Standard Coverage Prescription Drugs If a non-generic drug is purchased, payment will be based on the cost of the generic equivalent. If there is no generic brand, normal coverage applies. Generic drug coverage 80% reimbursement No maximum on shared dispensing fees $500 maximum each anniversary year Vision Care This benefit helps with the cost of prescription lenses and frames, contact lenses, and laser eye surgery. This benefit does not include industrial safety glasses. $150 every 2 benefit years $30 for Optometrist visits every 2 benefit years Hospital Benefits This benefit helps with the cost of semi-private accommodation at a general hospital. A cash benefit is provided when a semi-private room is not available. 100% coverage for a semi-private room (costing up to $175) for up to 60 days each anniversary year. 50% coverage for a semi-private room (costing up to $175) for the following 90 days each anniversary year. $50 cash each day when a semi-private room is not available, to a maximum of $3000 each anniversary year. Survivor Benefit Your FollowMe (formerly ConversionPlus) Health and Dental plan will be provided FREE for 1 year, following the death of an adult policyholder. Fracture Benefit This benefit provides up to $350 cash if you fracture a bone. If more than one bone is fractured in a single accident, the benefit amount is paid for the most severe fracture. Accidental Death and Dismemberment Provides payment for a loss directly resulting from accidental bodily injury or accidental loss of life occurring within a year of the date of accident. $25,000 for adults under 65 $10,000 for children and adults 65 and older Extended Health Care Benefits Includes visits to Acupuncturists, Chiropractors, Osteopaths, Podiatrists, Naturopaths, Chiropodists, Registered Massage Therapists, Physiotherapists, Psychologists, and Speech Therapists. This benefit is payable only after your Provincial Health Insurance Plan maximums have been reached, if applicable. Registered Specialists and Therapists $600 combined maximum each anniversary year Psychologist $75 maximum for your first visit $60 maximum each subsequent visit Maximum of 10 visits each year Speech Therapist $60 maximum for your first visit $40 maximum each subsequent visit Maximum of 10 visits each year Lifeline® Emergency Response Service This benefit is for people trying to cope with medical problems at home while living independent lives. Lifeline provides a button device to be worn at home. Once pressed, a signal alerts our 24-hour monitoring staff that help is needed. The monthly cost includes the unit and the monitoring service. The installation fee is not included. 6 months per lifetime Homecare and Nursing Equipment, Prosthetic Appliances and Durable Medical Equipment Covers the services of registered health professionals including Registered Nurse, Registered Nursing Assistant or healthcare aid; includes surgical bandages and dressings and the purchase or rental of medically necessary equipment. Payment will be coordinated where benefits are available through Assistive Devices Program. For each of the Homecare & Nursing, Prosthetic Appliances, and Durable Medical equipment: $750 in year 1 $1,250 in year 2 $2,500 in subsequent years $225 per year for custom-made Orthotics is part of Durable Medical equipment Hearing Aids Provides for the cost to purchase or repair hearing aids. $300 every 5 benefit years Ambulance Services Provides for trips to hospitals in a licensed ground ambulance. This benefit is payable only after your Provincial Health Insurance Plan maximums have been reached, if applicable. Unlimited ground support $4,000 air ambulance Accidental Dental Provides for dental treatment required because of an accidental blow to the head or mouth. Treatment must be sought within 90 days of the accident. $2,500 per year |