Health Insurance Rates for Self-Employed Plans
Low Cost Medical Insurance to Cover Freelancing Canadians
Nov 9, 2009
Free Canadian health insurance is a misleading term. Provincial health plans offers little or no coverage for many essential medical expenses including artificial limbs, casts, crutches, emergency ambulance transportation and in-hospital private duty nursing.
Group benefit plans can cover gaps in government health care. Many employers provide their employees with Extended Health Care benefit coverage, also called Supplementary Medical Care.
People without group coverage such as self-employed entrepreneurs or freelance project specialists can pay for private medical coverage from individual health care specialists like Group Medical Services (GMS).
The following analysis lists the monthly premium rates calculated for different GMS health insurance plans.
Basic Medical Insurance Rates for Singles
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. Note that these rates will vary by province due to different levels of underlying coverage.
- Under age 35 … $4.50 monthly premium ($54 per year)
- 35 to 44 years … $4.75 ($57)
- 45 to 54 years … $5.50 ($66)
- 55 to 59 years … $6.38 ($76.50)
- 60 to 64 years … $7 ($84).
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.
Basic Medical Insurance Rates for Families
GMS also offers its Basic Plan to self-employed Canadians with families. The following list presents Basic Plan rates for couples without dependent children.
- Under age 35 … $7.25 monthly premium ($87per year)
- 35 to 44 years … $8 ($96)
- 45 to 54 years … $9.38 ($112.50)
- 55 to 59 years … $11.13 ($133.50)
- 60 to 64 years … $12 ($144).
Listed below are Basic Plan rates for couples with one or more dependent children.
- Under age 35 … $8.75 monthly premium ($105 per year)
- 35 to 44 years … $9.63 ($115.50)
- 45 to 54 years … $11.13 ($133.50)
- 55 to 59 years … $13.13 ($157.50)
- 60 to 64 years … $13.75 ($165).
Extended Health Insurance Plans for Singles
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.
- Under age 35 … $15.75 monthly premium ($189 per year)
- 35 to 44 years … $16.88 ($202.50)
- 45 to 54 years … $18.50 ($222)
- 55 to 59 years … $20 ($240)
- 60 to 64 years … $21.50 ($258).
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 $50,000 lifetime maximum per person for out-of-province referral.
Extended Health Insurance Plans for Families
Below are average Omni Plan rates for couples without dependent children.
- Under age 35 … $29.75 monthly premium ($357 per year)
- 35 to 44 years … $32 ($384)
- 45 to 54 years … $34.88 ($418.50)
- 55 to 59 years … $38.13 ($457.50)
- 60 to 64 years … $40.88 ($490.50).
The following average rates are for couples insuring at least one dependent child under the Omni Plan.
- Under age 35 … $37.88 monthly premium ($454.50 per year)
- 35 to 44 years … $40.38 ($484.50)
- 45 to 54 years … $43.75 ($525)
- 55 to 59 years … $47.38 ($568.50)
- 60 to 64 years … $50.88 ($610.50).
Comprehensive Prescription Drug Premiums for Singles
Given that prescription drugs account for roughly 70% of health insurance plan claims in Canada, it should come as no surprise that the highest premium rates are for medical coverage which includes out-of-hospital prescription drugs.
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.
- Under age 35 … $50.38 monthly premium ($604.50 per year)
- 35 to 44 years … $56.88 ($682.50)
- 45 to 54 years … $63.88 ($766.50)
- 55 to 59 years … $74.63 ($895.50)
- 60 to 64 years … $84.50 ($1,014).
Comprehensive Prescription Drug Premiums for Families
Below are average rates with prescription drugs included for couples without dependent children.
- Under age 35 … $86.25 monthly premium ($1,035 per year)
- 35 to 44 years … $100 ($1,200)
- 45 to 54 years … $112 ($1,344)
- 55 to 59 years … $132.13 ($1,585.50)
- 60 to 64 years … $150.13 ($1,801.50).
The average rates for a comprehensive medical insurance plan that includes prescription drug coverage for couples with children are moderately higher than premiums for couples only.
Below are average rates with prescription drugs included for couples without dependent children.
- Under age 35 … $108.88 monthly premium ($1,306.50 per year)
- 35 to 44 years … $123.88 ($1,486.50)
- 45 to 54 years … $140.75 ($1,689)
- 55 to 59 years … $166.88 ($2,002.50)
- 60 to 64 years … $187.50 ($2,250).
Self-employed people should carefully assess their family health history before deciding on which private health care plan is best for themselves and their dependents. The above rates provide some pricing guidance to benchmark the most competitive coverage for their premium dollars.
Sources
This analysis provides independent calculations and insights based on data on the Group Medical Services website for Individual Health Plans.
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