Medicals
Related FAQs
Why do health insurance companies need to know about my pre-existing conditions?
Disclosing your pre-existing conditions is most relevant for Medically Underwritten health care plans.
With Medically Underwritten plans, by getting the opportunity to review your health history, the insurance company can potentially offer you a more comprehensive plan at a lower relative cost (i.e., better value).
The caveat to Medically Underwritten plans is that while they will offer better value to those who qualify medically, they will exclude (i.e., not cover) health conditions that you are already being treated for or taking medication for. These health conditions are referred to as 'pre-existing conditions'.
Pre-existing conditions are disclosed on a simple questionnaire. Medical tests such as blood or urine samples are not required when applying for health care plans.
For those who do not qualify medically for a Medically Underwritten plan, there are Guaranteed Acceptance plans available that will cover pre-existing conditions without need for a medical questionnaire.
With Medically Underwritten plans, by getting the opportunity to review your health history, the insurance company can potentially offer you a more comprehensive plan at a lower relative cost (i.e., better value).
The caveat to Medically Underwritten plans is that while they will offer better value to those who qualify medically, they will exclude (i.e., not cover) health conditions that you are already being treated for or taking medication for. These health conditions are referred to as 'pre-existing conditions'.
Pre-existing conditions are disclosed on a simple questionnaire. Medical tests such as blood or urine samples are not required when applying for health care plans.
For those who do not qualify medically for a Medically Underwritten plan, there are Guaranteed Acceptance plans available that will cover pre-existing conditions without need for a medical questionnaire.
Do I need a medical exam to get health insurance coverage?
No, there is no physical or other medical exam required to qualify for any health or dental care plan.
Medical exams are common for other forms of insurance, such as Life, Disability, and Critical Illness insurance.
Medical exams are common for other forms of insurance, such as Life, Disability, and Critical Illness insurance.
Do health insurance plans cover pre-existing conditions and medications I am already taking?
There are three types of plans available, each treating pre-existing conditions and medications differently.
Guaranteed Acceptance plans will cover pre-existing conditions and medications without requiring a medical questionnaire.
Guaranteed Issue plans cater to those leaving an employee group benefits plan, covering pre-existing conditions and medications without a medical questionnaire if you transition within 60-90 days of your group benefits terminating.
Medically Underwritten plans exclude pre-existing conditions and medications, only covering new conditions and medications after the coverage starts.
Guaranteed Acceptance plans will cover pre-existing conditions and medications without requiring a medical questionnaire.
Guaranteed Issue plans cater to those leaving an employee group benefits plan, covering pre-existing conditions and medications without a medical questionnaire if you transition within 60-90 days of your group benefits terminating.
Medically Underwritten plans exclude pre-existing conditions and medications, only covering new conditions and medications after the coverage starts.
Do I need to be in good health and under a certain age to apply for health insurance?
No.
There are Guaranteed Acceptance health insurance plans available that do not require a medical questionnaire and can be applied for at any time. These plans are ideal for individuals who may not qualify for a Medically Underwritten health insurance plan due to their health history.
There are Guaranteed Acceptance health insurance plans available that do not require a medical questionnaire and can be applied for at any time. These plans are ideal for individuals who may not qualify for a Medically Underwritten health insurance plan due to their health history.
Can I add or remove my spouse to my health and dental plan?
Yes, you can add or remove your spouse from your health and dental insurance plan. However, depending on the policy, underwriting may be required, meaning your spouse might need to qualify medically. This could involve answering medical questions.
Adding or removing a spouse can occur at any time during the lifetime of the policy. Depending on the situation, the difference in premium will either be billed or refunded accordingly.
Adding or removing a spouse can occur at any time during the lifetime of the policy. Depending on the situation, the difference in premium will either be billed or refunded accordingly.
Which health insurance plans cover pre-existing conditions?
There are three different types of health care plans:
Each type of plan has a different approach to 'pre-existing conditions'.
Medically Underwritten Plans:
Will exclude pre-existing conditions. Conditions that are considered chronic in nature will generally be excluded on a permanent basis, while conditions that are acute in nature may be excluded initially with the potential to be reconsidered after a period of time (e.g., 12, 24, 36, 48 months).
Guaranteed Issue Plans:
Will cover pre-existing conditions, so long as you apply within 60-90 days of your employee group benefits terminating (some insurance companies offer 60 days to make this transition, while others 90 days).
Guaranteed Acceptance Plans:
Will always cover pre-existing conditions. An in-depth blog post article can be found here: https://aeva.ca/blog/what-are-exclusions-for-pre-existing-conditions-how-do-they-work
- Medically Underwritten
- Guaranteed Issue
- Guaranteed Acceptance
Each type of plan has a different approach to 'pre-existing conditions'.
Medically Underwritten Plans:
Will exclude pre-existing conditions. Conditions that are considered chronic in nature will generally be excluded on a permanent basis, while conditions that are acute in nature may be excluded initially with the potential to be reconsidered after a period of time (e.g., 12, 24, 36, 48 months).
Guaranteed Issue Plans:
Will cover pre-existing conditions, so long as you apply within 60-90 days of your employee group benefits terminating (some insurance companies offer 60 days to make this transition, while others 90 days).
Guaranteed Acceptance Plans:
Will always cover pre-existing conditions. An in-depth blog post article can be found here: https://aeva.ca/blog/what-are-exclusions-for-pre-existing-conditions-how-do-they-work
What do you need to get health insurance?
To be eligible for an individual health insurance plan, you must meet the following requirements (regardless of the insurance company):
Be a resident of Canada and have coverage under your government health insurance plan. You must also be at least 18 years of age on the date of application for the policy, except for children of an insured person. Quebec residents must also be registered under the RAMQ Prescription Drug Insurance Plan or have equivalent coverage under a group plan.
Note: If the plan is Medically Underwritten, it will require a medical questionnaire, and you will need to qualify medically. If you do not qualify due to your health history, there are alternative options, such as a Guaranteed Acceptance plan, available.
Be a resident of Canada and have coverage under your government health insurance plan. You must also be at least 18 years of age on the date of application for the policy, except for children of an insured person. Quebec residents must also be registered under the RAMQ Prescription Drug Insurance Plan or have equivalent coverage under a group plan.
Note: If the plan is Medically Underwritten, it will require a medical questionnaire, and you will need to qualify medically. If you do not qualify due to your health history, there are alternative options, such as a Guaranteed Acceptance plan, available.