
□ For which companies do you sell insurance?
□ How/when can I contact you for advice or more information?
□ How much supplementary health and/or dental insurance do I need? How did you come up with that number?
□ How much coverage do I need if I have children?
□ What is the best type of policy for me?
□ Can you provide me with some alternatives or options?
□ Have you ever been sanctioned by a regulator?
About the policy
Once your insurance agent or company has assessed your situation and your individual needs, they will recommend some options for you to consider. Review them carefully. You need to understand everything in your selected policy(s) before you buy. The following are questions you should ask before you sign anything:
About the basic features
type of policy is this?
□ When does my policy take effect? How long will my policy last?
□ What is covered and what is not? Are there any exclusions?
□ Are my children/dependants covered? For how long?
□ What are my
□ What will the
premium be? Will they change over time? How do I pay them?
□ What happens if I run into financial problems and cannot pay my premiums?
□ How do I file a claim?
□ Are there any options for additional coverage I should know about?
About your health
□ Do I need a medical exam to purchase the product? Will I need any in the future?
□ What happens if my health changes?
□ If I become disabled and cannot work, what happens to my premiums?
You may be interested in...
Supplementary Health and Dental Insurance 101: Getting Started: learn the basics of supplementary health and dental insurance.
Financial Literacy Portal: your one-stop shop for links to other great financial information.
Working with an Insurance Agent or Company: understand what to expect when working with an insurance agent, company or agency.
Types of Supplementary Health and Dental Insurance: learn what the different policy types are and what options you have.
Supplementary Health and Dental Insurance Glossary: to better understand common supplementary health and dental insurance terms, refer to this glossary.