Health & Dental Plans
GMS Individual Health Plans - Individual health and dental plans including, drug coverage for pre-existing conditions.
GMS TravelStar - Individual travel insurance, including emergency medical and trip cancellation.
Individual Benefit Plans are designed for people who are not covered by any type of group benefit plan but would like to have coverage. In some cases this may be a person whose employer is unable to offer a benefit program. In a growing number of cases, it is because the person is self employed and the sole employee.
Presently, individual plans are offered through a small number of insurers. As with other forms of insurance, there is the choice of basic coverage all the way up to very comprehensive coverage.
Basic plans will pay for certain prescription drugs and a limited number of medical services not covered by the provincial government health plan. From this can be added more deluxe health coverage, basic dental, deluxe dental, and if you are a member of a business group such as The Chamber of Commerce, you can also include life and both short and long term disability insurance. Cost per month ranges from about $50-$80 for a basic one person plan up to a few hundred dollars for an older individual with a full comprehensive family plan.
Anyone considering a plan should examine their past few years' medical/dental expenses, and if that trend is likely to continue, weigh the premium cost for a plan against anticipated expenses. As an example, if a single person is currently spending $500 - $700 each year on medical/dental expenses, and a medical/dental plan costs $500, they may be better off without a plan. This is due to the fact that individual plans tend to limit the amount of a claim they will reimburse. This means that not only do you pay the premium, but in addition you also pay part of the cost of each medical or dental expense you incur.
When the expenses you and your family are incurring for your health care far exceed the premiums you would pay for an individual health plan, there is merit in having one. It is important to note that all individual plan applicants and families are required to complete a health questionnaire. The insurer can refuse coverage if you or a family member has a medical condition that could cause a higher than normal number of claims from the plan. Alternatively the plan may exclude reimbursement for any medication used to treat a medical condition that existed before the plan was placed. This is known as the pre-existing condition exclusion.
**If you are a business owner, you may be able to write off health plan premiums, in which case, a plan may be a good economic decision. Since 1998, self employed unincorporated individuals can claim premiums paid for a health benefit plan as a business expense against their business income.
