Canadians: Will I need private insurance coverage after RE?

[YK-Phil]

I will be pulling the plug sometime in 2016 and I am wondering whether it makes sense to subscribe to private insurance coverage after I leave my current job and lose my employer benefits plan. In retirement, we will be living in British Columbia, with regular overseas stays for 3-6 months of the year. I will be 58, DW will be 41, both in excellent health, physically and mentally active, with little dental care needs except annual cleanings, routine check-ups, and the occasional filling. Our current prescription costs are under $35/month for me, and zero for my wife. Every year, we fully use our very generous massage therapy, acupuncture and physiotherapy allowances, but these are nice to have but not essential in retirement.

In order to budget our retirement expenses, I researched available private plans and have narrowed down my choices to the ManuLife "Follow Me" Health & Dental Benefits at $334/month, and $448 for the Premium Option at $48/month. These plans are designed for anyone who is leaving Group Insurance and are Guaranteed Issue, ie. No Medical Questions are asked, so that there are no Exclusions for Pre-Existing Conditions, all Pre-Existing Conditions are covered. They also combine comprehensive coverage for Prescription Medication, Dental, Eye Glasses, Hospitalization, Extended Health Benefits, etc.

Based on our current health spending, and the very good benefits and the low monthly premiums (between $0 and under the BC Medical Services Plan, it doesn't seem to make sense to buy private coverage, but I'd like to have some advice from other Canadians.

If you are in a similar situation, please tell me why you do, or do not have private coverage, especially if you spend extended periods of time out of the country.

[choppingwood]

I have private insurance (less the dental insurance, which I self-insure) through GMS.

I am 61 and in good health. I do have an extra twenty years of knowledge of the kinds of health issues that members if family have faced. I have factored that into deciding what kind of coverage I need. I also did some research on what kinds of health issues people my own age and older do have.

So, I guess if I were in your position, I would run some scenarios about what would happen if your health or your wife's changed dramatically and/or for the long-term. For example, my sister became symptomatic of congenital liver disease in her mid-40s. This continued through a liver transplant in her mid-50s. Expenses included prescriptions, home care, hospital equipment for her home. Post-surgery she had an accident in her home, which left her in hospital for months and resulted on complications that led to the failure of the transplant. That meant that better than basic hospital coverage was really meaningful.

A family friend and her husband and children were all in a terrible traffic accident, which left them all badly injured and in need of assistance at home. The need was indefinite. The accident also took place in the US, so everyone had the unusually high costs of medical care in the US, followed by the transfers to Canada as each was able.

Less dramatically, my other sister, who is four years older than myself, has in the last ten years had a small stroke, diabetes, and miscellaneous health issues. Her prescription coverage in Ontario (Trillium, which is income-based) covers Lipitor, but without this the medication costs something like $1000 a month. Some arthritis medications, when other medications don't work, cost much more than that.

So, for me, it was important to get significant coverage for hospitalization, home care, and prescriptions. I have a little travel insurance as well, but know other people who travel a lot, who have 90 days of travel coverage each year.

I used to have Coverme during a different break in my career. GMS now suits me better, and is noticeably less expensive. It is specific about its coverage of pre-existing conditions, which I really like. A medical exam will result in much cheaper premiums, which could be a lot of money over the long-term. I am not sure that it would entirely preclude coverage for pre-existing conditions. I didn't go that way, but I have some second thoughts about it.

Hope this helps.