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FlexCare®

Core Plans

 

1) ComboPlus  Starter

2) ComboPlus  Basic

3) ComboPlus  Enhanced

4) DrugPlus  Basic

5) DrugPlus  Enhanced

6) DentalPlus  Basic

7) DebtalPlus  Enhanced
ComboPlusTM Starter
(No medical questionnaire required)
 		      
      Prescription Drugs      
 
     
  • Generic drug plan (name brand allowed but price paid will be deemed to be the generic equivalent price)
  • Shared dispensing fee to a maximum of $6.50
  • 70% on the first $720 of eligible prescription cost to a maximum of $504 in coverage (70% of $720) per anniversary year
     
      Exclusions - Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, and drugs not requiring a prescription.      
     
Dental		      
 
     
  • Dental coverage with a 70% payment for fillings, cleanings, scalings, examinations, and polishing on the first $575 of these services - to a maximum of $400 in coverage (70% of $575) per anniversary year
  • Recall visits every 9 months
      
      Coverages are designed to concur with your current provincial Dental Association Fee Guide for General Practitioners. The Flexcare ComboPlus Dental coverage will be adjusted to match any increases in the fee guide.

The following Core benefits are also included with ComboPlus Starter:

      
     
Extended Health Care (Starter)		      
 
     
  • $250,000 lifetime maximum
  • Best Doctors® Solutions Services - upon diagnosis of a serious illness or injury, you can receive an evaluation of your medical records by world-class specialists who confirm the initial diagnosis and recommend appropriate treatment options. This fast, yet in-depth review can reduce potentially serious complications from a misdiagnosis and help your local physician determine the proper course of action. In addition to medical advice, Best Doctors provides the following services: treatment planning, identification of the most appropriate care provider, and care management.
  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $20 maximum per visit, 20 visit maximum per discipline per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable).
  • Chiropractic X-ray - $35 maximum per anniversary year
  • Psychologist or approved social worker - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year
  • Physiotherapist - $250 maximum per anniversary year
  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment - maximum per anniversary year for each of these three categories of benefits separately, is according to the following table:
  Year 1     Year 2     Year 3     Year 4     Year 5+  
$1,000 $1,300 $1,500 $1,700 $3,000

Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.
  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year
  • Lifeline® Personal Response Service - lifetime maximum of 3 months of service, not including installation fee
  • Accidental Dental - $2,000 maximum per anniversary year
  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable).
  • Hearing Aid - $400 maximum per 4 consecutive benefit years
Vision Care
  • $100 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery
  • $30 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)
  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.

No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.

 

      
      Travel      
 
     
  • $5 million emergency health coverage for trips lasting a maximum of 9 days.
      
      Note: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 65 and over; 8 or 21 day Add-On Travel coverage not available with ComboPlus Starter.      
     
Accidental Death & Dismemberment		      
 
     
  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a child
  • Additional coverage can be purchased as an Add-On.
      
      Survivor Benefit      
 
     
  • Provides for coverage to be continued for 1 year, following the death of an adult policyholder. Available 1 year after policy effective date.
      
     
Anniversary Year means the consecutive 12 months following the Effective Date of the Agreement, and each 12 month period thereafter.

Benefit Year means the 12 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.

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ComboPlusTM Basic
(Medical questionnaire required)
 		      
      Prescription Drugs      
 
     
  • Generic drug plan (name brand allowed but price paid will be deemed to be the generic equivalent price)
  • Full coverage of reasonable and customary dispensing fees
  Percentage Paid To a maximum of
(per anniversary year)
On your first $765 of eligible prescription costs 70% $535
On your next $3,850 of eligible prescription costs 90% $3,465
Total benefits payable per anniversary year $4,000

 

      
      Exclusions - Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, and drugs not requiring a prescription.      
 

     
Dental		      
 
     
  • Dental coverage is for fillings, cleanings, scalings, examinations, polishing and certain extractions
  • Recall visits every 9 months
  Percentage Paid To a maximum of
(per anniversary year)
On your first $300 of eligible services 80% $240
On your next $850 of eligible services 50%    $425
Total benefits payable per anniversary year $665
 

      
      Coverages are designed to concur with your current provincial Dental Association Fee Guide for General Practitioners. The Flexcare ComboPlus Dental coverage will be adjusted to match any increases in the fee guide.

