Note: all coverage amounts are on a per person basis
ComboPlusTMStarter
(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.
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.
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.
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.
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.
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.
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.
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:
