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Frequently Asked Questions

  • QuestionIs there an age limit to qualify for Health Assist plans?

    Answer You must be under 80 to be eligible to apply for a Health Assist plan. Once your application is approved, there is no age limit – your coverage will continue as long as your premiums are paid. Health Assist coverage offers lifetime coverage.

    Question Until what age can I include my children on my health plan?

    Answer While kids these days never seem to grow up, your children can be included on your plan until the age of 21, even if they’re enrolled in post-secondary education full-time. (Unfortunately, we can’t guarantee they’ll have left your basement by then.)

    Question What government health coverage do I have to have to be eligible to apply for Health Assist insurance plans?

    Answer You must have valid provincial health insurance plan coverage. For example, residents of Ontario must have OHIP, BC residents need to have MSP, Nova Scotia residents must have MSI plan coverage and Quebec residents must also have RAMQ Heath Insurance and, if applying for a plan that includes prescription drug coverage, RAMQ Prescription Drug Insurance.

  • Question When will my Health Assist coverage begin?

    Answer Your coverage begins on your effective date, which is generally the first of the month following approval of your application.

    Question Is there a waiting period?

    Answer There are no waiting periods with Health Assist plans.

    Question How long does it take to get coverage?

    Answer The length of time depends on the type of plan you choose and how you apply.

    If you apply for a guaranteed acceptance plan, there is no medical underwriting. If you apply online, your application is approved as soon as GreenShield receives your payment, which could be within a day or two.

    When you apply for a medically underwritten plan, you’re required to complete a health questionnaire. The GreenShield Medical Underwriting team evaluates your health info. If you apply online, please allow two weeks for us to process your application and get back to you. The team evaluates each application on a case-by-case basis.

    If you apply by completing a paper application and mailing it to us, please allow three weeks for processing. (It’s so much more efficient to apply online! )

    Question What is the Counter-Offer process?

    Answer If you apply for a medically underwritten plan, you’re required to complete a health questionnaire. GreenShield evaluates your health info. If you have any medical conditions, GreenShield will send you a counter-offer. The counter-offer includes options: a) The medically underwritten plan applied for, excluding prescription medications that treat pre-existing medical conditions; and b) alternative plans that provide coverage for pre-existing conditions for you to consider.

  • Question Do the rates for Health Assist insurance plans change?

    Answer The rates for Health Assist insurance plans are subject to change.
    GreenShield continuously monitors the Canadian health marketplace. When the cost of providing health and dental services increases, we have to adjust our rates accordingly so that we can continue to provide you with the benefits you rely on. You can rest assured we keep any rate increases as minimal as possible.

    Rates also increase as the age of the person listed as the primary applicant on your plan increases and shifts from one age band to the next.

    Rates may change if you move from one province to another When you contact us to let us know, we’ll confirm your rate for you.

    Question Will my Health Assist rates ever decrease?

    Answer Yes — when your rate category changes from family to couple, or from couple to single. And in the majority of cases, if your Health Assist insurance plan includes prescription drug coverage, your rates will decrease when the primary applicant on your plan reaches 65 years of age.

    Question Will I be notified if my rates change?

    Answer These rate changes will take place on the anniversary of your effective date. GreenShield will notify you in a letter mailed through Canada Post 30 days in advance of the effective date of the rate change.

    Question When are payments due?

    Answer Your first payment for one month’s premium will be taken when your application is approved. The next payment (for one month’s premium) will be taken on or about your coverage start date (your coverage effective date), depending on the day of the week the first of the month falls. This ensures your payments (and benefits!) are secure a month in advance. Subsequent payments are taken on or around the first of every month.

  • Question Can I cancel anytime?

    Answer You can request to cancel your coverage at any time. We’d need written notice at least 10 business days before the next premium withdrawal date. Otherwise, your coverage will end at the end of the month for which premiums are paid. But if you cancel your coverage, you’ll need to wait 2 years to be eligible to apply for any GreenShield individual health plan. With this in mind, if your needs change, you may want to consider switching to another Health Assist plan that offers different benefits.

    Question Can I change my plan?

    Answer You may apply to increase benefit coverage at any time by submitting a written application for the change in coverage (once coverage is in effect, a Plan Member may not increase benefit coverage under a LINK plan). For medically underwritten plans, evidence of health satisfactory to GreenShield is also required.