The following Core benefits are also included with ComboPlus Basic:

      
     
Vision (Basic)		      
 
     
  • $100 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery
  • $30 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)
  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.
      
      No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.      
     
Extended Health Care (Basic)		      
 
     
  • $250,000 lifetime maximum
  • Best Doctors® Solutions Services - upon diagnosis of a serious illness or injury, you can receive an evaluation of your medical records by world-class specialists who confirm the initial diagnosis and recommend appropriate treatment options. This fast, yet indepth review can reduce potentially serious complications from a misdiagnosis and help your local physician determine the proper course of action. In addition to medical advice, Best Doctors provides the following services: treatment planning, identification of the most appropriate care provider, and care management.
  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $20 maximum per visit, 20 visit maximum per discipline per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)
  • Chiropractic X-ray - $35 maximum per anniversary year
  • Psychologist or approved social worker - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year
  • Physiotherapist - $250 maximum per anniversary year
  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment - $3,000 maximum per anniversary year, for each of these three categories of benefits separately
Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.
  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year
  • Lifeline® Personal Response Service - lifetime maximum of 3 months of service, not including installation fee
  • Accidental Dental - $2,000 maximum per anniversary year
  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)
  • Hearing Aid - $400 maximum per 4 consecutive benefit years
      
      Travel      
 
     
  • $5 million emergency health coverage for trips lasting a maximum of 9 days.
  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.
      
      Note: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 65 and over.      
     
Accidental Death & Dismemberment		      
 
     
  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a child
  • Additional coverage can be purchased as an Add-On.
      
      Survivor Benefit      
 
     
  • Provides for coverage to be continued for 1 year, following the death of an adult policyholder.
      
     
Anniversary Year means the consecutive 12 months following the Effective Date of the Agreement, and each 12 month period thereafter.

Benefit Year means the 12 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.
     

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      ComboPlusTM Enhanced
(Medical questionnaire required) 		     
     
Prescription Drugs		      
 
     
  • Name brand or generic drugs, including birth control and fertility drugs
  • Full coverage of reasonable and customary dispensing fees
  Percentage Paid To a maximum of
(per anniversary year)
On your first $2,220 of eligible prescription costs 90% $2,000
On your next $6,000 of eligible prescription costs 100% $6,000
Total benefits payable per anniversary year $8,000
 

      
      Exclusions - Smoking cessation drugs, over-the-counter drugs, and drugs not requiring a prescription.      
     
Dental		      
 
     
  • Dental coverage is for fillings, cleanings, scalings, examinations, polishing and certain extractions
  • Recall visits every 6 months
  Percentage Paid To a maximum of
(per anniversary year)
On your first $500 of:
examinations, diagnostic services		 100%* $500
On your next $700 of:
ALL Ongoing Maintenance Services		 60% $420
Total benefits payable per anniversary year $920

*Note: 100% for examinations, scaling and diagnostic services only. For all other Ongoing Maintenance Services, percentage paid is 90%.

The following six dental services have a combined first anniversary year maximum of $400, and a combined 3 consecutive years maximum of $1,250. For orthodontics, crowns, bridges and dentures, no benefit is available until Year 3. The payment percentage increase from the effective date of the contract is as follows:

    Year 1     Year 2     Year 3 & beyond  
Oral Surgery 60% 60% 80%
Periodontics 60% 60% 80%
Endodontics (Root Canal) 60% 60% 80%
Orthodontics 0% 0% 60%
Crowns, Bridges 0% 0% 60%
Dentures 0% 0% 60%
 

      
      Coverages are designed to concur with your current provincial Dental Association Fee Guide for General Practitioners. The Flexcare ComboPlus Dental coverage will be adjusted to match any increases in the fee guide.

The following Core benefits are also included with ComboPlus Enhanced:

      
     
Vision (Basic)		      
 
     
  • $100 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery
  • $30 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)
  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.
      
      No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.      
     
