As we’ve covered in previous blogs, there’s lots to think about when you’re leaving a job, starting a new one, losing your job, or going through a life change. How these changes impact your health insurance is a big one. And while there may be other things you’d rather be thinking about, it’s worth taking the time to understand your options once you leave a group plan so you’re in the best position moving forward with your coverage.

In this blog we’re digging deeper into the details of underwritten and guaranteed-issue health insurance plans to help you decide which one is best for you. These are important elements to consider if you’re leaving a group benefits plan and wondering what’s next.

Underwritten Plans for Health Insurance

First off, you might be wondering what an underwritten plan is, or what does underwriting mean? It’s good to understand this term because you’ll likely come across it many times when you’re searching for a plan.  And if you’re applying for health insurance it’s helpful to know because it could save you money.

Underwriting is a process insurers use to assess your health and the risks associated with insuring you when you apply for an insurance plan. The amount of ‘risk’ your health represents to the insurer can affect the coverage you’ll receive and how much you’ll pay in premiums each month.

When it comes to health insurance, underwriters are looking to understand your risk of injury or illness if they cover you and how much this will cost (both you and them). Underwriting for health insurance may involve a questionnaire where you’ll be asked about your health, medical history, prescription drug use, etc.

With many insurance providers, the underwriting process determines whether you’ll be offered a plan and what your coverage will look like. This process can take a few days, depending on the complexity of your case.

Here’s where GMS is different. Most of our Personal Health plans are underwritten on the spot, and we don’t limit or exclude benefits based on your medical history, with the exception of prescription drug coverage. We’ll offer you a price based on your answers to the medical questions and the coverage you choose. And you’ll be able to use most benefits the day you buy your plan.   

An underwritten plan might be for you if:

  • You’re OK shopping around and have flexibility with your coverage.
  • You’re OK answering medical questions through the underwriting process.
  • You’re on a budget and want to get the best premium possible (based on your health and medical history).

But what if you’d rather not be underwritten? Can you buy a plan without answering medical questions? We’re glad you asked.

Guaranteed Acceptance Health Insurance or Guaranteed-Issue Health Plans

Guaranteed-issue plans are just that - you have guaranteed acceptance! They’re not underwritten, which means your personal cost and coverage aren’t based on your medical history.  

Guaranteed-issue plans are a good choice for people who have one or more pre-existing medical condition. These kinds of health insurance plans will cover anyone, but they come at a price. Monthly premiums are higher because of the higher risk that the insurer is taking on.

A guaranteed-issue plan might be for you if:

  • You don’t want to go through the underwriting process and risk denial of coverage.
  • You want guaranteed coverage given your health and medical history.
  • You’re less budget-focused and concerned more about getting the right coverage that fits your needs.

Insurance Coverage when You’re Leaving a Group Plan

It’s clear there are a lot of options when it comes to health insurance.  What matters is finding a plan that’s right for you. And if you’ve just left a job with group benefits, you have an additional option to consider.

Typically when you leave a group benefits plan you have a window of time in which Canadian insurers will offer you acceptance into a health plan that’s only offered to individuals who are coming off a group benefits plan.  These are guaranteed-issue plans and are often called conversion plans, because you’re converting from a group plan to a personal health plan.

The new insurer is taking on some risk because it’s a guaranteed plan and they don’t know the details of your health and/or medical history to understand the risks of insuring you and therefore the costs. Conversion plans often include similar benefits to what you would have received under your previous group plan, like dental, prescription drugs and medical professionals like physiotherapists to name a few.

But what about the cost of these plans? That will depend on the insurer and what’s covered. But keep in mind it’s not a one-to-one comparison to what you were contributing to previously under your group plan. Since there’s no underwriting involved and usage of these plans are typically higher, insurers must charge more to account for the risk. If you’re curious about the value of health insurance, check out our blog why health insurance is worth the cost for more information.  

GMS Has You Covered

If you’re leaving a group benefits plan, GMS has options for you! If you’re within 90 days of leaving your job, you’re eligible for our conversion coverage, Replacement Health. There are three plan options to choose from, and you can purchase online for same-day coverage, no medical questions asked. 

Looking for more flexibility? A GMS Personal Health Plan may interest you instead. These plans are medically underwritten, but you’ll be able to choose anywhere from basic to extensive coverage. The rates are determined by the benefits you choose and your medical history.

Learn more about these options or use our help me choose tool to get a recommendation.