If you already have employee health benefits, you may not need additional health insurance. However, be sure to check your policy details. Sometimes there are heavy coverage restrictions on group plans. With your own personal health insurance, you get to decide your coverage plans and how much you pay.

Yes, you can get health insurance if you have an existing health condition. When you apply for coverage, you'll be asked about any pre-existing conditions. These are health conditions that you have been diagnosed with prior to applying for health insurance. If you apply for coverage within 90 days of losing your employee benefits coverage, pre-existing conditions are commonly covered, but the plan may be more expensive. There are also guaranteed acceptance plans with no medical questionnaire, but these are more expensive than standard plans as well.

Canada's dental benefit was introduced in 2022, to help lower dental costs for eligible families earning less than $90,000 annually. A tax-free payment of $260, $390, or $650 is available for each eligible child, only if they do not have any other dental coverage elsewhere. It is different from private dental insurance in that it is a free social program based on family income.

Medical insurance covers out-of-pocket expenses for standard injuries and illnesses. It will pay a portion of these expenses (usually 70-90%). Critical illness insurance on the other hand is a one-time payment to you if you are diagnosed with a critical or terminal illness. For example, if you are diagnosed with cancer, critical illness insurance will give you a one-time payment to cover things like travel costs to specialized treatment facilities or an extra special family vacation - extended medical will cover your cancer surgery and a portion of your cancer treatment.

Extended health insurance covers out-of-pocket medical expenses that occur in your day-to-day life in Canada. This may include prescription drug coverage, coverage for vision care, and more. Travel medical insurance covers you for any unexpected medical expense you incur while traveling outside of your home province or country. For example, if you need ambulance services during your trip to the US.

Extended benefits usually cover paramedical expenses such as physiotherapy, chiropractic, and psychological services, including therapy. Always check your policy wordings to see how much coverage you get each year, if the coverage is capped at a maximum percentage or dollar amount per year, and if your coverage includes psychologists and/or psychotherapists. Some providers may require a doctor's recommendation for paramedical claims.

In many provinces, your vehicle insurance has accident benefits that cover the cost of therapies and medical treatments associated with the accident. However, that coverage is very limited. For example, the accident benefits may only provide 3 sessions of physiotherapy, but the whiplash sustained in the accident requires you to have more sessions to regain mobility. This is where your extended health benefits would come in—they could cover the cost (up to policy maximums) for the remaining sessions.

To submit a health or dental claim, go to your provider's website. Most insurance providers have online submission forms you can fill out or printable forms you send off in the mail. You will need the receipt as proof of the medical bills you paid, although some only require you to hold onto the receipt in case there is any claim dispute. Some providers also do direct billing, meaning that you don't have to pay upfront. The insurance company is directly billed at the point of the transaction.

Most insurance companies have an appeal process if your claim was denied. Sometimes claims can be denied due to a lack of documentation or because the policy does not cover that specific type of medical bill. Many insurance companies will also have a guide of what they believe is reasonable to charge for a service and will only cover a percentage of that fair price. For example, if the going rate for a massage is $100/hr in your province, they may not cover the full 80% of your fancy spa massage that cost $500/hr or they may deny the claim outright. If you cannot come to an agreement with the insurance company and your appeal was denied, you also have the option to file a legal dispute.