As retirement approaches, a significant question looms: What happens to your benefits? While many employee benefits discontinue once you retire, that may not be the case for everyone. Understanding these details is crucial for a smooth transition into your retirement years. In this blog post, we delve into the various retiree benefits that may still apply and the mechanisms behind them, from employer-sponsored packages to group benefits conversion. Additionally, we explore Ontario’s Health Insurance Plan (OHIP) and the need for supplemental insurance to cover any gaps, ensuring your health and financial security well into retirement.

Will I have Benefits After Retirement?

While many employee benefits cease upon retirement, some continue under specific circumstances or have options for extension. Here’s a detailed look at the circumstances where certain benefits may still apply after retirement and how they work:

• Employer-Sponsored Retiree Benefits: Some employers offer retiree benefits packages, which typically include health, dental, and life insurance coverage. These packages vary widely in terms of coverage and whether there will be a cost involved for you. It is essential to check with your employer about the specifics of any retiree benefits they offer.
• Group Benefits Conversion: If your employer does not offer retiree benefits but you were part of an employer-sponsored group benefits plan, you might have the option to convert your group benefits to an individual plan. This process usually must be done within a specific time frame after retirement.

Some employers may offer a flexible benefits package, which allows retirees to customize their benefits plan depending on what they need most. Retirees are free to decide to pay an additional premium for additional coverages not included in the employer’s traditional benefits package. When approaching retirement, you should start by:

• Review Your Employer’s Retiree Benefits Manual: Obtain and thoroughly review any documents your employer provides regarding retiree benefits.
• Consult Your HR Department: Engage with human resources or the benefits administrator to understand what specific benefits you are eligible for and any costs involved.
• Consider Supplemental Insurance: If your employer-sponsored benefits package does not cover all your needs, you may need to look into supplemental insurance plans. You can generally still use your retiree-sponsored benefits if you also have private insurance. In fact, having both can provide better coverage and help reduce out-of-pocket costs. It’s important to understand how the coordination of your retiree benefits and private insurance works. For example, if your retiree benefits fully cover pharmaceuticals, but not dental, you should aim for a private insurance plan with comprehensive dental coverage. 

OHIP Coverage After Retirement

Ontario’s Health Insurance Plan (OHIP) offers basic health insurance coverage for all residents of Ontario, but enhances their coverage for residents over 65. Here’s a full list of what that entails:

Basic OHIP Coverage

• Hospital Services: Covers in-patient care like standard ward accommodations (room with three or more beds) and all necessary medical care while in the hospital. For out-patient services, OHIP covers diagnostic services, like X-rays and blood tests, provided through the hospital. 
• Physician Services: Covers visits to family doctors and specialists. Includes routine exams, necessary surgeries, and other medically required procedures.
• Laboratory Services: Blood tests and other diagnostic services ordered by your doctor and performed in approved facilities are covered.
• Surgical Procedures: Most medically necessary surgeries are covered, whether performed in a hospital or an approved clinic.

Additional OHIP Coverage after Age 65

• Ontario Drug Benefit (ODB) Program: The ODB is a program specifically made for Ontarians 65 and over for enhanced access to pharmaceutical medicine. This program helps cover the cost of many prescription medications. There may be a yearly deductible and a dispensing fee for each prescription filled.
• Assistive Devices Program (ADP): Covers up to 75% of the cost for many types of assistive devices, such as wheelchairs, hearing aids, prosthetics, and respiratory equipment.
• Eye Exams: OHIP covers one major eye exam every 12 months, including assessments for certain medical conditions like diabetes, for people aged 65 and over. Some minor assessments may be covered if they are deemed medically necessary.
• Home Care Services: Through the Ontario Health’s Home and Community Care Support Services, OHIP covers services like nursing care, physiotherapy, and homemaking services if you need assistance at home. There may be limits to the amount and duration of services. 
• Physiotherapy: Covers physiotherapy services provided in publicly funded clinics for individuals aged 65 and over, as well as for those who require it after hospitalization.

Although OHIP can help support Ontario residents in their health and wellness, the services and coverage they can offer is ultimately limited. OHIP does not cover dental care or vision care, and does not offer travel insurance for medical emergencies outside of Canada. Additionally, it either does not or only partially covers paramedical services such as physiotherapy, chiropractic care, and massage therapy. Although OHIP covers a decent amount of pharmaceuticals, there are many types of prescription medicines OHIP is unable to cover. 

Insurance Plans For After Retirement

A private insurance plan can make up for the services OHIP doesn’t cover. Private health insurance plans can provide more comprehensive coverage beyond the basic health insurance that OHIP offers, and even include other forms of insurance like dental care, travel, critical illness, life insurance, and even long-term care. 

Expanding your insurance as a senior to be more extensive is especially crucial as your health deteriorates with age. OHIP may not be able to cover the full extent of health issues you will face throughout the later half of your life, causing you to often pay out-of-pocket. To ensure you’ll not be blindsided with out-of-pocket medical expenses, take the time to look at what private insurers offer and compare the costs, benefits, and overall value.

Conclusion: Ensuring a Secure and Well-Covered Retirement

Navigating the landscape of benefits after retirement requires careful planning and understanding of your options. While many benefits may cease, employer-sponsored retiree packages and the possibility of converting group benefits offer valuable extensions. For Ontario residents, OHIP provides solid foundational coverage, though its limitations necessitate consideration of supplemental private insurance. By reviewing your employer’s retiree benefits thoroughly, consulting HR, and exploring additional insurance plans, you can ensure comprehensive coverage and reduced out-of-pocket costs. Use tools like HealthQuotes’ Quick Quotes to compare available options and secure a more financially stable and health-conscious future in your retirement.