Not all Canadians are covered by a group plan. Self-employed individuals, retirees, and those whose employers do not offer benefits must purchase individual coverage.
Individual products are underwritten: the insurer reviews the applicant's health history and may exclude pre-existing conditions, apply a waiting period, or decline coverage. Common individual policy features:
- A drug benefit with a formulary and a deductible.
- A paramedical benefit with per-discipline annual maximums.
- A dental benefit covering basic services only, or basic and major.
- An emergency out-of-province/out-of-country medical benefit.
- An option to add CI or LTC coverage.
Waiting periods on individual dental: to prevent anti-selection (people buying dental coverage only because they know they need expensive work), many individual dental plans impose a waiting period of 3 to 12 months before major restorative benefits become payable.