|
Ontario Blue Cross
Blue
Vision
SUMMARY OF
BENEFITS
EXPRESS Health Benefit
Plan
No medical
examination required
|
1.
Extended
Health Benefit |
|
Covers cost of medical and hospital expenses
incurred by you or member of your family in case of illness,
pregnancy and injury |
The following extended health benefits are
reimbursed at 100% without deductible, up to the specified
maximum.
Amounts refer to each covered person.
●
Hospitalization (private or semi-private
accommodations): |
|
up to $200 per day for semi-private or
private accommodation in a public general hospital for a
maximum duration of 90 days per calendar year. |
|
(Benefits are not paid for
hospitalization due to a pregnancy or pregnancy-related
condition during the first 8-month period after the
effective date of coverage) |
|
●
Registered Specialists |
A written recommendation from a physician
is not required for items 1 through 9 below
|
|
SPECIALIST |
FIRST VISIT |
SUBSEQUENT
VISITS |
MAXIMUM #
OF VISITS |
|
1 |
Chiropractor (x-rays, up to a
maximum refund of $25 |
$12 |
$12 |
25 |
|
2 |
Osteopath |
$12 |
$12 |
25 |
|
3 |
Physiotherapist |
$12 |
$12 |
25 |
|
4 |
Podiatrist |
$12 |
$12 |
25 |
|
5 |
Psychologist |
$75 |
$60 |
12 |
|
6 |
Speech Therapist |
$60 |
$40 |
12 |
|
7 |
Chiropodist |
$12 |
$12 |
25 |
|
8 |
Naturopath |
$12 |
$12 |
25 |
|
9 |
Ophthalmologist or Optometrist
|
For Insured under 65 year of age,
up to a maximum refund of $50 per two years |
|
10 |
Massage Therapist |
$15 |
$15 |
20 |
|
|
The following eligible expenses covered at
80% without deductible, up to the specified maximum.
Amounts refer to each covered person. |
-
Hearing Aids - up to $300 (excluding
batteries) every 5 years. Subject to a three month
waiting period.
-
Prostheses and accessories (artificial
limbs, wheelchair rental, etc.) up to a maximum refund
of $2,500 per calendar year
-
Nursing Services and Home Care Services -
RNA and Health Care Aides, up to maximum refund of
$2,500 per calendar year
-
Surgical stocking, up to a maximum refund
of $100 per calendar year
-
Orthopedic shoes or podiatric ortheses,
up to $175 per year for both combined
-
Purchase or rental equipment (crutches,
walkers, canes etc.), up to a maximum refund of $2,500
per calendar year
-
Ambulance Services
- amount of coverage equals costs not
covered by OHIP
-
Accidental Dental Treatment, up to $2,000
per calendar year
Basic Travel Insurance
|
-
Covers trip of 15
days or less
-
$5,000,000 hospital
and medical benefits
-
Transportation cost
-
Round-the-clock
CanAssitance travel Assistance
-
Medical follow-up in
Canada
|
|
2. Prescription Drug Benefit |
(for persons under 65 years of age)
-
Eligible expenses covered at 80%
-
No deductible
-
Pay Direct Card
-
Maximum overall reimbursement (per
insured): first calendar year -$500 and subsequent
calendar years - $750
-
No lifetime maximum
-
Reimbursement is based on the lowest-cost
generic equivalent if available (a generic drug is a
generally less expensive alternative to an
interchangeable brand name drug product)
|
|
Blue Cross Assistance |
|
●
All Blue Choice Health Care Plans include
24-hour toll-free telephone assistance for your health
related questions. |
Back to Top
⇑
Blue
Vision
GLOBAL Health Benefit
Plans
Health Statement
required
Core Benefits
|
Extended
Health Benefit - Regular
Coverage |
|
Covers cost of medical and hospital expenses
incurred by you or member of your family in case of illness,
pregnancy and injury |
The following extended health benefits are
reimbursed at 100% without deductible, up to the specified
maximum.
Amounts refer to each covered person.
●
Hospitalization (private or semi-private
accommodations): |
|
up to $200 per day for semi-private or
private accommodation in a public general hospital for a
maximum duration of 90 days per calendar year. |
|
(Benefits are not paid for
hospitalization due to a pregnancy or pregnancy-related
condition during the first 8-month period after the
effective date of coverage) |
|
●
Registered Specialists |
A written recommendation from a physician
is not required for items 1 through 9 below
|
|
SPECIALIST |
FIRST VISIT |
SUBSEQUENT
VISITS |
MAXIMUM #
OF VISITS |
|
1 |
Chiropractor (x-rays, up to a
maximum refund of $25 |
$12 |
$12 |
25 |
|
2 |
Osteopath |
$12 |
$12 |
25 |
|
3 |
Physiotherapist |
$12 |
$12 |
25 |
|
4 |
Podiatrist |
$12 |
$12 |
25 |
|
5 |
Psychologist |
$75 |
$60 |
12 |
|
6 |
Speech Therapist |
$60 |
$40 |
12 |
|
7 |
Chiropodist |
$12 |
$12 |
25 |
|
8 |
Naturopath |
$12 |
$12 |
25 |
|
9 |
Ophthalmologist or Optometrist
|
For Insured under 65 year of age,
up to a maximum refund of $50 per two years |
|
10 |
Massage Therapist |
$15 |
$15 |
20 |
|
|
The following Eligible expenses covered at
80% without deductible, up to the specified maximum.
Amounts refer to each covered person. |
-
Hearing Aids - up to $300 (excluding
batteries) every 5 years. Subject to a three month
waiting period.
