Young women and an elderly Women
Healthcare benefits bridge the widening gap between provincial health insurance plans and the coverage your employees and their families need.

 

What is it?

Healthcare benefits cover many of the services not covered by a provincial health care plan including paramedical services such as massage, chiropractor, physiotherapy, psychologist/social worker, speech therapist, dietician, osteopath, podiatrist, and acupuncturist.

Out-of-country care is available for emergencies while travelling outside Canada. Under this coverage, the reimbursement level is 100%.

Hospital accommodation is part of the plan.

Best Doctors® is included. This service connects employees and their covered dependants who’ve been diagnosed with a serious illness with world-renowned medical experts.

Hearing aids, compression hose and orthopedic shoes are covered.

Accidental dental coverage is provided under your health benefits if you do not choose dental insurance. Under this coverage, the reimbursement level is 100%.

How will it benefit my employees?

Your employees will be reimbursed for a variety of medical expenses, helping free up their finances for the things that matter most.

How does it work?

There’s no medical examination required, so employees can be approved within minutes.

Employees can submit claims online and be reimbursed by direct deposit.

More details

  • Calendar year deductible: None
  • Reimbursement level: 80% (the plan member pays the remaining 20%)
  • Lifetime maximum: Unlimited

Includes:

  • Ambulance services
  • Hospital coverage including out-of-country care including emergency care, non-emergency care and out-of-province care
  • Travel assistance
  • Nursing care: $5,000
  • Compression hose: $250
  • Orthopedic shoes and foot orthotics: $300

Accidental dental is covered under healthcare if dentalcare is not selected. Under this coverage, the reimbursement level is 100%.

General limitations

No benefit is payable if the person dies or experiences irreversible cessation of all functions of the brain during the waiting period.

No benefits will be paid for a critical illness that is directly or indirectly related to a condition for which the person obtained medical care within 24 months before they became insured.

In addition, no benefits will be paid for a critical illness resulting directly or indirectly from or associated with:

  • Intentionally self-inflicted injury or attempt at suicide, whatever the person’s state of mind, and whether or not the person is able to understand the nature and consequences of his or her actions, at that time
  • War, insurrection, or voluntary participation in a riot
  • Participation in a criminal offence or provoking an assault
  • Use of any drug, poisonous substance, intoxicant, or narcotic, unless prescribed for the person by a licensed physician
  • An accident occurring while the person was operating a motorized vehicle if their blood alcohol level was higher than 80 milligrams of alcohol per 100 millilitres of blood

Best Doctors includes:

  • Toll-free number for the covered person to call
  • Collections of each covered person’s applicable medical history to determine the appropriate Best Doctors specialist
  • Ongoing support to help the covered person through the process and arrange for treatment (at the covered person’s expense, including travel)

Medical supplies

The rental or purchase of the following medical supplies are covered when prescribed by a physician:

  • Breathing equipment
  • Orthopedic equipment
  • Prosthetic equipment
  • Mobility aids
  • Communication aids (includes hearing aids up to $700)
  • Diabetic supplies

Other eligible medical supplies include but are not limited to: hospital beds, trapeze bars, colostomy supplies, tube feeding pumps, transcutaneous nerve stimulators, extremity pumps, compression hose, custom-made burn garments, wigs for cancer patients, one pair of eyeglasses following non-refractive eye surgery.

Medical supplies

Unlimited coverage for diagnostic laboratory and X-ray procedures performed in the person’s province of residence when coverage is not available under the provincial government plan.

Coordination of benefits with government or other group plans applies.

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