Should You Invest In Health And Dental Benefits

Brad Ward 29 Nov 2017

In the province of Ontario, we are fortunate to have many of our medical expenses paid for through OHIP. Still, however, there are many more expenses that OHIP does NOT cover and those can add up. Purchasing health and dental insurance is one way to offset the cost of things such as dental visits, prescription medication, glasses, chiropractic care and more. 

But how can you know if you should purchase this coverage for you and your family, and how much coverage is needed? Every family has different needs, so a one-size-fits-all package might not be appropriate. Many insurance companies offer custom packages in which you can select the coverage that best suits your needs and lifestyle. Here is some more information on what these benefits are and who they are best suited for. 

What are health and dental benefits?

Health and dental benefits are coverage provided by an insurance company, typically, to either pay for or reimburse policyholders for expenses. These benefits usually cover items like visits to the dentist, prescription medications, vision care, physiotherapy, massage therapy and sometimes even counseling sessions. Health and dental benefits may be purchased by an employer in the form of group insurance, or it may be purchased by individuals and families. For this article, we will be focusing on the types of policies that are purchased by individuals and families.

Who are benefits suited for?

Generally speaking, you should only consider purchasing health and dental benefits, if you do not already have group coverage through an employer. If you have insurance through work – even if you have to pay for a portion of the premiums yourself – it will be less expensive than your policy. 

That being said, if you do not have any coverage, a medical emergency – or sometimes even just general care – can be very expensive, so purchasing your insurance can be a smart move. 

Consider purchasing your health and dental benefits if:

You are self-employed and do not yet have company group insurance. 
You work for an employer that does not offer health coverage.
You are retiring or leaving your job, and your group benefit coverage will be ending. (On this last point, note that you typically have an insufficient period in which you can convert your group coverage to individual coverage, which is usually cheaper than applying for new coverage. Talk to your insurance provider as soon as you start making plans to leave your employer to ensure that you can take advantage of this option!)

What does No Medical mean?

Often insurance companies will offer you an option for insurance called “No Medical," or “Guaranteed’. This can apply to either health and dental benefits, or to life insurance benefits. This means that the company will extend you benefits without asking about your medical history. When you apply for benefits, you will often go through a medical questionnaire which asks you questions about previous medications, any previous illnesses or diagnoses, smoking history, weight and so on. 

If you have any complications or a history of illnesses, it can increase the premiums you pay for your insurance. With guaranteed, no medical insurance you don't have to answer these questions. 

What’s the catch? Good question! With a no medical option for insurance you will likely pay higher premiums than a typical policyholder will. This might be the better option for you if you know your medical history will drastically increase your premiums, so it might be worth it to skip the medical and take the higher premium. 

What kind of benefits can I get?

Most insurance companies offering health and dental coverage will offer a variety of options. The one best for you will depend on the needs of you and your family. If you are a single person, the amount of coverage you require will be drastically different from the amount that a family of four needs. 

Sometimes companies will offer what's known as cafeteria-style benefits. What this means is you have a menu with options to choose from. There might be Health A, B, and C and then Dental A, B and C as well. Each level will offer more or less coverage, depending on the insurance company. You can choose to mix the levels of coverage. For example, if you feel you’ll need more dental coverage –  perhaps your children will need braces in the coming years – but fewer prescriptions or massage therapy you might pick the highest level of coverage for dental but a medium health level. 

Are all benefits the same?

No.  Each insurance company is going to offer a slight variation in the plan. The foundation of the benefit plan will likely be similar to each company, but there will be small variations in the details of the package. It could be things like covering 90% of a medical expense or 85%, or perhaps the plan only includes generic medications and not brand names. Those are all details that will be laid out in your benefit package for you to review. You'll have to consider the plan to make sure these features match what you're looking for. 

What is it going to cost?

The cost is going to come from a couple of factors: the level of coverage you want and your medical history. Insurance companies will have pay scales which will be based on the level you picked, and the number of people you want to be covered in your policy. This will often be worded in terms like "Single Coverage," "Single plus Spouse," "Single plus Spouse plus one Dependent" and so on. 

Is it worth it?

Taking care of your health is one of the most important things that you can do for yourself and your family. Many people that do not have health and dental coverage – either individually or through their employer end up delaying specific medical care because they feel they cannot afford it. In the long run, however, this can be more serious – and more expensive problems. For example, if you require a dental crown now and do not get one, you might end up needing more extensive dental surgery later. 

If you do not have health and dental coverage, it does make a lot of sense to talk to your life insurance provider today. 

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