For many Canadians retirement is a time of change and excitement. Some have travel plans, while others have things they want to accomplish at home.
One important aspect about retirement that sometimes goes unmentioned is the loss of employee benefits and healthcare. Oftentimes those who are retiring are 65 years old and have pre-existing health conditions along with prescription drug medications.
Another consideration at retirement age is provincial healthcare which (usually) covers things like prescription drugs and some vision care costs (OHIP covers eye exams at age 65 but does not cover glasses, contact lenses, etc.). It’s important to know that these provincial healthcare plans vary from province to province, but generally speaking seniors do get more coverage than non-seniors, especially when it comes to medications.
So, if retiring Canadians who have provincial healthcare plan coverage for their medications, what is the point of getting a private, individual health insurance plan?
Why Get a Retirement Group Conversion Health Plan?
Group conversion plans are specifically designed for people who have recently lost their group benefits coverage (which happens when retiring), and acceptance is guaranteed as long as you apply within a given time period after losing that group coverage (60 or 90 days are common).
But why consider buying a conversion health plan when retiring?
For starters, provincial healthcare plans such as OHIP (Ontario), AHCIP (Alberta) and Medicare (New Brunswick ) do not cover all medications that retirees sometimes need. Senior drug benefits (via provincial health plans) also come with deductibles and copays (flat fees) which private health insurance plans usually cover.
In addition private conversion health plans offer a wide range of coverage other than prescription drugs. Just some examples of these are:
- Dental benefits (routine and emergency costs).
- Hospital coverage for private and semi-private rooms.
- Vision care (although provincial healthcare plans do offer some vision care coverage).
- Travel medical insurance.
- Registered specialists such as physiotherapists, massage therapists, chiropractors, etc.
- Durable medical equipment such as wheel chairs, walkers and walking aids.
- In-home nursing care (private duty nursing, personal home support workers, etc.)
Another factor is that Canadian insurers know that provincial healthcare plans will cover most of a retiree’s drug costs, and they take this limited exposure to drug claims into account when determining premiums for group conversion plans.
More About Retirement Health Insurance
There are several different types of private Canadian health insurance. There are medically underwritten plans, but acceptance for these plans is based on the answering of medical questions along with an examination of the applicant’s medical history. As such almost all retirees will not qualify for one of these underwritten plans.
A much more appropriate option are guaranteed issue plans that do not require a medical. Conversion plans are one type of guaranteed issue plan, and are usually the best choice for a retiree since many retiring Canadians are also leaving a full-time job that comes with group benefits.
Two reputable conversion plans are FollowMe from Manulife Financial as well as the Replacement Health plan from GMS. They are both designed for people who have recently lost their employee benefits and offer coverage that is typical of individual health and dental insurance plans. To qualify for the GMS Replacement Health plan you must apply with 90 days of losing your group coverage (there is also a 90 day deadline for Manulife’s FollowMe conversion plan). Note that other conversion plans have a 60 day deadline.
FollowMe and Replacement Health Plans
Please use the following links for quotes, plan summaries and coverage details for these two conversion plans:
• Concise summary of coverage.
• Full plan details.
• Request a FollowMe quote.
• Online quotes and plan information.
Need Help with Retiree Health Insurance?
As experienced Canadian insurance brokers we can help out if you need assistance. If you are currently on a maintenance prescription drug we can look up all the DINs before you commit to a plan so there are no surprises for you when you’re on a plan. (DINs stand for Drug Identification Number (used by Health Canada to identify a drug prior to being sold in Canada).
We can also help out with generic substitutes and whether or not your provincial healthcare plan (like OHIP) covers certain medications.
Feel free to contact us to see what plan suits you best!