Extended Health Care (Basic)		      
 
     
  • $250,000 lifetime maximum
  • Best Doctors® Solutions Services - upon diagnosis of a serious illness or injury, you can receive an evaluation of your medical records by world-class specialists who confirm the initial diagnosis and recommend appropriate treatment options. This fast, yet indepth review can reduce potentially serious complications from a misdiagnosis and help your local physician determine the proper course of action. In addition to medical advice, Best Doctors provides the following services: treatment planning, identification of the most appropriate care provider, and care management.
  • Chiropractic X-ray - $35 maximum per anniversary year
  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $20 maximum per visit, 20 visit maximum per discipline per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)
  • Psychologist or approved social worker - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year
  • Physiotherapist - $250 maximum per anniversary year
  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment - $3,000 maximum per anniversary year, for each of these three categories of benefits separately
Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.
  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year
  • Lifeline® Personal Response Service - lifetime maximum of 3 months of service, not including installation fee
  • Accidental Dental - $2,000 maximum per anniversary year
  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)
  • Hearing Aid - $400 maximum per 4 consecutive benefit years
      
      Travel      
 
     
  • $5 million emergency health coverage for trips lasting a maximum of 9 days.
  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.
      
      Note: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 65 and over.      
     
Accidental Death & Dismemberment		      
 
     
  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a child
  • Additional coverage can be purchased as an Add-On.
      
      Survivor Benefit      
 
     
  • Provides for coverage to be continued for 1 year, following the death of an adult policyholder.
      
     
Anniversary Year means the consecutive 12 months following the Effective Date of the Agreement, and each 12 month period thereafter.

Benefit Year means the 12 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.
     

Back to Top ⇑

      DrugPlusTM Basic
(Medical questionnaire required) 		     
     
Prescription Drugs		      
 
     
  • Generic drug plan (name brand allowed, but price paid will be deemed to be the generic equivalent price)
  • Full coverage of reasonable and customary dispensing fees
  Percentage Paid To a maximum of
(per anniversary year)
On your first $765 of eligible prescription costs 70% $535
On your next $3,850 of eligible prescription costs 90% $3,465
Total benefits payable per anniversary year $4,000
     
      Exclusions - Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, and drugs not requiring a prescription.

The following Core benefits are also included with DrugPlus Basic:		      
     
Vision (Basic)		      
 
     
  • $100 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery.
  • $30 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)
  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.
      
      No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.      
     
Extended Health Care (Basic)		      
 
     
  • $250,000 lifetime maximum
  • Best Doctors® Solutions Services - upon diagnosis of a serious illness or injury, you can receive an evaluation of your medical records by world-class specialists who confirm the initial diagnosis and recommend appropriate treatment options. This fast, yet indepth review can reduce potentially serious complications from a misdiagnosis and help your local physician determine the proper course of action. In addition to medical advice, Best Doctors provides the following services: treatment planning, identification of the most appropriate care provider, and care management.
  • Chiropractic X-ray - $35 maximum per anniversary year
  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $20 maximum per visit, 20 visit maximum per discipline per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)
  • Psychologist or approved social worker - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year
  • Physiotherapist - $250 maximum per anniversary year
  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment - $3,000 maximum per anniversary year, for each of these three categories of benefits separately
Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.
  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year
  • Lifeline® Personal Response Service - lifetime maximum of 3 months of service, not including installation fee
  • Accidental Dental - $2,000 maximum per anniversary year
  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)
  • Hearing Aid - $400 maximum per 4 consecutive benefit years
      
      Travel      
 
     
  • $5 million emergency health coverage for trips lasting a maximum of 9 days.
  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.
      
      Note: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 65 and over.      
     
Accidental Death & Dismemberment		      
 
     
  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a child
  • Additional coverage can be purchased as an Add-On.
      
      Survivor Benefit      
 
     
  • Provides for coverage to be continued for 1 year, following the death of an adult policyholder.
      
     
Anniversary Year means the consecutive 12 months following the Effective Date of the Agreement, and each 12 month period thereafter.

Benefit Year means the 12 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.
     

Back to Top ⇑

      DrugPlusTM Enhanced
(Medical questionnaire required) 		     
     
Prescription Drugs		      
 
     
  • Name brand or generic drugs, including birth control and fertility drugs
  • Full coverage of reasonable and customary dispensing fees
  Percentage Paid To a maximum of
(per anniversary year)
On your first $2,220 of eligible prescription costs 90% $2,000
On your next $6,000 of eligible prescription costs 100% $6,000
Total benefits payable per anniversary year $8,000

 

      
      Exclusions - Smoking cessation drugs, over-the-counter drugs, and drugs not requiring a prescription.

