Shopping for Individual Supplementary Health or Dental Insurance

If you have health benefits through your employer, your group insurance coverage has been chosen for you and cannot be changed, unless you have a flexible plan, also known as the “cafeteria-style” plan. If it covers all of your medical needs, that’s great! However, if you are not covered, or simply wish to top up your insurance to cover a particular medical need, you may want to purchase supplementary health or dental insurance. It’s a good idea to shop around and compare the plans that different companies offer.

Insurance for visitors or returning Ontarians: If you are living in Ontario temporarily, or returning to Ontario after a long absence, you may not yet qualify for OHIP, in which case, you may wish to consider supplementary health insurance. For example, some companies offer insurance to cover medically necessary services to visitors or returning Ontarians. Some offer emergency-only coverage, some include semi-private hospital rooms, and some pay for an emergency return home for visitors if you are disabled, or die. Be sure to shop around to find the best premium and coverage for your needs.

If you choose to purchase supplementary health or dental insurance, use this checklist to guide you through the steps.

What to Do Before You Buy

□ Review your employee policy. If you have supplementary health and/or dental insurance through your employer, review your policy to see what kind of coverage you have. If you need more, you can start shopping around, or ask an insurance agent or company for help.

□ Review your partner’s policy. Make sure you understand how much coverage you may already have, as well as what coverage you don’t have. You may be able to combine (coordinate) your benefits to cover up to 100 per cent of your medical or dental expenses. There are agreements in place that determine which policy pays first. Make sure you understand how your policies would work together.

□ Make a list of your medical and dental needs. Consider the medical needs of you and your family over a year. Do you need glasses? Prescriptions for the kids? Physiotherapy for a sports injury? Dental care? Having a list handy will help you decide what kind of policy to look for. To learn more about the different kinds of policies, visit Types of Health and Dental Insurance.

□ Ask your family and friends for recommendations. If they’ve already purchased supplementary health or dental insurance, they can help you find a good insurance company or agent.

□ Verify if the insurance agent or company is licensed. In Ontario you can buy supplementary health or dental insurance from an insurance agent or company. You can check they are licensed with FSCO, and the status of the license, by visiting Agents Licensed in Ontario or Licensed Insurance Companies in Ontario .

□ Go online. There are many useful sites that can help you compare products before you buy. Remember, online comparisons are not the same as personal advice from a trusted and licensed agent or company. It’s a good idea to speak with an insurance agent or company who can assess your individual needs, answer your questions, and provide advice over the life of the policy.

What to Do When You Buy

□ Check the application process. Insurance companies can make information available to you in a number of ways: online, over the phone or face-to-face. Some allow you to purchase supplementary health and/or dental insurance online, but others will require you to speak with an agent after you get a quote. Choose the method that makes you feel most comfortable.

□ Compare different policy types and quotes. Individual supplementary health insurance policies and dental insurance policies offer a range of benefits to suit your specific needs. Most standard supplementary health insurance policies will cover things like prescription benefits and vision care. If you want dental care, you may need to purchase a separate policy. Make sure you understand exactly what is covered under each option. For more details, visit Types of Health and Dental Insurance.

□ Consider add-ons. Your unique situation will determine whether you need extra coverage for things like travel, disability, critical illness, or long-term care. There are lots of options available. Visit the Canadian Life and Health Insurance Association’s Guide to Supplementary Health Insurance and speak to your insurance agent or company for more details.

Use FSCO’s Questions to Ask about Supplementary Health and Dental Insurance checklist to help you make an informed decision about supplementary health and dental insurance.

What to Do After You Buy

□ Inform your loved ones about your policy. They need to know the details of the plan, where you store the insurance card, how to contact your insurance agent or company and how to make a claim.

□ Review your medical and dental needs at milestone events. When you get married, or have kids, your family’s medical needs change. It’s the perfect time to check whether your supplementary health and/or dental insurance policy still meets your needs, and make adjustments if necessary.