Average Medical Insurance Rates for Seniors

Private Health Insurance Plans Available Past Age 80

Nov 9, 2009

Health Plans for Seniors Age 80, stev.ie (Flickr)

Older Canadians over age 60 can buy health insurance plans from $84 per year, while average premiums for prescription drug benefits become less expensive after age 65.

Older Canadians not covered by a group benefits plan can buy additional health insurance coverage that supplements government health care plans.

Premium rates for these supplementary private plans are relatively inexpensive, depending on the specific coverage provided. In Canada, private health insurance may supplement but must not replace government-provided medical benefits.

This analysis compares the medical care plan premium rates for different types of coverage underwritten by individual health care specialist Group Medical Services (GMS).

Basic Health Insurance Plan Rates for Single Seniors

The Basic Plan covers adjustable beds, artificial limbs, breast prostheses, casts, crutches, in-hospital prescription drugs, scooters, walkers and wheelchairs bought anywhere in Canada.

Also covered are services incurred in the insured person’s province of residence such as air and ground ambulance, hospital room, in-hospital prescription drugs and private duty nursing.

Below are the average single rates by age averaged for all Canadian provinces. Minimum and maximum rates will vary by province due to different provincial levels of underlying coverage.

Age 60 to 64 … $7 monthly premium ($84 per year)
65 to 69 years … $8 ($96)
70 to 74 years … $9 ($108)
75 to 79 years … $10.50 ($126)
80 years and over … $13.38 ($160.50).

Except for casts and crutches, supplies and services under the Basic Plan have internal maximums. For example, wheelchairs, scooters and adjustable beds are limited to $500 per 5-year period. Ground ambulance is subject to a $2,000 maximum per year, while air ambulance has $3,000 annual limit.

Basic Health Insurance Plan Rates for Older Couples

The rates below are for Basic Plan coverage of older couples without dependent children.

Age 60 to 64 … $12 monthly premium ($144 per year)
65 to 69 years … $14 ($168)
70 to 74 years … $16 ($192)
75 to 79 years … $19.25 ($231)
80 years and over … $24.63 ($295.50).

Extended Medical Insurance Plan Rates for Singles Over Age 60

The GMS Omni Health Insurance Plan includes all medical services and supplies as the Basic Plan incurred anywhere in Canada, and allows for higher internal maximums. The Omni Plan also covers eye exams, glasses, contacts, laser surgery, paramedical practitioners, hearing aids, diabetic supplies, blood pressure monitors, custom foot orthotics, accidental dental treatment, and out-of-province referral expenses.

Age 60 to 64 … $21.50 monthly premium ($258 per year)
65 to 69 years … $24.25 ($291)
70 to 74 years … $25.88 ($310.50)
75 to 79 years … $26.38 ($316.50)
80 years and over … $28.50 ($342).

Omni Plan imposes no maximums on ground ambulance, casts or crutches. However, all other charges under the Omni Plan are subject to internal limits such as the $8,000 yearly maximum for air ambulance and the $50,000 lifetime maximum per person for out-of-province referral.

Extended Medical Insurance Plan Rates for Older Couples

Below are average Omni Plan rates for couples age 60 and over.

Age 60 to 64 … $40.88 monthly premium ($490.50 per year)
65 to 69 years … $45.63 ($547.50)
70 to 74 years … $50.38 ($604.50)
75 to 79 years … $51 ($612)
80 years and over … $53.88 ($646.50).

Comprehensive Prescription Drug Premiums for Single Seniors

Medical insurance rates are highest when they price for prescription drugs, which have a high claims frequency. However, the comprehensive health care premiums for older seniors start to trend lower at age 65 when the provincial health plans provide superior government-provided drug coverage.

The following list shows the monthly and annual premiums for a comprehensive plan that includes all Omni Health Plan coverage plus up to $5,000 per year for prescription drugs and oral contraceptives. There is also a $500 annual maximum for drugs needed to treat an illness or injury that started on or before the effective date of health insurance.

Age 60 to 64 … $84.50 monthly premium ($1,014 per year)
65 to 69 years … $69 ($828)
70 to 74 years … $74 ($888)
75 to 79 years … $76.38 ($916.50)
80 years and over … $80.50 ($966).

Comprehensive Prescription Drug Premiums for Older Couples

Below are average rates with prescription drugs included for older couples. The decrease in premiums at age 65 is due to few claims since the underlying provincial health plans provide more drug coverage.

Age 60 to 64 … $150.13 monthly premium ($1,801.50 per year)
65 to 69 years … $124.13 ($1,489.50)
70 to 74 years … $135.63 ($1,627.50)
75 to 79 years … $140.63 ($1,687.50)
80 years and over … $147.63 ($1,771.50).

Older Canadians who lose group health benefits from their employer when they retire can choose from a selection of private health insurance plans that meet their needs.

In Canada, seniors continue to have a wide selection of available medical plans even when they pass age 80 and beyond.

Sources

This analysis provides independent calculations and insights based on data on the Group Medical Services website for Individual Health Plans.

The copyright of the article Average Medical Insurance Rates for Seniors in Health Insurance is owned by Daniel Workman. Permission to republish Average Medical Insurance Rates for Seniors in print or online must be granted by the author in writing.