Does Health Insurance Cover Pre-Existing Conditions? Exploring Your Options

Decoding the Truth: Does Health Insurance Actually Cover Pre-Existing Conditions?

Published August 16, 2023

Canada has an excellent healthcare system, but many individuals with pre-existing medical conditions often find it challenging to get comprehensive health insurance. If you're wondering, "Does health insurance cover pre-existing conditions?" You've come to the right place.

In this blog post, we're outlining how health insurance plans handle pre-existing conditions in Canada. Find out about insurance plan options, how to apply, and how to select the right policy.

Exploring Pre-Existing Conditions in Canada

Do you have a chronic or recurring condition before you purchase an insurance plan? Then this is considered a pre-existing condition. Pre-existing can range from mild and manageable conditions like asthma to severe ones like cancer or heart disease.

However, "pre-existing condition" isn't a term that is universally defined in the insurance world. Each insurance company might have a different stance on what exactly constitutes a pre-existing condition. But, in general, if you have a diagnosed condition before applying for coverage, insurers will likely consider you have a pre-existing condition.


Canadian woman wondering if her health insurance covers her pre-existing condition


Insurance Plan Types for Covering Pre-Existing Conditions

In Canada, three common types of health insurance plans deal with pre-existing conditions differently: traditional health insurance, guaranteed issue insurance, and simplified issue insurance.

1. Traditional Health Insurance

For starters, Traditional insurance plans typically have the strictest rules surrounding pre-existing conditions. To qualify for coverage under these plans, you must go through a medical exam and an extensive questionnaire about your health history.

Insurance companies may refuse to cover you if they consider your pre-existing condition too risky. Or, they might provide coverage but exclude any expenses related to your pre-existing condition.

  • Who's This Best For: Best for those in good health without significant pre-existing conditions, who are comfortable undergoing medical examination and disclosing their full health history.


Canadian examining paperwork for traditional health insurance policy


2. Guaranteed Issue Insurance

Next, Guaranteed Issue insurance plans, often marketed towards individuals who can't get coverage elsewhere due to their age or health status. Here, everyone who applies is approved, regardless of the pre-existing conditions they may have. These plans typically have lower coverage amounts and higher premium costs than traditional insurance.

  • Who's This Best For: Ideal for individuals who struggle to get coverage due to their age or pre-existing health conditions. Suited to those who place more significance on guaranteed coverage over costs and coverage amounts.


Elderly Canadian getting Approval for a Guaranteed Issue insurance plan despite his pre-existing condition.


3. Simplified Issue Insurance

Finally, another suitable option for Canadians with pre-existing conditions is the Simplified Issue Insurance plan. Like Guaranteed Issue plans, Simplified Issue Insurance does not require a medical exam. However, they do require you to answer a few health-related questions. If you qualify based on your answers, you could get coverage without a waiting period, and these plans usually offer higher coverage levels than Guaranteed Issue policies.

  • Who's This Best For: Can be a favorable option for Canadians with pre-existing conditions who want coverage without a waiting period and potentially higher coverage levels. Suitable for those comfortable with answering some health-related questions.


Young Canadian Woman searching online for a Simplified Issue Insurance Plan.


Applying for Health Insurance With Pre-Existing Conditions

When applying for health insurance, honesty is the best policy. If you lie or omit information about your health history to get better rates or qualify for a policy, it can lead to your policy being cancelled or your claim denied. Here are some steps to apply for health insurance with a pre-existing condition:

  1. First, meticulously review your medical history. Know your diagnoses, understand your prescriptions and remember any treatments you have been through.
  2. Next, research before applying. Compare policies from different insurers and understand the coverage, costs, and restrictions. Make use of online insurance coverage quote tool for a hassle-free experience.
  3. When in doubt, seek help from an insurance professional. They can answer your questions, explain the fine print, and help you find a policy that accepts your pre-existing condition. Reach out to an insurance specialist.

Selecting the Best Policy: What to Consider?

Here are a few factors to consider when looking for the best policy:

  • Your Budget: Buy a insurance you can afford. A policy that costs too much might lead to lapse of coverage if you stop paying the premium.
  • Your Timeline: Choose a policy that covers the the period you need protection the most (e.g. when your kids are in school, or while you have mortgage payments.)
  • Your Urgency: If you require immediate coverage, a Simplified Issue Insurance policy might be the best for you, as they often have no waiting periods.
  • Accessibility: If you have a pre-existing condition, you may have to be realistic about the policies that you can be approved for. That's why Insurance Supermarket offers a broad spectrum of policy types for everyone, regardless of health history.


Canadian woman carefully considering different factors to select the best insurance policy



Yes, health insurance can cover pre-existing conditions, but the extent of coverage largely depends on the type of plan and the insurance company's rules. Whether you have a mild or severe pre-existing condition, it's crucial to extensively research, compare policies, and ask for professional advice to find the best policy that fits your needs and budget. After all, the best policy is one that gives you peace of mind and ensures you are appropriately covered should something happen.

Find a Policy That's Right for You With Insurance Supermarket

Getting the protection you need should not be complicated or stressful, even with pre-existing conditions. With Insurance Supermarket's comprehensive product offerings, find a solution that safeguards your health and financial future, no matter your health history.

Don't be held back by pre-existing conditions. Get the coverage you deserve with Insurance Supermarket! Let us help you find the right policy. Click below to start on your path to coverage.

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