Posted by Medavie Blue Cross on October 17, 2022
We know health insurance can be a confusing and sometimes intimidating topic. Our Insurance 101 series is designed to help you understand insurance basics in bite-size pieces.
Posted by Medavie Blue Cross on October 17, 2022
We know health insurance can be a confusing and sometimes intimidating topic. Our Insurance 101 series is designed to help you understand insurance basics in bite-size pieces.
Today we're going to tackle a source of common confusion: when it comes to health insurance, how do you know who provides what?
You may have seen references to different types of health insurance, like group or employer plans and individual or self-insured plans. You may have even seen references to public and private health insurance. With all these options, it's understandable that anyone would get confused.
So, let's clear up what this means:
Let’s dig a bit deeper.
In Canada, we're fortunate to have health care services covered under publicly funded plans managed by the provincial governments. These are public health insurance plans.
Provincial health care plans in Atlantic Canada are Medical Services Insurance (MSI) in Nova Scotia, Medicare in New Brunswick, Health PEI in Prince Edward Island and the Medical Care Plan in Newfoundland and Labrador.
Most provincial plans will cover medically necessary hospital and doctor visits, lab services and diagnostics, surgeries performed in the hospital, and some limited dental and optometric services, like eye exams for children and seniors and routine dental for kids under the age of 14.
Private health insurance fills the gaps left by public health insurance, covering things that often fall under preventative care.
In Canada, we're fortunate to have health care services covered under publicly funded plans managed by the provincial governments. These are public health insurance plans.
Provincial health care plans in Atlantic Canada are Medical Services Insurance (MSI) in Nova Scotia, Medicare in New Brunswick, Health PEI in Prince Edward Island and the Medical Care Plan in Newfoundland and Labrador.
Most provincial plans will cover medically necessary hospital and doctor visits, lab services and diagnostics, surgeries performed in the hospital, and some limited dental and optometric services, like eye exams for children and seniors and routine dental for kids under the age of 14.
Private health insurance fills the gaps left by public health insurance, covering things that often fall under preventative care.
Private health insurance plans are offered by health insurance companies and privately purchased by either individuals or companies. They aren't connected to provincial governments. They offer coverage for expenses that are NOT covered by public plans, such as:
A typical health care plan pays a percentage of the cost of covered services, and the plan holder will pay monthly premiums to keep their health insurance active.
Private health insurance is broken into two categories: group health insurance and individual health insurance.
Private health insurance plans are offered by health insurance companies and privately purchased by either individuals or companies. They aren't connected to provincial governments. They offer coverage for expenses that are NOT covered by public plans, such as:
A typical health care plan pays a percentage of the cost of covered services, and the plan holder will pay monthly premiums to keep their health insurance active.
Private health insurance is broken into two categories: group health insurance and individual health insurance.
If you are working, you likely have employee benefits through a group health insurance plan, and your employer might may from 50% to 100% of your insurance premiums. Coverage under these plans is related to where you work, so if you quit your job or are terminated, you would no longer have health insurance.
Your family can also be covered under your group health insurance plan.
What group insurance covers varies based on the company you're employed with but can include:
If you are working, you likely have employee benefits through a group health insurance plan, and your employer might may from 50% to 100% of your insurance premiums. Coverage under these plans is related to where you work, so if you quit your job or are terminated, you would no longer have health insurance.
Your family can also be covered under your group health insurance plan.
What group insurance covers varies based on the company you're employed with but can include:
Individual health insurance is also known as personal health insurance or family health insurance, which does not involve an employer. They're made for and purchased by individuals, couples, or families. They remain in force until the person who took out the plan (the insured) either cancels their policy or stops paying their premiums.
Most personal health insurance plans offer a variety of coverage options like:
It's up to the person purchasing the plan to decide what they want to include on their plan. Usually, the more you add to your plan, the higher your premiums will be.
Personal health insurance is a crucial consideration for anyone who is self-employed or retired and who would not have access to group insurance benefits.
Individual health insurance is also known as personal health insurance or family health insurance, which does not involve an employer. They're made for and purchased by individuals, couples, or families. They remain in force until the person who took out the plan (the insured) either cancels their policy or stops paying their premiums.
Most personal health insurance plans offer a variety of coverage options like:
It's up to the person purchasing the plan to decide what they want to include on their plan. Usually, the more you add to your plan, the higher your premiums will be.
Personal health insurance is a crucial consideration for anyone who is self-employed or retired and who would not have access to group insurance benefits.
We know it can be hard to figure out the ins and outs of health insurance, which is why we’re here to help. Whether you have group insurance or individual insurance, we can help you understand your coverage and what it means for you.