Understanding Health and Dental Insurance

What Is Health and Dental Insurance?

Health and dental insurance helps cover dental expenses, as well as vision care and complementary medical care (e.g., fees for licensed medical practitioners). It also may provide reimbursement for prescription drugs not covered by the Régie de l’assurance maladie du Québec (RAMQ), or by any other provincial or federal program for people living elsewhere in Canada. Health and dental insurance complements the public system and even your group insurance if you have one.

What types of care are usually covered by health and dental insurance?

Private health and dental insurance usually covers:

• Medical care provided by licensed health professionals (e.g., massage therapists, osteopaths, acupuncturists, etc.) and even ambulance or telemedicine services.

• Dental care: routine checkups, cleanings, X-rays, fillings and extractions, periodontal treatments, pit and fissure sealants.

• Eye care: examinations and examination reports, ophthalmic glasses or contact lenses, laser surgery. 

• Mental health services (diagnosis and treatment) from psychiatrists, psychologists, psychotherapists or social workers.

For whom is health and dental insurance intended?

Health and dental insurance is for any person wishing to keep control of their medical expenses and enjoy peace of mind, especially in the event of the unexpected:

• People who are about to retire or semi-retire, and who will no longer be able to benefit from the group insurance coverage offered by their employer. Hint: It’s a good idea to start shopping around for your personal insurance before entering retirement.

• People already retired.

• Self-employed workers.

• Part-time workers who are not covered by their employer’s group insurance plan.

• Business owners.

• People with specific health needs.

• People eager to provide more comprehensive coverage for their families (e.g., covering the costs of physiotherapy after a cheerleading or football injury).

• People who feel the need to complement their group insurance (some group insurances only cover a percentage of prescriptions or set maximum annual earnings ceilings). 

What are the eligibility criteria for health and dental insurance?

There are no pre-established criteria for eligibility for health and dental insurance. Most insurance companies will consider the general state of health and age of applicants. Good to know: The eligibility criteria for CAA Health and Dental Insurance, offered by Securian Canada, is to be covered by the RAMQ, and to be aged between 18 and 79.

How much does health and dental insurance cost?

The cost of health and dental insurance coverage depends on several factors, such as your age, your province of residence, and the number of people covered (spouse and dependents). You’re best advised to request a quote based on your needs and situation. Good to know: Some plans may require additional medical examinations or the completion of a medical questionnaire.

Is it complicated to take out health and dental insurance?

Like all insurance, the first step is to clearly establish your needs. While most plans cover similar types of expenses, they can differ significantly in terms of annual ceilings, exclusions, premiums, and reimbursement percentages. The right plan for you should reflect your current and future needs. For instance, a plan with a high deductible for vision care may not be the best fit for you if you wear contact lenses … and the same goes for a plan offering a maximum annual prescription drug reimbursement of $500 if you use medication on a daily basis.  

Bottom line: take the time to discuss your needs and options with a professional. Shop around for the right insurance and request several quotes. Find out about claims and reimbursement procedures.
Good to know: CAA Health and Dental Insurance, offered by Securian Canada, comes in three types of policies with different levels of coverage to suit your budget.