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<< Back to: Manulife Financial Health & Dental Plans

 

Manulife Financial
FlexCare Health & Dental Insurance Plans

Manulife FlexCare Health & Dental Core Plans let you choose dental coverage, drug coverage or a combination of both.

With each Core Plan you'll also receive coverage for registered specialists, travel emergencies, accidental death & dismemberment and more.

You can enhance your Flexcare Core plan coverage using Add-Ons riders.

Hospitalization benefits and unlimited prescription drugs coverage is also available with Flexcare Stand-Alone options.

 

 

 

 

Flexcare Core Plans : Summary of Benefits

 

 

Health & Dental Plans

Drug Plans

Dental Plans
(no medical questionnaire)
 
  ComboPlus  Starter
(no medical questionnaire)
 

 DrugPlus  Basic

 

DentalPlus  Basic

 
 

ComboPlus  Basic

ComboPlus  Enhanced

  DrugPlus  Enhanced   DentalPlus  Enhanced  

 

Note: all coverage amounts are on a per person basis

 

 



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 $750 of eligible prescription cost to a maximum of $525 in coverage (70% of $750) per year

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

NOTE: Prescription drug coverage is based on Calendar Year for residents of British Columbia and Saskatchewan. For all other provinces, coverage is based on Anniversary Year.

 

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)

  • Lifetime maximum - $250,000 for age under 65 and $260,000 for age 65 and over

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist, Dietitian - $25 maximum per visit, 20 visit maximum per discipline per anniversary year

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Psychologist, Psychotherapist or Clinical Counsellor - $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 person per anniversary year for each of these three categories of benefits separately, is according to the following table:

For age under 65

  Year 1  

  Year 2  

  Year 3  

  Year 4  

  Year 5+  

$1,000

$1,300

$1,500

$1,700

$3,000

 

For age 65 and over

  Year 1  

  Year 2  

  Year 3  

  Year 4  

  Year 5+  

$1,100

$1,500

$1,700

$2,000

$3,500

  • Custom-made Orthotics - $225 maximum per person per anniversary year

  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum for age under 65 and 15 visit maximum for age 65 and over per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years

  • Accidental Dental - $2,000 maximum per person per anniversary year

  • Ambulance - unlimited ground and air transportation

  • Hearing Aid - $400 maximum per person for age under 65 and $500 maximum per person for age 65 and over per 4 consecutive benefit years

Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.

 

Vision Care

  • $150 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery

  • $70 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

Travel

  • $5 million emergency health coverage for trips lasting a maximum of 9 days. (A $100 deductible applies per claim).

  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.

Note: Coverage may be limited or excluded for any illness or condition which first manifested itself within the 9 month period preceding the effective date of coverage. Not available to persons age 70 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

 

 

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 year)

On your first $750 of eligible prescription costs

70%

$525

On your next $4,972 of eligible prescription costs

90%

$4,475

Total benefits payable per year

$5,000

 

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

 

NOTE: Prescription drug coverage is based on Calendar Year for residents of British Columbia and Saskatchewan. For all other provinces, coverage is based on Anniversary Year.

 

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 $400 of eligible services

80%

$320

On your next $860 of eligible services

50%

   $430

Total benefits payable per anniversary year

$750


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

  • $250 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery

  • $70 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

Extended Health Care

  • Lifetime maximum - $250,000 for age under 65 and $260,000 for age 65 and over

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist, Dietition - $25 maximum per visit, 20 visit maximum per discipline per anniversary year

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Psychologist, Psychotherapist or Clinical Counsellor - $80 maximum first visit, $65 maximum subsequent visits, 15 visit maximum per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment : under age 65 - 4,000 maximum and age 65 and over - $4,500  per anniversary year, for each of these three categories of benefits separately.

  • Custom-made Orthotics - $225 maximum per person per anniversary year

  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum for age under 65 and 15 visit maximum for age 65 and over per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground and air transportation

  • Hearing Aid - $400 maximum per person for age under 65 and $500 maximum per person for age 65 and over per 4 consecutive benefit years

Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.

 

Travel

  • $5 million emergency health coverage for trips lasting a maximum of 9 days. (A $100 deductible applies per claim.)

  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.

Note: Coverage may be limited or excluded for any illness or condition which first manifested itself within the 9 month period preceding the effective date of coverage. Not available to persons age 70 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.

 

ComboPlusTM Enhanced

(Medical questionnaire required)

 

  Prescription Drugs

  • Name brand or generic drugs, including birth control drugs

  • Full coverage of reasonable and customary dispensing fees

 

Percentage Paid

To a maximum of
(per year)

On your first $2,222 of eligible prescription costs

100%

$2,000

On your next $8,000 of eligible prescription costs

90%

$8,000

Total benefits payable per year

$10,000

 

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

 

NOTE: Prescription drug coverage is based on Calendar Year for residents of British Columbia and Saskatchewan. For all other provinces, coverage is based on Anniversary Year.

