Area of Law: Insurance Law
Answer # 2736
Private health insuranceRegion: Ontario Answer # 2736
1. Employer health insurance plans
To help with uninsured costs, many employers offer health insurance plans to their employees. The cost of workplace health insurance is sometimes paid by the employer as part of a benefit package, while in some cases, employees are required to pay a monthly fee for the plan.
Since the employer is purchasing the insurance for a group of employees, the premiums are generally lower than if the employees were to purchase the same type of insurance on their own. The cost of private group health insurance depends on a number of factors, including what benefits are covered, how many individuals are covered, and the age and current state of health of those insured.
2. Individual health insurance plans
Private health insurance plans for individuals, sometimes called extended health care insurance, can be purchased by people to cover services that may not be covered under provincial health insurance or a company plan. For example, you may wish to purchase critical illness health insurance, or supplemental health coverage to cover expenses such as medical equipment, alternative treatments, and emergency travel coverage.
Individual health insurance is bought from private insurance providers, usually with the help of an insurance agent.
Coverage under private health insurance plans
Most private health insurance plans provide coverage for basic medical costs, such as prescription drugs, preventative dental, and vision care. In addition to basic plans, employers and individuals can purchase plans offering more services. Such superior, or enhanced plans might include services such as restorative dental, emergency dental, private hospital rooms, ambulance services, prescription eyeglasses, registered specialists and therapists, home care and nursing services. Plans may cover either 100% of the cost of treatments insured, or a percentage of the cost, in which case individuals are required to pay for the difference owing.
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