HEALTH SERVICES no deductible and no co-payment

Benefits

Paramedical Services

Physiotherapist, Psychologist, Speech Therapist, Chiropractor, Osteopath, Homeopath, Podiatrist/Chiropodist, Naturopath:

Maximum of $400 per person, per calendar year for each  practitioner

Acupuncturist & Registered Massage Therapist:

$20.00 per visit to a maximum of 20 visits per person per calendar year

by land or air to the nearest hospital.

maximum $10,000. 

Medical Items including, prosthetic appliances, braces, wheelchair & hospital bed.

Orthotics

Not Covered

 $200 every 3 years

$300 every 3 years

Vision care

All Plan members have access to a national preferred provider vision network arrangement, where you are eligible to receive a discount on eye wear.

Eye exams - Not covered

Eyeglasses, Contact Lenses/Laser Eye Surgery - Not Covered

Eye exams - $60 every 2 years

Eyeglasses, Contact Lenses/ Laser Eye Surgery - Not Covered

Eye exams - $60 every 2 years

Eyeglasses, Contact Lenses/ Laser Eye Surgery - $250 every 2 years

Semi-Private Hospital Accommodations

Not covered

Not covered

                                                        Prescription Drugs

Benefits

Prescription Drugs

Benefits do not include medication for the treatment of anti-obesity, smoking cessation products, erectile dysfunction and fertility. Serums and vitamins are also ineligible unless injected and medically necessary.

Covered at 80% to a maximum of $1,000 per person, per benefit year

Covered at 90% to the following maximums per person, per benefit year:

First 12 months - $1,000

Next 12 months - $1,500 Each 12 months thereafter - $2,000

Covered at 90% to the following maximums per person, per benefit year:

First 12 months - $1,500 Next 12 months - $2,500 Each 12 months thereafter -
  $3,500

                                                                Dental Benefits

(optional, can only be purchased in conjunction with the Health Benefits)

Benefits

Basic Dental Services

Covered at 80%

Covered at 80%

Covered at 80%

• Preventive services

include preventive cleaning of teeth; topical application of fluoride for persons age 19 or under; pit and fissure sealants on permanent molars, for children age 15 or under; space maintainers that replace prematurely lost teeth for persons age 18 or under.

recall examinations every 9 months;

recall examinations every 9 months

recall examinations every 6 months

• Periodontal scaling/ cleaning

the fees for periodontal treatment are based on units of time (15 minutes per unit) and/or number of teeth in a surgical site in accordance with the Fee Guide for General Practitioners:

up to 6 units every 12 months.

up to 8 units every 12 months.

up to 8 units every 12 months.

• Diagnostic services including complete oral examinations once every 3 years; emergency and specific oral examinations once every 3 years; full series x-rays and panoramic x-rays once every 3 years; bitewing x-rays once every 9 months.

• Basic oral surgery including extractions of teeth and/or residual roots.

Covered at 70%

Covered at 70%

• Endodontic treatment including root canal therapy; removal of the pulp from the crown and root portion of the tooth; assistance of root tip closure; root resections and retrograde fillings, root amputation; emergency procedures.

• Periodontal treatment including provisional splinting and certain periodontal appliances; displacement packing, management of infections and desensitization.

• Standard denture services including, denture cleaning once every 9 months; denture repairs and/or tooth/teeth additions; standard relining and rebasing of dentures;  denture adjustments, remount and equilibration procedures.

• Comprehensive oral surgery including, surgical exposure, repositioning, transplantation or enucleation of teeth; removal of cysts and tumours; incision, drainage and/or exploration of soft or hard tissue.

$750.00  in the first 12 months,

$1,000 every 12 months thereafter

$1,000 in the first 12 months,
$1,000 in the second 12 months and
$1,200 every 12 months thereafter

$1,000 in the first 12 months,
$1,000 in the second 12 months and
$1,200 every 12 months thereafter