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The costs OHIP was never designed to cover.
Prescriptions, dental work, glasses, physiotherapy, mental health support. For anyone self-employed, retired, or between jobs, these arrive as full-price invoices.
- Typically covers
- Drugs, dental, vision, paramedical
- The exact list, limits and co-insurance percentages vary by plan.
- Guaranteed acceptance
- Sometimes available
- Some plans accept applicants without medical questions, usually with lower limits or waiting periods.
- After leaving a job
- Conversion windows are short
- Many group plans allow conversion to individual coverage without medical questions only within a limited period after coverage ends.
What we look at together
The right plan depends almost entirely on what your household actually spends. We start by adding up last year's real out-of-pocket costs, then find the plan whose limits match — rather than the one with the longest feature list.
For the self-employed, the recently retired, and anyone between group plans.
Prescription drug coverage
Annual maximums, co-insurance percentages, and whether the drugs your household actually takes are on the formulary.
Dental
Routine cleanings versus major work, the waiting periods before major coverage starts, and the annual caps.
Paramedical and mental health
Physiotherapy, massage, chiropractic and psychology — usually capped per practitioner per year.
Leaving a group plan
If you are retiring or changing jobs, there is often a short window to convert without medical questions. Missing it changes your options considerably.
Is this for you
When it helps, and when to wait.
We would rather tell you this is not your priority right now than sell you something you do not need. If the right-hand column describes you, say so on the call.
Worth a conversation if
- You are self-employed or a contractor with no group plan
- You are retiring and losing employer benefits
- Your household has ongoing prescription or dental costs
- You are new to Canada and not yet covered provincially
Worth pausing if
- Your employer plan already covers your family well — check before duplicating
- Your annual out-of-pocket spend is genuinely low; sometimes paying as you go is cheaper
Health & dental — questions
Good questions to bring to the call.
These are the ones that come up most on this topic. Yours is welcome even if it is not here.
It depends on what you actually spend. We add up your household's real costs from last year first. If the arithmetic says you would pay more in premiums than you claim, we will tell you that.
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Everything on this page describes how these products generally work in Canada. Figures, terms, definitions and availability vary by insurer and by policy, and nothing here is a quote, a rate, or a guarantee of coverage or approval. Any strategy should be reviewed against your own situation with a licensed representative before you act on it.