You may be retiring, changing jobs or striking out on your own. Whatever the reason for leaving your employer, under most group plans, you’re insured only as long as you remain part of the group being covered. So generally speaking, if your job ends, your coverage ends, too.
However, if you’re leaving because you’ve been laid off, your benefits may continue for a few weeks. In some cases, you can get individual coverage to replace your group insurance if you apply within a specified time, usually 90 days.
Even if it’s your decision to go, you may be able to make sure you’re still covered: Check with your benefits provider to find out whether you can switch over from your group plan to individual coverage. You may be able to include your spouse and dependent children in your new plan, as long as they had been covered under the group plan with the company you’re leaving, and there may be no medical requirements (such as a questionnaire or an exam) as long as you sign up as soon as your group coverage lapses; terms and conditions vary among insurance providers.
Provincial plans don’t cover all health-care costs
As Canadians, we benefit from insurance coverage through our provincial governments. But it’s important to remember that government insurance doesn’t cover many medical expenses included in a group or individual supplementary health and dental plan.
Health-care costs vary from province to province, but generally speaking, most provinces do not cover:
- routine eye exams for those aged 19-64
- glasses or contact lenses
- prescription drugs outside a hospital setting
- acupuncture, physiotherapists, naturopaths and nutritionists
- regular dental services, orthodontia and dentures
- anything other than a standard ward room in a hospital
Expenses such as dentistry, prescription drugs, para-health services (such as physiotherapy), ambulance, medical equipment and in-home nursing can add up very quickly. That’s where supplementary health insurance can come in.
Quebec: All residents of Quebec must be covered by prescription drug insurance through the Régie de l'Assurance Maladie du Québec (RAMQ) or through group benefits plans. An individual plan does not take the place of a group plan. You cannot opt out of RAMQ because you have an individual plan.
Don’t forget disability, critical illness and long-term care insurance
Think carefully as well about continuing some of the other kinds of coverage you may currently have, especially disability, critical illness and long-term care insurance. This is particularly important if you decide you want to work for yourself and don’t have access to a supplementary group plan. Disability insurance replaces a portion of your income if you become disabled and unable to work.Critical illness insurance will help you protect your savings in the event of certain serious illnesses, while long-term care insurance will provide you with funds for longer-term care expenses later in life.