Transitioning to independence: Personal health plans for young adults

As students transition from adolescence to adulthood, one significant change they face is managing their health insurance. This transition often comes with questions and concerns for those previously covered under a parent’s group plan. At Saskatchewan Blue Cross, we are committed to ensuring this shift is as smooth and supportive as possible.

Understanding the transition 

Children, also referred to as child, means the natural, adopted, or stepchildren of the member or the member’s spouse; or any other children for whom the member or the member’s spouse have been appointed as a guardian. Dependent children are eligible for benefits if they are:

• dependent upon the member for financial care and support, and
• not legally married or in a common-law relationship that is one full year or more in duration, and
• less than 21 years of age; or, if 21 years of age but less than 26 years of age, they must be attending an accredited educational institution, college or university on a full-time basis.

When a dependent child reaches the standard dependent termination age, their coverage will automatically terminate unless we receive written notification of their status as a student or a disabled dependent. 

At this juncture, a policy letter will be generated and mailed to the transitioning student advising of their valuable Conversion privilege, where they can secure coverage under the Conversion personal health plan with no medical questions within 60 days of losing coverage under their parent’s group plan, ensuring continuity of care. Dependents must choose to opt into their own plan. 

Conversion personal health plan: Key benefits for young adults  

Health practitioners

• Young adults often lead active lives, whether through sports, outdoor adventures, or long hours of study. Access to a variety of health practitioners ensures they can address physical strains, mental health needs and alternative health approaches, promoting overall well-being and preventing minor issues from escalating. This coverage protects them from the high costs of specialized care, ensuring they can maintain optimal health without financial strain. 
• Coverage: $300 per person per year 
• Services included: Chiropractor, chiropodist/podiatrist, physiotherapist/athletic therapist, registered massage therapist, clinical psychologist, naturopath, speech-language pathologist and acupuncturist. 

Vision care

• In the digital age, where screen time is at an all-time high, maintaining good vision is crucial. Regular eye exams can detect early signs of vision problems and other health issues, while coverage for eyewear ensures that young adults can afford necessary glasses or contacts. This benefit protects against the risk of undiagnosed vision problems affecting performance and daily life. 
• Eye exam: Up to $75 for one eye exam in a 24-month period. 
• Eyewear: Up to $100 for prescription eyewear or laser surgery in a 24-month period. 

Out of Saskatchewan (within Canada) Emergency Services 

• Young adults love to explore and travel, and emergency services coverage ensures they are protected anywhere in Canada. Unlimited coverage means they can travel with peace of mind, knowing they are protected against unexpected medical emergencies, which can otherwise be financially devastating. 
• Coverage: Unlimited 
• Pre-existing conditions: 90-day pre-existing condition clause. 

Accidental Death and Dismemberment (AD&D)

• Life is unpredictable, and accidents can happen at any time. AD&D coverage provides a financial safety net in the event of serious injury or death, offering peace of mind to young adults and their families. This protection can alleviate the financial burden on loved ones during challenging times. 
• Policyholder and spouse: $25,000 
• Dependent(s): $5,000 

Prescription drugs

• Medication: Prescription medications can be a significant expense, especially for young adults managing chronic conditions or unexpected illnesses. With 80% unlimited coverage. This benefit ensures that essential medications are affordable, protecting against the financial strain of out-of-pocket prescription costs and promoting adherence to necessary treatment plans. Drugs listed on the SK Formulary are covered.
• Coverage: 80% to a maximum chosen by the policy holder of either $500 or $1,500 

Click here for a full list of the benefits included in the Conversion personal health plan.

Supporting the transition  

Insurance advisors play a crucial role in this transition by: 

• Ensuring plan administrators are well-informed about the upcoming changes and conversion privileges after group benefits end. 
• Reminding plan administrators to notify members with dependents aged 21 and over to make necessary changes if eligibility requirements are no longer met. 
• Highlighting the conversion privileges available to transitioning members, including the policyholder, spouse, and dependent children. 
• By emphasizing continuity of care and the comprehensive benefits offered, advisors can provide peace of mind to plan administrators and their members during this critical time. 

For more information or to discuss how we can assist during these transitions, please contact your dedicated Saskatchewan Blue Cross Account Executive. We are here to support you every step of the way.