-
Prostheses and accessories (artificial
limbs, wheelchair rental, etc.) up to a maximum refund
of $2,500 per calendar year
-
Nursing Services and Home Care Services -
RNA and Health Care Aides, up to maximum refund of
$2,500 per calendar year
-
Surgical Stocking, up to a maximum refund
of $100 per calendar year
-
Orthopedic Shoes or podiatric ortheses,
up to $175 per year for both combined
-
Purchase or rental equipment (crutches,
walkers, canes etc.), up to a maximum refund of $2,500
per calendar year
-
Ambulance Services
- amount of coverage equals costs not
covered by OHIP
-
Accidental Dental Treatment, up to $2,000
per calendar year
|
Back to Top
⇑
|
Extended
Health Benefit - Enhanced
Coverage |
|
Covers cost of medical and hospital expenses
incurred by you or member of your family in case of illness,
pregnancy and injury |
The following extended health benefits are
reimbursed at 100% without deductible, up to the specified
maximum.
Amounts refer to each covered person.
●
Hospitalization (privet or semi-privet
accommodations): |
|
up to $200 per day for semi-private or
private accommodation in a public general hospital for a
maximum duration of 90 days per calendar year. |
|
(Benefits are not paid for
hospitalization due to a pregnancy or pregnancy-related
condition during the first 8-month period after the
effective date of coverage) |
|
●
Registered Specialists |
A written recommendation from a physician
is not required for items 1 through 9 below
|
|
SPECIALIST |
FIRST VISIT |
SUBSEQUENT
VISITS |
MAXIMUM #
OF VISITS |
|
1 |
Chiropractor (x-rays, up to a
maximum refund of $25 |
$20 |
$20 |
25 |
|
2 |
Osteopath |
$20 |
$20 |
25 |
|
3 |
Physiotherapist |
$20 |
$20 |
25 |
|
4 |
Podiatrist |
$20 |
$20 |
25 |
|
5 |
Psychologist |
$75 |
$60 |
20 |
|
6 |
Speech Therapist |
$60 |
$40 |
12 |
|
7 |
Chiropodist |
$20 |
$20 |
25 |
|
8 |
Naturopath |
$20 |
$20 |
25 |
|
9 |
Ophthalmologist or Optometrist
|
For Insured under 65 year of age,
up to a maximum refund of $50 per two years |
|
10 |
Massage Therapist |
$20 |
$20 |
20 |
|
|
● Vision Care
: Lenses, frames, contact
lenses - up to maximum refund $150 every two calendar years. |
|
The following Eligible expenses covered at
80% without deductible, up to the specified maximum.
Amounts refer to each covered person. |
-
Hearing Aids - up to $300 (excluding
batteries) every 5 years. Subject to a three month
waiting period.
-
Prostheses and accessories (artificial
limbs, wheelchair rental, etc.) up to a maximum refund
of $2,500 per calendar year
-
Nursing Services and Home Care Services -
RNA and Health Care Aides, up to maximum refund of
$2,500 per calendar year
-
Surgical Stocking, up to a maximum refund
of $100 per calendar year
-
Orthopedic Shoes or podiatric ortheses,
up to $175 per year for both combined
-
Purchase or rental equipment (crutches,
walkers, canes etc.), up to a maximum refund of $2,500
per calendar year
- Ambulance Services - amount of coverage equals costs not
covered by OHIP
-
Accidental Dental Treatment, up to $2,000
per calendar year
Basic Travel Insurance |
-
Covers trip of 15
days or less
-
$5,000,000 hospital
and medical benefits
-
Transportation cost
-
Round-the-clock
CanAssitance travel Assistance
-
Medical follow-up in
Canada
|
Back to Top
⇑
Optional Benefits
|
Prescription Drug Benefit - Basic |
(for persons under 65 years of age)
- Eligible expenses covered at 80%
- No deductible
- Pay Direct Card
- Maximum overall reimbursement (per
insured): $5,000 per calendar year
- No lifetime maximum
- Reimbursement is based on the lowest-cost
generic equivalent if available (a generic drug is a
generally less expensive alternative to an
interchangeable brand name drug product)
|
| |
|
Prescription Drug Benefit - Deluxe |
(for persons under 65 years of age)
-
Eligible expenses covered at 80%
-
No deductible
-
Pay Direct Card
-
Maximum overall reimbursement (per
insured): $10,000 per calendar year
-
No lifetime maximum
-
Reimbursement is based on the lowest-cost
generic equivalent if available (a generic drug is a
generally less expensive alternative to an
interchangeable brand name drug product)
|
Back to Top
⇑
|
Dental Care
Benefit |
| |
- Preventive Care (examination and diagnostic
services, radiographs, laboratory tests, preventive
services) are reimbursed at 70% for the first calendar
year, at 75% for the second calendar year, and at 80%
thereafter.
- Basic
Care (removal of erupted teeth, restorative
services, root canal,endodontics, periodontics, denture
services, surgical services, adjunctive services) are
reimbursed at 70% for the first calendar year, at 75%
for the second calendar year, and at 80% thereafter.
- Major Restorative Services (prosthodontic
services removable, prosthodontic services fixed bridge,
extensive restorative procedures) are reimbursed at 50%
up to a maximum $500 and not before the third year
this benefit is in effect.
- Maximum overall reimbursement: first calendar year $750,
second calendar year $1,000, subsequent calendar year
$1250, including Major Restorative Services.
-
Recall visits covered every 9 months.
-
Coverage is paid in accordance with the
current Ontario Dental Association Fee Schedule
|
Back to Top
⇑
|
Blue Cross Assistance |
|
●
All Blue Choice Health Care Plans include
24-hour toll-free telephone assistance for your health
related questions. |
|