 

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 eligible services

100%

$500

On your next $700 of eligible services

60%

   $420

Total benefits payable per anniversary year

$920

 

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 2. 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%

60%

60%

Crowns, Bridges

0%

60%

60%

Dentures

0%

60%

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

  • $250 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery

  • $70 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

Extended Health Care

  • Lifetime maximum - $250,000 for age under 65 and $260,000 for age 65 and over

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist, Dietitian - $25 maximum per visit, 20 visit maximum per discipline per anniversary year

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Psychologist, Psychotherapist or Clinical Counsellor - $80 maximum first visit, $65 maximum subsequent visits, 15 visit maximum per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment : under age 65 - 4,000 maximum and age 65 and over - $4,500  per anniversary year, for each of these three categories of benefits separately.

  • Custom-made Orthotics - $225 maximum per person per anniversary year

  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum for age under 65 and 15 visit maximum for age 65 and over per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground and air transportation

  • Hearing Aid - $400 maximum per person for age under 65 and $500 maximum per person for age 65 and over per 4 consecutive benefit years

  • Healthcare Online: Healthcare Online provides 24/7 access to healthcare professionals remotely via web, mobile applications, and phone. Clinicians include dietitians, physicians, nurses, nurse practitioners, social workers and psychologists. The service provides easy access to lab results, referrals, and prescriptions or refills that are sent directly to the pharmacy for pick up or delivery.

Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.

 

Travel

  • $5 million emergency health coverage for trips lasting a maximum of 9 days. (A $100 deductible applies per claim.)

  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.

Note: Coverage may be limited or excluded for any illness or condition which first manifested itself within the 9 month period preceding the effective date of coverage. Not available to persons age 70 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 year)

On your first $750 of eligible prescription costs

70%

$525

On your next $4,972 of eligible prescription costs

90%

$4,475

Total benefits payable per anniversary year

$5,000

 

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

 

NOTE: Prescription drug coverage is based on Calendar Year for residents of British Columbia and Saskatchewan. For all other provinces, coverage is based on Anniversary Year.

 

The following Core benefits are also included with DrugPlus Basic:

 

Vision

  • $250 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery

  • $70 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

Extended Health Care

  • Lifetime maximum - $250,000 for age under 65 and $260,000 for age 65 and over

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist, Dietitian - $25 maximum per visit, 20 visit maximum per discipline per anniversary year

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Psychologist, Psychotherapist or Clinical Counsellor - $80 maximum first visit, $65 maximum subsequent visits, 15 visit maximum per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment : under age 65 - 4,000 maximum and age 65 and over - $4,500  per anniversary year, for each of these three categories of benefits separately.

  • Custom-made Orthotics - $225 maximum per person per anniversary year

  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum for age under 65 and 15 visit maximum for age 65 and over per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground and air transportation

  • Hearing Aid - $400 maximum per person for age under 65 and $500 maximum per person for age 65 and over per 4 consecutive benefit years

Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.

Travel

  • $5 million emergency health coverage for trips lasting a maximum of 9 days. (A $100 deductible applies per claim.)

  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.

Note: Coverage may be limited or excluded for any illness or condition which first manifested itself within the 9 month period preceding the effective date of coverage. Not available to persons age 70 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 drugs

  • Full coverage of reasonable and customary dispensing fees

 

Percentage Paid

To a maximum of
(per year)

On your first $2,222 of eligible prescription costs

100%

$2,000

On your next $8,000 of eligible prescription costs

90%

$8,000

Total benefits payable per year

$10,000

 

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

 

NOTE: Prescription drug coverage is based on Calendar Year for residents of British Columbia and Saskatchewan. For all other provinces, coverage is based on Anniversary Year.

 

The following Core benefits are also included with DrugPlus Enhanced:

 

Vision

  • $250 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery

  • $70 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

Extended Health Care

  • Lifetime maximum - $250,000 for age under 65 and $260,000 for age 65 and over

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist, Dietitian - $25 maximum per visit, 20 visit maximum per discipline per anniversary year

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Psychologist, Psychotherapist or Clinical Counsellor - $80 maximum first visit, $65 maximum subsequent visits, 15 visits maximum per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment : under age 65 - 4,000 maximum and age 65 and over - $4,500  per anniversary year, for each of these three categories of benefits separately.

  • Custom-made Orthotics - $225 maximum per person per anniversary year

  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum for age under 65 and 15 visit maximum for age 65 and over per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground and air transportation

  • Hearing Aid - $400 maximum per person for age under 65 and $500 maximum per person for age 65 and over per 4 consecutive benefit years

  • Healthcare Online: Healthcare Online provides 24/7 access to healthcare professionals remotely via web, mobile applications, and phone. Clinicians include dietitians, physicians, nurses, nurse practitioners, social workers and psychologists. The service provides easy access to lab results, referrals, and prescriptions or refills that are sent directly to the pharmacy for pick up or delivery.

Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.

Travel

  • $5 million emergency health coverage for trips lasting a maximum of 9 days. (A $100 deductible applies per claim.)

  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.

