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Guarding your wellness, easing your wallet

The expenses for preventive care or medical bills resulting from an injury or illness can cost you your savings and may upset your budget. Though the provincial health coverage plan covers many medical expenses, the gaps can burn a hole in your pocket.

If you get injured and need rehabilitation therapies, you need the services of a physiotherapist or chiropractor.
If ever you get diagnosed with a disease that requires expensive prescription drugs for the treatment.
You want to ensure you can get reimbursed if you spend on your dental treatment or vision care.
You don't like your savings to pay for medical expenses if you ever get injured or fall sick.

As we know, dental treatment is costly in Canada; you need to pay the expenses out of pocket for the treatment other than the emergency dental. The Provincial Health card does not cover procedures like Dental implants, wisdom tooth removal and cleaning/scaling.
You can choose the dental benefits under the Personal Health Plan and get the procedures done which are otherwise not covered under the Provincial Health Plan.
Similarly, you need to spend on prescriptions from your pocket. The provincial health card gets you treated at no cost, but you may be required to continue medicine longer. As in the case of most common Diabetic or hypertension medicines, which are prescribed for lifelong treatment, the cost has to be borne by yourself.
The Personal Health plan covers the prescription cost up to the coverage limit specified in the policy.

Along with the prescription and the dental benefits, this plan may cover:

Vision Care
Services of Paramedical Practitioners
Emergency Travel Medical
Semi-Private room
Medical Equipment and Services

Self-employed individuals may deduct their PHI premiums for business purposes if the following requirements are met.

"They are actively involved in their business alone or with a partner, and it is unincorporated."
In the current year, self-employment should be their primary source of income, or income from other sources is at most $10,000.
All permanent full-time employees unrelated to the employer receive the same benefits and coverage.
A private health services plan is established with an insurer or trustee who operates such a plan. The plan qualifies when at least 50% of the employee group covered comprises arm's length employees. There is no limit on the amount that can be deducted.

Otherwise, the deductible is limited to $1,500 for the individual, $1500 for their spouse and $750 for each child.
An arm's length employee is not a family member and has no controlling interest in the business.

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FAQs

Frequently Asked Questions

What is Personal Health Insurance?
Personal health insurance is a type of coverage that can help you manage the costs of medical care. Did you know that health insurance typically takes care of a wide variety of medical expenses? From your regular doctor visits to hospital stays, prescription drugs and even preventive care, it's got you covered!

Why Do I Need Personal Health Insurance?
Having personal health insurance is crucial for managing healthcare expenses and ensuring access to high-quality medical services. It offers financial security in the event of unexpected illnesses, accidents, or the need for routine medical care.

What Does Personal Health Insurance Cover?
Personal health insurance covers a variety of medical services, including but not limited to:

Doctor visits
Hospital stays
Prescription medications
Preventive care (e.g., vaccinations, screenings)
Emergency room visits
Specialist consultations

The specific coverage may vary between insurance plans, so it's important to review policy details.

Can I Choose My Own Doctors with Personal Health Insurance?
Many personal health insurance plans offer the flexibility to choose your own healthcare providers. It's important to note that some insurance plans have a network of preferred providers. To avoid any surprise costs, check with your insurance provider to understand the network and associated costs for out-of-network care.

How Much Does Personal Health Insurance Cost?
The cost of personal health insurance depends upon a number of factors such as your age, health status, coverage needs, and geographic location. Compare different plans to find one that meets your budget and healthcare requirements.

Can I Get Personal Health Insurance if I Have Pre-Existing Conditions?
In many cases, personal health insurance plans are available to individuals with pre-existing conditions. However, coverage details may vary. It is important to carefully review the policy terms and conditions to understand how pre-existing conditions are handled, including any waiting periods that may apply.

How Do I Enroll in Personal Health Insurance?
Enrollment processes vary, but you can typically enroll in personal health insurance during open enrollment periods or after qualifying life events. Explore options through your employer, government programs, or private insurance providers.

Are Prescription Medications Covered?
Yes, personal health insurance plans often provide coverage for prescription medications. Review the plan's formulary to understand which medications are covered and any associated cost.

How Do I Make Changes to My Personal Health Insurance Plan?
To make changes to your personal health insurance plan, contact your insurance provider. Changes might include adding or removing dependents, adjusting coverage levels, or updating personal information.

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