The following Core benefits are also included with DrugPlus Enhanced:		      
     
Vision (Basic)		      
 
     
  • $100 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery.
  • $30 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)
  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.
      
      No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.      
     
Extended Health Care (Basic)		      
 
     
  • $250,000 lifetime maximum
  • Best Doctors® Solutions Services - upon diagnosis of a serious illness or injury, you can receive an evaluation of your medical records by world-class specialists who confirm the initial diagnosis and recommend appropriate treatment options. This fast, yet indepth review can reduce potentially serious complications from a misdiagnosis and help your local physician determine the proper course of action. In addition to medical advice, Best Doctors provides the following services: treatment planning, identification of the most appropriate care provider, and care management.
  • Chiropractic X-ray - $35 maximum per anniversary year
  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $20 maximum per visit, 20 visit maximum per discipline per anniversary year. (payable only after Government Health Insurance Plan maximums have been reached, if applicable)
  • Psychologist or approved social worker - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year
  • Physiotherapist - $250 maximum per anniversary year
  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment - $3,000 maximum per anniversary year, for each of these three categories of benefits separately
Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.
  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year
  • Lifeline® Personal Response Service - lifetime maximum of 3 months of service, not including installation fee
  • Accidental Dental - $2,000 maximum per anniversary year
  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)
  • Hearing Aid - $400 maximum per 4 consecutive benefit years
      
      Travel      
 
     
  • $5 million emergency health coverage for trips lasting a maximum of 9 days.
  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.
      
      Note: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 65 and over.      
     
Accidental Death & Dismemberment		      
 
     
  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a child
  • Additional coverage can be purchased as an Add-On.
      
      Survivor Benefit      
 
     
  • Provides for coverage to be continued for 1 year, following the death of an adult policyholder.
      
     
Anniversary Year means the consecutive 12 months following the Effective Date of the Agreement, and each 12 month period thereafter.

Benefit Year means the 12 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.
     

Back to Top ⇑

      DentalPlusTM Basic
(No medical questionnaire required) 		     
     
Dental		      
 
     
  • Dental coverage is for fillings, cleanings, scalings, examinations, polishing and certain extractions
  • Recall visits every 9 months
  Percentage Paid To a maximum of
(per anniversary year)
Year 1
On your first $1,150 of eligible services 50% $575
Total benefits payable for the first anniversary year $575
Year 2 and beyond
   
On your first $300 of eligible services 80% $240
On your next $850 of eligible services 50%    $425
Total benefits payable for your second and subsequent anniversary years $665
 

      
      Coverages are designed to concur with your current provincial Dental Association Fee Guide for General Practitioners. The Flexcare DentalPlus coverage will be adjusted to match any increases in the fee guide.

The following Core benefits are also included with DentalPlus Basic:

      
     
Vision (Basic)		      
 
     
  • $100 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery
  • $30 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)
  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.
      
      No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.      
     
Extended Health Care (Basic)		      
 
     
  • $250,000 lifetime maximum
  • Best Doctors® Solutions Services - upon diagnosis of a serious illness or injury, you can receive an evaluation of your medical records by world-class specialists who confirm the initial diagnosis and recommend appropriate treatment options. This fast, yet indepth review can reduce potentially serious complications from a misdiagnosis and help your local physician determine the proper course of action. In addition to medical advice, Best Doctors provides the following services: treatment planning, identification of the most appropriate care provider, and care management.
  • Chiropractic X-ray - $35 maximum per anniversary year
  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $20 maximum per visit, 20 visit maximum per discipline per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable).
  • Psychologist or approved social worker - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year
  • Physiotherapist - $250 maximum per anniversary year
  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment - maximum per anniversary year for each of these three categories of benefits separately, is according to the following table:
  Year 1     Year 2     Year 3     Year 4     Year 5+  
$1,000 $1,300 $1,500 $1,700 $3,000

Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.
  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year
  • Lifeline® Personal Response Service - lifetime maximum of 3 months of service, not including installation fee
  • Accidental Dental - $2,000 maximum per anniversary year
  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)
  • Hearing Aid - $400 maximum per 4 consecutive benefit years
      
      Travel      
 
     
  • $5 million emergency health coverage for trips lasting a maximum of 9 days.
  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.
      
