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Private health insurance laws

health insurance
Under the Private Health Insurance Act, health insurance companies must be registered. They must provide coverage to anyone who searches for them and inform them in advance of any changes to their policy. Health insurance companies must also follow strict rules for things like increasing premiums and waiting times.

Laws and rules

The Private Health Insurance Act of 2007 is the primary law that establishes the requirements for private health insurance and health insurance companies.

The rules for private health insurance are under this law. Provides more details on different areas of private health insurance.

Find other private health insurance laws in the Federal Legislative Register.

Who can provide private health insurance?

Organizations wishing to provide private health insurance must register in accordance with the Private Health Insurance Act of 2007. See the list of registered health insurance companies.

Obtaining private health insurance (community classification)

Unlike other types of insurance, such as auto and life insurance, which are generally classified as risky, the community classification means that health insurance companies must:
  • Everyone gets the same premium for the same product
  • Providing coverage for all who seek it
  • Different premiums are not charged based on:
  1. Past or future health potential
  2. History claims
  3. Age, pre-existing condition, gender, race, or lifestyle.
Health insurance companies may limit their members to a specific industry or group.

Distinctive increases and changes

Health insurance companies must request premium increases from the Minister of Health. This happens at the same time every year. The highlighted changes take effect on April 1 of each year.

Learn more about the process behind premium increases and what you can do if you want a cheaper policy.


If health insurance companies choose to impose waiting periods to provide insurance for hospital services, they must not exceed:
  • 12 months for pre-existing conditions
  • 12 months for pregnancy and delivery services
  • 2 months for psychological care, rehabilitation or palliative care (even if it is a pre-existing condition)
  • Two months for all other services.
Health insurance companies should not impose a waiting period if you upgrade your psychological care coverage (once in your life).

Health insurance companies can set any waiting period to cover additions.

Health insurance companies should not force you to meet additional waiting times if you switch to a new policy that offers the same level of benefits as your previous policy. This applies even if you move to a different insurance company.

Communication with policy makers.

Health insurance companies must:
  • Providing Private Health Information Data - Describes the features of the policy and explains what is covered
  • We inform you in advance if your premiums will increase or if your policy will change; This gives you time to shop if you want to find a different policy.
  • We let you know if you have to pay the costs for covered treatments or services out of your own pocket; this is called informed financial approval

Pay for prosthetics

Health insurance companies must pay benefits to a group of prosthetics, including those who:
  • You get in the hospital
  • Your health insurance
  • They are implanted or applied by a service covered by medical care.