    You can downgrade to a lesser plan after you’ve had the coverage for one year.

    Question When do Health Assist insurance plans end?

    Answer Health Assist plans can equal lifetime protection. Once your application is approved, your Health Assist benefits will continue, regardless of your age, as long as your premiums are paid. You won’t have to apply again, even if your health changes in the future.

  • Question Are birth control pills covered?

    Answer Birth control pills approved by Health Canada for contraceptive purposes are eligible for coverage at time of prescription renewal - provided the plan you choose has prescription drug coverage. Understandably, you can't claim them if the prescription was paid for BEFORE your coverage effective date.

  • Question I have Diabetes. What equipment and supplies are eligible for coverage?

    Answer Test strips, Diabetic syringes, Diabetic needles and Diabetic testing agents are eligible for coverage under prescription drug benefits. Auto injectors, insulin pen injectors, lancets and blood glucose monitors are eligible for coverage under the Medical Items benefit of Health Assist plans.

    Question Are continuous glucose monitors covered?

    Answer Yes, continuous glucose monitors like the Free Style Libre and Dexcom, are eligible for coverage under the Medical Items benefit included in Health Assist plans. This is subject to GreenShield Special Pre-Authorization and approval which includes documentation that confirms medical criteria (like insulin dependence and testing requirements), to reasonable and customary fees and to the maximums of the plan you select.

    Question Are referrals required for registered professionals and therapists?

    Answer Physician referrals are not required for registered professionals and therapists.

    Question Can I use Maple for my family members too?

    Answer Yes, absolutely! Health Assist plans include coverage for 4 virtual visits every year. You can use the visits for yourself, or for a family member who lives with you. You set up the Maple account and list the family members who can use it. Then, through the Maple platform, you (or your family member) will be connected to general health care practitioners via your smartphone, tablet or desktop, through text, audio or video. If you use Maple for more than 4 virtual visits during the year, you’ll receive GreenShield preferred pricing.

  • Question Emergency Medical Travel insurance – is there an age when the Emergency Medical Travel benefit ends?

    Answer No, your Health Assist Emergency Medical Travel benefit continues along with your other Health Assist benefits, regardless of your age (as long as your premiums are paid, of course!).

    Question Emergency Medical Travel insurance – when does it start?

    Answer It starts on the date of departure from your province of residence. It’s on a per trip basis. The number of days covered depends on the plan you choose.

    Question What currency are the Emergency Medical Travel coverage payments?

    Answer Emergency Medical Travel insurance is based on Canadian dollars.

  • Question How do I submit a health or dental claim?

    Answer There are a several ways to have a claim paid. You can have your health care provider bill us directly, you can submit a claim through Online Services or the mobile app, or you can print off a claim form and send it in via Canada Post. (Keep in mind that if you choose to submit your own claim, you will need to pay for your services up front.)

    Question How quickly will my health or dental claim be processed?

    Answer Amazingly, most prescription drug, dental, extended healthcare and vision claims can be processed instantly using your GreenShield ID card, right at your health care provider’s office. How convenient is that!

    Question How will my claim be paid?

    Answer If you've signed up for direct deposit services, you'll receive an email letting you know a deposit has been made. Otherwise, your cheque will arrive by mail.

    Question How long do I have to submit a claim?

    Answer Life is busy, which is why GreenShield generally gives you 12 months to submit a claim after the date of service (unless otherwise stated in your Health Assist Contract).

    Question How do Health Assist insurance plans work with RAMQ?

    Answer Your prescription drug claims need to be submitted to RAMQ first. When RAMQ reimburses a portion of the drug cost, unpaid balances (including co-payments and deductibles) will be co-ordinated so that you may be reimbursed up to 100% of the eligible expense incurred. (If the drug is not covered by RAMQ and is covered by your Health Assist plan, the standard co-pay applies.)

  • Question I’m self-employed, so are there any tax advantages to buying a Health Assist insurance plan?

    Answer Absolutely! If you’re self-employed, a small business-owner, contract worker or freelancer, your Health Assist payments may be a tax-deductible expense. (We recommend speaking to your financial advisor for exact details pertaining to your situation.)

    Question What are pre-existing conditions?

    AnswerPre-existing conditions are medical conditions that you have at the time you apply, or had before you apply, or in some cases, had medical consultations about before you apply. (Examples would be asthma, diabetes, or high cholesterol – not a cold or the flu.)

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