      Note: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 65 and over.      
     
Accidental Death & Dismemberment		      
 
     
  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a child
  • Additional coverage can be purchased as an Add-On.
      
      Survivor Benefit      
 
     
  • Provides for coverage to be continued for 1 year, following the death of an adult policyholder. Available 1 year after policy effective date.
      
     
Anniversary Year means the consecutive 12 months following the Effective Date of the Agreement, and each 12 month period thereafter.

Benefit Year means the 12 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.
     

Back to Top ⇑

      DentalPlusTM Enhanced
(No medical questionnaire required) 		     
     
Dental		      
 
     
  • Dental coverage is for fillings, cleanings, scalings, examinations, polishing and certain extractions
  • Recall visits every 6 months
  Percentage Paid To a maximum of
(per anniversary year)
Year 1
On your first $1,200 of eligible services 60% $720
Total benefits payable for the first anniversary year $720
 
Year 2 and beyond
On your first $500 of eligible services 90% $450
On your next $700 of eligible services 60%    $420
Total benefits payable for your second and subsequent anniversary years $870

The following six dental services have a combined maximum of $1,250 per 3 year period. For oral surgery, periodontics and endodontics (root canal), benefits are available beginning Year 2; for orthodontics, crowns, bridges and dentures, no benefit is available until Year 3. The payment percentage increase from the effective date of the contract is as follows:

    Anniversary Year 1     Anniversary Year 2     Anniversary Year 3 & beyond  
Oral Surgery 0% 60% 80%
Periodontics 0% 60% 80%
Endodontics (Root Canal) 0% 60% 80%
Orthodontics 0% 0% 60%
Crowns, Bridges 0% 0% 60%
Dentures 0% 0% 60%
     
      Coverages are designed to concur with your current provincial Dental Association Fee Guide for General Practitioners. The Flexcare DentalPlus coverage will be adjusted to match any increases in the fee guide.

The following Core benefits are also included with DentalPlus Enhanced:

      
     
Vision (Basic)		      
 
     
  • $100 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery
  • $30 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)
  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.
      
      No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more      
     
Extended Health Care (Basic)		      
 
     
  • $250,000 lifetime maximum
  • Best Doctors® Solutions Services - upon diagnosis of a serious illness or injury, you can receive an evaluation of your medical records by world-class specialists who confirm the initial diagnosis and recommend appropriate treatment options. This fast, yet indepth review can reduce potentially serious complications from a misdiagnosis and help your local physician determine the proper course of action. In addition to medical advice, Best Doctors provides the following services: treatment planning, identification of the most appropriate care provider, and care management.
  • Chiropractic X-ray - $35 maximum per anniversary year
  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $20 maximum per visit, 20 visit maximum per discipline per anniversary year. (payable only after Government Health Insurance Plan maximums have been reached, if applicable).
  • Psychologist or approved social worker - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year
  • Physiotherapist - $250 maximum per anniversary year
  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment - maximum per anniversary year for each of these three categories of benefits separately, is according to the following table:
  Year 1     Year 2     Year 3     Year 4     Year 5+  
$1,000 $1,300 $1,500 $1,700 $3,000

Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.
  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year
  • Lifeline® Personal Response Service - lifetime maximum of 3 months of service, not including installation fee
  • Accidental Dental - $2,000 maximum per anniversary year
  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)
  • Hearing Aid - $400 maximum per 4 consecutive benefit years
      
      Travel      
 
     
  • $5 million emergency health coverage for trips lasting a maximum of 9 days.
  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.
      
      Note: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 65 and over.      
     
Accidental Death & Dismemberment		      
 
     
  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a child
  • Additional coverage can be purchased as an Add-On.
      
      Survivor Benefit      
 
     
  • Provides for coverage to be continued for 1 year, following the death of an adult policyholder. Available 1 year after policy effective date.
      
     
Anniversary Year means the consecutive 12 months following the Effective Date of the Agreement, and each 12 month period thereafter.

Benefit Year means the 12 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.
     

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                                            Revised: October 02, 2009