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Understanding health insurance

June 24, 2014

Can you afford to get sick?

Recovering from a serious illness will require all your energy and attention. The good news is there are options and resources that can help.

The news from the doctor was bad, if not unexpected. Cancer. Surgery, then radiation, then chemotherapy. A year or more in treatment, in hospitals, at home and out of the workforce. Your mind just goes to 100 different things at once. There’s all the medical issues, for sure, but you also think of your family, all the stresses it’s going to put on them. That's the kind of  emotional roller coaster ride cancer can bring with it when it invades a life.

Chances are, you know someone who's been touched by cancer, or some other serious illness. You’ve seen them struggle with fear and pain and watched them battle fatigue and nausea. Good thing government health insurance means they don’t have to worry about medical bills, too, right? Not exactly. Believing that government health insurance will cover everything is one of several common assumptions people make about dealing with a serious illness. But if you take a closer look, the realities may surprise you.

Costs not usually covered by provincial health plans:

  • Alternative treatments and experimental drugs
  • Travel and accommodation for treatments away from home
  • Adaptations to home or vehicle to accommodate your condition
  • Home nursing care
  • Wigs, special makeup
  • New clothing needed due to weight loss or gain
  • Hospital beds or other equipment for home
  • Physiotherapy may be only partially covered
  • Treatments outside Canada

Group insurance coverage through work:

  • Most disability insurance plans will pay about 60 to 70% of your income.
  • You will still have to pay 100% of your monthly expenses.
  • Your expenses may actually be higher while you're recovering.
  • Your household income could be further reduced if your spouse or partner has to take a leave of absence from work to care for you.

Tasks you may require help with as you recover:

  • Dressing and bathing yourself, styling your hair, putting on makeup
  • Driving
  • Shopping for groceries
  • Preparing meals, doing housework and laundry
  • Gardening, lawn care, snow removal
  • Tending to children, and driving them to and from school and activities
  • Emptying the litter box, walking the dog

It's not fun to think about all this, but the good news is there are options and resources that can help:

1. Check your coverage

If you have long-term disability and/or supplemental health insurance at work, find out exactly what you’re covered for, and for how much. You can then assess whether you may wish to increase your coverage.

Other insurance options to explore include long-term care insurance, which can cover the cost of institutional or home care, and critical illness insurance, which provides a lump-sum payment to be used at your discretion in the event of a serious illness covered under the policy.

2. Explore other resources

Non-profit national, provincial and local groups offer both hands-on and online help, and can connect you with a support group. For example, the Canadian Cancer Society can arrange for a volunteer to drive you to treatments, and the Dealing with practical issues section in its Life After Cancer Treatment booklet discusses financial matters and returning to work following any serious illness. The Alzheimer’s Society of Canada lists a host of services for individuals with dementia, their families and caregivers, and local chapters provide hands-on support. Parkinson Society Canada offers a variety of support and education services.

There’s no question that a serious illness can change your life. But if you’re prepared for the possibility, you can spend less of your energy worrying over paying the bills, and more on getting better.

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