Are You Happy With Your Employee Group Health Insurance Coverage?

Majority of Canadians are part of some form of group health insurance coverage. Over ten years ago, group health insurance was only gaining popularity. Today group health insurance coverage is offered by the majority of employers in Canada. As of 2008  nearly 75% of Canadians had some kind of health insurance to cover supplemental medical expenses which was provided through a group health plan with their employer.

This is probably the reason why individual health insurance is somewhat less popular in Canada, because nearly 8/10 employers offer group health insurance. Majority of the group health benefits cover 80% of charges for health coverage, while other companies are offering new (and existing) employees 100% health benefit coverage in order to lure and keep top talent.

I’ve been part of group health insurance plan with two different employers spanning nearly nine years. Its great to have your own individual group card and be able to walk into a pharmacy to only pay 20% of the total bill for prescription drugs. However, not all group health insurance coverage is the same. Some group health coverage plans are better than others. For example, my group health plan does not cover eye-wear, and I wear glasses, so it would definitely be nice to not have to dish out $300+ every two or so years for new glasses. However, nothing is perfect, and not all health insurance plans are created equal. I’m generally happy to work for an employer who provides group health insurance, because its still better than not having any health insurance at all.

Here’s a quick guide on group and private health insurance, and what you can do in case you’re not happy with your group health insurance coverage.

Group Health Insurance

Group health insurance policies consider all the members of the policy, meaning that all employees under the plan are blended into one pool when it comes to pricing. Employee group health coverage has two big benefits you can’t get with an individual plan:

1. You generally can’t get rejected because of your health.
2. Most employers continue to subsidize a big chunk of the costs covering mostly 80%, and in rare cases 100% on certain health coverage.

Individual Health Insurance

The upside of individual health and dental insurance is that the individual can choose up to what amount to be covered for, and what exactly they’d like to be covered under. Insurance companies underwrite each applicant vs. a group approach in the group health insurance. Individuals who get approved for insurance may be approved for a standard plan or rated. A rated policy means the insured is approved, but at a higher premium than what is offered to healthier individuals. Rated policies may also carry certain exclusions for pre-existing conditions, such as diabetes or high blood pressure. Like any other insurance, health insurance companies have the right to reject applicants due to current or past health status, so if you’re a smoker chances are you’ll be outright rejected or stand to pay a higher premium.

What Can You Do If You’re Not Happy With Your Group Health Insurance?

Since the 2008 financial crisis, many employers are having a tough time covering the costs themselves, and are shifting a much bigger share of the premium to their employees. So, there has been a steady rise of people inquiring about individual insurance for additional coverage or totally private health insrance coverage. To see what you could get on your own, you can shop for individual health insurance policies from several companies at The Health Insurance Group.

Anyway you slice it health insurance is not cheap. Leaving a company health plan in favor of an individual private plan might not be the smartest financial move due to higher costs of the policy which solely depend on your current and past health history, and the various coverage you’d like as part of your policy.

Shop Around

Not all health plans are created equal. Plans vary a great deal, both in cost and in benefits. It is absolutely crucial to shop around, and when you do consider an insurance policy, you need to read the fine print very carefully so you know exactly what is covered and how much you are going to spend, not just in premiums, but in deductibles, co-pays and straight out of the pocket expenses. Plans with low deductibles and premiums might not provide adequate coverage. You need to decide what is important: overall cost or coverage. For example, a high-deductible plan might be just the right fit for someone who goes to the doctor only a few times a year.

Readers, are you part of a group health insurance plan? Are you happy with your coverage? Have you ever thought about getting private health insurance?

Eddie

Photo Credit – Talkradionews