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Ontario Blue Cross


Blue Vision      

 SUMMARY OF BENEFITS

1. Blue Vision EXPRESS Health Benefit Plan  (No medical examination required) :

This plan includes Extended Health Benefit and Prescription Drug Benefit

 

2. Blue Vision GLOBAL Health Benefit Plans :

Core benefits:

Extended Health Benefit Regular or
  Extended Health Benefit Enhanced

Optional benefits:

Prescription Drug Benefit Basic
  Prescription Drug Benefit Deluxe
  Dental Care Benefit

If you select Optional benefits, you must also purchase the Extended Health Benefit

 

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.  

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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

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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

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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)

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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

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Blue Cross Assistance

●  All Blue Choice Health Care Plans include 24-hour toll-free telephone assistance for your health related questions.  

 

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Investments:    RESP     RRSP     TFSA     Guaranteed Investments     Segregated Funds

                                                       July 27, 2010