Any (Canadian) health insurance advice?

In My Humble Opinion
1

Despite what 's said about Canada’s communist utopian health care system, Health Canada won’t cover my prescription drugs, mostly because I make good money. The drugs are for epilepsy, which obviously isn’t going away anytime soon.

So here’s the situation. I was diagnosed at 23, when I lived at home under my mother’s coverage. Then I moved into a residency program that will cover me until July of 2014. My meds cost me about $700 CAD (precisely $687.02 USD as of this posting) per month, and will likely only go up. Since this is a pre-existing condition, I can’t buy regular insurance that will cover these. I’m unlikely to find a job that will give me group coverage, since most of us are technically “self-employed” once we’re out on our own. I’m not going to get married in the foreseeable future.

Has anyone else been in this situation? $8400/year is a significant chunk of my post-tax income (presently 60000/yr), and would basically prevent me from saving for retirement (I won’t have a pension, again because of the self-employment). Any advice? I’m glad I’m coming at this with a year of lead time, but it’s still a scary prospect.

Thanks for any sympathy/comisery/tips!

2

I think people are going to want to know what province you’re in, because each province has its own rules.

3

Which province do you live in? I live in BC, and there is something called Fair PharmaCare here that is meant to cover the gaps for most people. I have extended health care through my employer so I’m not too familiar with the logistics of the program. From a quick search, the website has a calculator about deductibles (Fair PharmaCare Calculator) and based on my salary, I would pay about $1750 a year before 70% of the rest is covered. I assume other provinces have something similar…

4

Does the Canadian Medical Association provide any insurance coverage for its members? I know that the Canadian Bar Association does, as well as retirement savings plans, given that many members of the bar are similarly self-employed and can’t rely on an employer for extra benefits.

5

If you move back to Saskatchewan, it looks like you’d be eligible under the Saskatchewan Drug plan - Special Support Program: Government of Saskatchewan

Under the plan, eligibility kicks in if your drug costs exceed 3.4% of your income. $8,400 is 14% of $60,000, so it looks like you should be eligible for some sort of benefit. I imagine other provinces have similar plans.

Note: I’m not speaking from personal experience, just from googling around a bit.

Note as well that if your annual medical costs exceed a certain amount (I think it may be that same 3% figure), you get to claim it on your income taxes at the end of the year and reduce the amount of tax you pay.

6

FWIW - you should qualify for the med expenses tax deduction on your income tax, so its at least tax-free bux ur spending.

7

I don’t know about New Brunswick (where your profile says you are from), but as I said in another message I have a very basic Blue Cross plan in Alberta, which pays 70% of my prescription costs (among other things - that’s what I care about). Pre-existing conditions are not an issue with that coverage. See if NB has anything similar.

8

I am self-employed, my wife has pre-existing conditions, we insured through our local chamber of trade scheme.

They didn’t worry about pre-existing conditions.

I believe this is nationwide, but you do have to join a chamber.

9

Since the OP is looking for advice, let’s move this to IMHO.

Colibri
General Questions Moderator

10

If you currently have coverage, you should be able to find new coverage without pre-existing questionnaires, etc.

This is what I signed up for when I went from being employed to self-employed:

11

My step son has pretty huge prescription expenses as well so we have looked into this. Alberta Blue Cross will cover most of the meds for pre-existing conditions as long as his coverage is continuous, we have to make sure he transitions to personal coverage as he comes off his fathers coverage when he finishes his apprenticeship.

There are drugs that they will not cover under regular programs, supposedly because there are cheaper alternatives, this is some what bureaucratic BS as it should be up to doctors to decide what drugs are best for his needs.

There are special programs for preexisting conditions and off list drugs that cost a lot more, but still can be worth it. These have a 3- month lead time of course before benefits kick in.

I’ll take Canadian health care over the American alternative any day, but there are still lots of ways that it can improve and lots of places where they still throw you under the bus.