Note: Coverage may be limited or excluded for any illness or condition which first manifested itself within the 9 month period preceding the effective date of coverage. Not available to persons age 70 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 $400 of eligible services

80%

$320

On your next $860 of eligible services

50%

   $430

Total benefits payable for your second and subsequent anniversary years

$750


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 DentalPlus Basic:

 

Vision

  • $250 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery

  • $70 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

Extended Health Care

  • Lifetime maximum - $250,000 for age under 65 and $260,000 for age 65 and over

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist, Dietitian - $25 maximum per visit, 20 visit maximum per discipline per anniversary year

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Psychologist, Psychotherapist or Clinical Counsellor - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per person per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment – maximum per person per anniversary year for each of these 3 categories of benefits separately, is according to the following table:

For age under 65

  Year 1  

  Year 2  

  Year 3  

  Year 4  

  Year 5+  

$1,000

$1,300

$1,500

$1,700

$3,000

 

For age 65 and over

  Year 1  

  Year 2  

  Year 3  

  Year 4  

  Year 5+  

$1,100

$1,500

$1,700

$2,000

$3,500

  • Custom-made Orthotics - $225 maximum per person per anniversary year

  • Speech Pathologist/Therapist – $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum for age under 65 and 15 visit maximum for age 65 and over per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground and air transportation

  • Hearing Aid - $400 maximum per person for age under 65 and $500 maximum per person for age 65 and over per 4 consecutive benefit years

Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.

 

Travel

  • $5 million emergency health coverage for trips lasting a maximum of 9 days. (A $100 deductible applies per claim.)

  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.

Note: Coverage may be limited or excluded for any illness or condition that first manifested itself within the 9 month period immediately preceding each departure date. Not available to persons age 70 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

70%

$840

Total benefits payable for the first anniversary year

$840

 

Year 2 and beyond

On your first $500 of eligible services

100%

$500

On your next $700 of eligible services

60%

   $420

Total benefits payable for your second and subsequent anniversary years

$920

 

The following 6 dental services have a combined maximum of $1,250 per person per 3-year period. For oral surgery, periodontics and endodontics (root canal), orthodontics, crowns, bridges and dentures, no benefit is available until Year 2. The payment percentage increases from the effective date of the contract as follows:

 

 

  Year 1  

  Year 2  

  Year 3 & beyond  

Oral Surgery

0%

60%

80%

Periodontics

0%

60%

80%

Endodontics (Root Canal)

0%

60%

80%

Orthodontics

0%

60%

60%

Crowns, Bridges

0%

60%

60%

Dentures

0%

60%

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 DentalPlus Enhanced:

 

Vision

  • $250 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery

  • $70 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

Extended Health Care

  • Lifetime maximum - $250,000 for age under 65 and $260,000 for age 65 and over

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist, Dietitian - $25 maximum per visit, 20 visit maximum per discipline per anniversary year

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Psychologist, Psychotherapist or Clinical Counsellor - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per person per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment – maximum per person per anniversary year for each of these 3 categories of benefits separately, is according to the following table:

For age under 65

  Year 1  

  Year 2  

  Year 3  

  Year 4  

  Year 5+  

$1,000

$1,300

$1,500

$1,700

$3,000

 

For age 65 and over

  Year 1  

  Year 2  

  Year 3  

  Year 4  

  Year 5+  

$1,100

$1,500

$1,700

$2,000

$3,500

  • Custom-made Orthotics - $225 maximum per person per anniversary year

  • Speech Pathologist/Therapist – $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum for age under 65 and 15 visit maximum for age 65 and over per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground and air transportation

  • Hearing Aid - $400 maximum per person for age under 65 and $500 maximum per person for age 65 and over per 4 consecutive benefit years

  • Healthcare Online: Healthcare Online provides 24/7 access to healthcare professionals remotely via web, mobile applications, and phone. Clinicians include dietitians, physicians, nurses, nurse practitioners, social workers and psychologists. The service provides easy access to lab results, referrals, and prescriptions or refills that are sent directly to the pharmacy for pick up or delivery.

Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.

 

Travel

  • $5 million emergency health coverage for trips lasting a maximum of 9 days. (A $100 deductible applies per claim.)

  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.

Note: Coverage may be limited or excluded for any illness or condition that first manifested itself within the 9 month period immediately preceding each departure date. Not available to persons age 70 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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All plans (except those indicated "No medical Questionnaire required ")are medically underwritten, which means you will have to answer several medical questions when applying for this insurance. After that, your application has to be approved by the insurance company. If approved, coverage is effective the first day of the month following final approval of the application.

 

 

NOTE: The product related information is for illustration purpose only. For more detailed information about Health & Dental insurance plans, please select your province:

Alberta  | Ontario | Newfoundland and Labrador | Prince Edward Island

Manitoba |  New Brunswick | Nova Scotia

British Columbia | Saskatchewan

 

Please call at 1-877-443-0101, 416-493-0101 to get a quote and your personal illustration for the plan selected.

 

 

 

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Revised: April 27, 2021.