As the Alberta government cuts back on the medical services they provide, more Albertans rely on private health care from a group insurance plan or through individual insurance. A private plan is needed for consumers to proactively protect themselves from the cost of emergency services and medical expenses that are not covered by the Alberta Health Care Insurance Plan (AHCIP).
When a group insurance plan is no longer available to you because it is not offered as part of your retirement or your severance package if you are laid off, “follow me” insurance is often a great alternative to ensure you are continuously protected. In addition to retirees and those who are laid off, such insurance can also appeal to individuals who leave their employment to become self-employed or lose access to their spouse’s policy due to divorce. For a small business owner, the premiums are a tax-deductive expense.
Follow me insurance is a health plan or a health & dental plan that follows you when you leave the group plan. It is designed to replace your group insurance plan as much as possible. If it is applied for within sixty days of termination of group health benefits, acceptance is guaranteed and no medical questionnaire is required. After the initial sixty days of leaving your group health plan, you can still buy into the plan, but there is an added necessity of a qualifying medical exam for acceptance.
Advantages of Follow Me Plans
One of the appeals of follow me insurance to those leaving group insurance plans is the potential to have uninterrupted insurance coverage, since there is no waiting period. A follow me insurance package can be purchased at the insurance brokerage where you had group coverage, which you are already familiar with, or you can select another insurance brokerage. Further, once accepted, the plan is portable, regardless of whether and where you work. The plan will stay with you as long as you keep up your payments.
Perhaps the biggest appeal is not having to qualify through a medical assessment for acceptance. Not only are you able to avoid the extensive application process and delay, not having to worry about pre-existing condition exclusions can be particularly helpful if you currently have a health condition or concern about your medical history.
Follow me plans often provide great value for plan premium when compared to other plans. While your previous group plan may have provided greater coverage than a follow me plan, you no longer have your employer paying a portion of the premium to provide that same coverage. When compared to many individual plans, alumni association plans, CARP (the organization for individuals aged 45+) and Chamber of Commerce plans, follow me insurance plans often provide more comprehensive coverage than the alternatives.
If you compare the coverage of a follow me plan with an individual plan where a medical assessment is required, you might find that the individual plan costs a little less but the insurance will also exclude you from coverage for all pre-existing conditions. Any medications you take regularly would not be covered and you would not have access to treatment coverage for ailments that are chronic or have reoccurred.
Follow me plans have additional value. They come with the option to insure your spouse or other dependents including three children or more; your total insurance premiums cost less when you can group your family onto one plan. Also, the premium may not be a taxable benefit to you if you are self-employed and you may still qualify for an eligible medical expense deduction on your income tax return for the uncovered balance.
There are flexible payment options and hassle-free electronic claims submission available. Further, there is an added bonus of being able to earn air miles on many packages.
Follow Me Plan Insurance Benefits
The highlights of most basic follow me plans include:
- prescription drugs/medicine;
- semi-private hospital accommodations
- ground ambulance services
- special in-home nursing services
- medical equipment
- hearing aids;
- specific medical or paramedical services (e.g., psychologists, chiropractors, physiotherapists, podiatrists, osteopaths, optometrists)
- vision care
Typically follow me dental plans cover expenses for:
- basic preventative and maintenance services (e.g., regular examinations, cleaning, filings, extractions and x-rays)
- accidental dental
- periodontal care
Some follow me plans provide insurance for accidental death and dismemberment and survivor benefits for adults and children. Some plans offer a health services navigator to help policyholders and their family members get easy access to information on how to navigate the health care system.
More extensive coverage is available in the middle and highest tier coverage levels, providing for a higher maximum annual amount of total coverage and a higher maximum amount for most categories, allowing you to get covered for more frequent treatment. When you purchase insurance at a higher tier level, you may also obtain emergency travel health insurance and, where dental coverage is provided, partial coverage for restorative dental care and orthodontics.
Contact Us at HDF Insurance
If you are leaving your group health insurance plan, contact your independent insurance broker in Edmonton to discuss your health insurance options. We can discuss follow me plans, compare them to other health insurance plans and obtain a free quote for you. Getting health insurance in place when you are leaving a group plan is important in the event that you become ill and have high medical expenses to contend with. At HDF Insurance we help you get the insurance you need to provide you with peace of mind. Contact us at 1-800-567-2048.