Here are some questions that are frequently asked about individual health dental insurance and individual benefit packages in Ontario. If your question is not found here, please contact one of our customer service representatives.
Q: Is Dental Insurance available as a stand alone product?
A: Dental Insurance is only available in Ontario as part of an extended benefits package requires the purchase of a minimal amount of extended health insurance. This extended health insurance typically covered what OHIP does not. Unfortunately, there are no insurance providers in Ontario who sell dental insurance as a stand alone product.
Q: Can I cancel my individual benefit package at any time and are there any fees?
A: You can cancel you individual benefits when ever you like and the premiums will be returned to you pro rata meaning that there is no cancelation fee
Q: We are covered by OHIP in Ontario why would I need Health Insurance?
A: Health Insurance in Ontario generally covered by OHIP. There are some lapses in coverage on the other hand for example; the cost of an ambulance, the cost of a private of semi private room in a hospital, rehabilitation costs, vision care, equipment such as crutches, surgical supplement and most naturopathic health care. A health insurance policy simply covers the lapse in OHIP.
Q: What are my payment options for an individual benefits plan?
A: Most companies allow you to pay for your policy in the following ways; pay on an annual basis via cheque or credit card, pay on a monthly payment plan via pre-authorized payment plan (automatic withdrawals from your bank account or credit card). Unfortunately there are no insurance companies who allow unscheduled payments similar without having a prior payment plan.
Q: Why should I be using a broker to buy my individual benefits and not the insurance company directly?
A: Using a broker not only provides you the unbiased personalized service of an independent representative but also allows for superior pricing to purchasing directly from the insurance companies. Insurance companies support the independent brokerage network by offering us lower rates because it is an added cost for them to service the public directly. The insurance company focuses on its products and we focus on you and your needs. Feel free to compare your rates with the insurers directly.
Q: Who are the major insurers for health dental insurance in Ontario?
A: There are mainly 5 companies who operate in the field of health and dental insurance in Ontario. We may offer you any of there products.
Q: Who do I speak with if I have any questions regarding my coverage or would like to make changes to my policy?
A: You would speak with you individual account manager. This is the person who initially contacted you and who you have been in communication with since requesting a quotation. We believe in a one on one relationship.
Q: How do I know if a given dentistry procedure will be covered and to what extent?
A: When your dentist suggests a particular procedure, ask him/her how this will be covered under your current policy. If you are looking how a particular procedure will be covered under a prospective policy, ask your individual account manager.
Q: Should I be looking at health and dental insurance simply to cover a given procedure?
A: The concept of insuranceis to cover the unexpected. All health and dental insurance (by every company) has been designed in this manner. All coverage is incremental as to avoid the behavior of implementing coverage on an expected event then renounce that coverage upon remediation. This would negatively affect current policy holders as claims would increase, thus pricing would have to. The concept of insurance is to share a risk and health and dental insurance in no different. The best priced policies have the slowest incremental increase of coverage and are much more stable than competing policies.
Q: My health and dental policy cost slightly more than what it cost to go to the dentist regularly. Why is it more expensive?
A: Not in every case is this fact. This depends greatly upon your age. Younger individuals will in many cases see there cost of being slightly less than what is cost to pay the dentist out of pocket. This is because of concept such as coinsurance and deductibles. Regarding the cases that that the premiums are slightly more than out of pocket expense, these individuals present an increased risk when it comes to health benefits due to there age. Remember that insurance is designed for the unexpected thus understanding which benefits you do have is very important. Within every product more than simple teeth cleaning is covered.
Q: What is Coinsurance?
A: Coinsurance is the percentage at which any procedure is covered minus the deductible. For example; if it costs $300 to go to the dentist and you have a 70% coinsurance, the amount paid for by the insurance company would be $210.
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