Frequently Asked Questions

When we're young and healthy we feel invincible so it's easy to put off applying for insurance. In reality, even if you're not spending much now, when you're healthy is the best time to sign up for health insurance. In fact, it's the only time you're guaranteed to get the lowest rates and that you'll be covered if anything happens in the future. 

If you become ill or injured and then try to apply the coverage you need, you may no longer qualify at all. Or your monthly premiums will be much higher, often for much lower levels of coverage.

Medically Underwritten refers to plans that ask health questions during the application process. Often a simple questionnaire, these questions are used by the insurer to gauge your health at the time of application and reduce the risk of large claims to the plan. As a result, these plans are able to provide better coverage for lower rates. 

Guaranteed Acceptance plans do not ask any medical questions and offer coverage regardless of health history. They can be a good option for people with ongoing high drug expenses or a serious health issue. However, they typically have limited coverage and cost more. If you're healthy these plans will not be the best value. 

Health Plus PRIORITY and OPTIMUM plans are medically underwritten. As a broker we also sell guaranteed acceptance plans from other insurers. Learn more about Medically Underwritten vs. Guaranteed Acceptance or reach out to us for help finding out what the right fit is for you. 

Your Health Plus insurance becomes effective on the first day of the month following the approval of your application. Your pre-authorized monthly payment is processed on the first of each month. 

While Health Plus is portable, meaning you can take it with you no matter where you work, we understand circumstances change. You may receive benefits through an employer or partner and no longer need Health Plus. It’s simple to cancel.  

To discontinue coverage, you must notify us by email or by letter 30 days in advance. Terminations are effective the first of the month. 

For example: to stop coverage as of June 1st you must notify us by May 1st. 

Once your application has been approved, we will contact you to let you know. You will receive your Welcome Kit by email within approximately 1 week. Your Health Plus ID card, including your ID number and temporary password for the MDM online claims portal, will be sent by mail within 3-4 weeks. Any eligible expenses during that time period (following the first of the month or alternate agreed upon start date) can be claimed once you receive your ID card. Should you need your ID number in advance, give us a call.  

Claims are paid through our administrator MDM Insurance Services. When you enrol you will receive a Health Plus ID card and access to the MDM online claims portal. 

Prescriptions can be paid automatically at the pharmacy using your ID card. Claims for all other services except travel can be submitted online, by mobile app, or by email/mail to MDM Insurance Services for reimbursement. For dental bills, the dentist can submit the claim on your behalf and you will be reimbursed by MDM. 

You will receive a How to Claim guide with your Welcome Kit with full details. A Medical Claim Form is also available online and in your online claims portal. 

Yes, a health questionnaire is required to apply for Health Plus PRIORITY and OPTIMUM plans. Have your doctor's information and the name of any medications you take available when completing the application.

Your health information will not be shared with anyone other than for the purpose of administering your insurance plan.  

A pre-existing condition refers to any health condition that occurred before your coverage date. 

The best way to know if you qualify is to call us or fill out an application (no commitment required). Some conditions may not affect your coverage at all, while some may disqualify you from the plan. It also may depend on how recent or well-managed your condition is. We’re happy to review your individual case and if you do not qualify, can go over alternative options with you.  

It depends on your medication. If you qualify for Health Plus while on medication for an existing health issue, your medication will likely be covered. However, an increased monthly rate may apply that takes into account the cost of your medication. 

Unlike other plans, we do not automatically exclude treatment for existing conditions. We'd be glad to review your individual situation and give you a quote. 

You can apply up to age 75. Once on the plan coverage remains in place until age 90, except travel coverage which stops at age 75.

Note: If you are already retired at the time of application travel is not included in your coverage. 

Family plans can include parents and dependent children. Children can be covered to age 21, or age 25 if they are a full-time student. When your kids outgrow your plan they can change to a Health Plus single plan without reapplying.  

Yes.  If you are covered under your provincial plan (such as OHIP in Ontario) or have equivalent insurance, you are eligible for Health Plus.  If you don't have equivalent insurance, we can arrange it for you.   

No. We designed Health Plus to be a comprehensive plan for people without health coverage through an employer. Health Plus plans are a package deal, but the best value health and dental package you’ll find. If you already have some coverage through an employer or partner and don’t need a full benefits plan, your SBIS advisor can look into alternate options for you.

You can’t directly add more coverage to your Health Plus plan. However, if you do exceed your maximum coverage levels our Cost Plus feature may be a good option for you. It allows you to put additional expenses through the plan tax-free. Ask us how this can work for you.

Health Plus plans ask for preapprovals for coverage beyond a certain amount for paramedical practitioners and dental scaling. All plan members have access to the base level of coverage, including for pre-existing conditions. 

If you've reached your before preapproval maximums and need care beyond routine for a new condition or injury you'll be covered. Simply have your doctor/practitioner or dentist complete a pre-approval form or submit the requested dental information. We will then approve additional treatment as required. 

Other insurers typically use low per-visit limits (e.g. $25) or low combined maximums to limit coverage and reduce claims. But we know this doesn't work for you. If you need higher levels of coverage you'll end up paying more out of pocket.