Applying for Coverage
Are you ready to apply for a PlanDirect plan? We can help.
Eligibility
You (and your spouse if you are applying for couple or family coverage) are eligible to apply for a PlanDirect plan if you are:
- A Canadian resident covered by the government healthcare plan in your province or territory of residence
- Age 50 to 70 if you have not had any supplementary health insurance coverage in the past 60 days
- Age 50 to 75 if you have had supplementary health insurance coverage in the past 60 days
If you were not insured for similar coverage in the 60 days before applying for PlanDirect, you may apply for the following plans:
- Value plan
- Basic plan
- Advantage plan
- Comprehensive plan
It you were insured for similar coverage in the 60 days before applying for PlanDirect, you may apply for the following plans:
- Value plan
- Basic plan
- Advantage plan
- Comprehensive plan
- Premier plan
If you have a spouse, he or she must be married or living common law with you to qualify for coverage.
Children also have maximum age limits for coverage and must be covered by the government plan in their province or territory of residence. Speak to your financial security advisor for details about coverage for children.
Choosing a plan
Before applying for your PlanDirect coverage:
- Review the product information carefully, and then select the plan that best suits your needs.
- Review the optional benefits information carefully, and then select the additional coverage you require.
- Calculate your premium cost based on your personal information and coverage choices.
- Print your personal premium calculation page to review with your financial security advisor.
How to apply
To apply for PlanDirect, contact your financial security advisor, who can help you determine the best PlanDirect plan for you and your family.
Once you have completed all sections and signed the PlanDirect application form, your financial security advisor will forward it to PDAdmin Group along with your void cheque (to establish pre-authorized payment) and a cheque for 2 months premium.
If you are applying for Preferred or Preferred Plus rates, you will also need to provide a letter from your employer, or a copy of your insurance billing, indicating the specifics of your previous coverage.
If you don’t have a financial security advisor, contact us. We can put you in touch with a representative in your area who can help you apply for PlanDirect.
Frequently asked questions
How soon does my coverage begin?
Once you are approved for coverage, you will receive an information package, including your policy documents and other useful material. Your coverage begins on the first day of the month following the date we approve your application. If you or a covered family member is confined to hospital on the date coverage is scheduled to begin, coverage will start on the date the patient is released from hospital.
What happens if my spouse, child or I do not qualify for coverage?
We review the information on the medical questionnaire, which forms part of the application for underwriting purposes. Based on your, or a family member's, medical history, we may decline coverage.
What if I change my mind?
If you are not satisfied with your policy, you may cancel it within 10 days after you receive it. We will cancel the policy from the start date and refund any premium paid.
Can I increase or decrease my coverage after I purchase a PlanDirect plan?
You can increase your coverage at any time, from:
- The Value plan to the Basic, Advantage or Comprehensive plan
- The Basic plan to the Advantage or Comprehensive plan
- The Advantage plan to the Comprehensive plan
You’ll have to provide updated medical information at the time you apply to increase your coverage. We must approve any increase in coverage, based on the medical information you provide.
You can change to a plan with a lower level of coverage if you’ve had your current plan for at least 1 year.
Optional benefits – You can add the optional Emergency Travel Medical Benefit (before age 70) or the Accidental Death and Dismemberment Benefit (before age 71) at any time. The Hospital Cash Benefit and the Major Dental Services and Supplies Benefit are only available at the time you purchase your PlanDirect policy.
When will my premium change?
Your premium is subject to change upon your policy’s annual renewal date. Your premium may also change during the year if you or your covered spouse or children become members of a different risk class (a group of insureds of similar ages and other characteristics residing in the same province or territory) while your policy is in force.
It may also change if you make a change to your coverage, for example an increase in coverage or addition of an optional benefit, or if you add or remove coverage for a spouse or dependant.
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