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The healthcare plans available to group clients provide comprehensive coverage to supplement provincial medical plans. A variety of options let you design a plan to fit your specific needs.
| Healthcare Benefits | |
|---|---|
| Single | $0, $25, $50, $100 or $250 |
| Family | x1 or x2 single |
| Hospital Coverage | |
|---|---|
| Coinsurance | 50%, 60%, 70%, 80%, 90% or 100% |
| Hospital Room Coverage | Covered |
| Ambulance | Covered |
| Acute/Convalescent Care | Covered |
| Nursing Maximum | $5,000, $10,000, $15,000/12 months |
| Chronic Hospital/Nursing | Optional: $25 per day, 100% coinsurance |
| Other Healthcare Coverage | |
|---|---|
| Coinsurance | 50%, 60%, 70%, 80%, 90% or 100% |
| Paramedical Practitioners (Optional) | Basic package: Chiropractors, Physiotherapists, Psychologists/Social Workers |
| Optional package: Podiatrists, Naturopaths, Osteopaths, Speech Therapists, Dietitians, Acupuncturists and Massage Therapists |
|
| 3 - 19 lives: Basic package or Basic plus Optional package | |
| 20+ lives: Basic package or Basic plus any or all from Optional package | |
| Paramedical Maximum | $300, $500 or $750/person/practitioner/12 months |
| Medical Supplies | Included Orthopedic Shoes - $300/12 months Hearing Aids - $700/5 years |
| Out of Country Coverage | 100% coinsurance - 60 day per trip maximum |
| Global Medical Assistance | Included |
| Medical Travel in Canada | Optional |
| Preferred Vision Service | Included - up to 20% discount on lenses/frames/contacts |
| Visioncare | |
|---|---|
| Lenses/Frames/Contacts | $100, $150, $200, $250 (per 24 months, optional 12 months for children) |
| Eye Exams | Covered if no Provincial Plan coverage |
| Coinsurance | 100% or same as other healthcare services |
| Deductible | Included as part of healthcare, unless 100% coinsurance, then the deductible is $0 |
Assure Health Inc. (AHI) Drug Card
| Drug Plans | |
|---|---|
| Drug Card Plans | Plan 80 - prescribed drugs Plan 81 - drugs requiring a prescription Plan 60 - prescribed drugs excluding smoking cessation products Plan 61 - drugs requiring a prescription excluding smoking cessation products |
| Per prescription deductible | $0, $1, $2, $5, $10, dispensing fee |
| Coinsurance | 50%, 60%, 70%, 80%, 90% or 100% |
| Generic Coverage | Optional |
| Managed Drug Care | Base Plan: Coverage for drugs on provincial formulary Supplemental Plan: Plan 80, 81, 60, 61 Generic Note: Must have lower coinsurance and/or higher deductible than Base Plan |
| Deferred Drug Card (Québec Only) | $50/30 days or $75/90 days |
Dentalcare coverage is available in three optional plan designs:
Each plan offers a wide variety of coinsurance options and plan maximums. As an additional option, clients with Major coverage may elect a separate bridge and denture maximum.
Our group plans also offer numerous combinations of dental deductibles. Our deductible arrangements can allow your company to share a common deductible between healthcare and dentalcare expenses.
Our standard deductible carryover provision waives the deductible in the current year if your client satisfied the previous year's deductible in the last three months of that calendar year.
| Dentalcare Benefits | |
|---|---|
| Basic Treatment | Oral Exams, X-rays, Fluoride, Sealant, Fillings, Extraction, Endodontics, Periodontics, Oral Surgery, Injections & Anesthesia |
| Cleanings | Standard: 2 in 12 months Options: 1 in 9 months or 1 in 12 months |
| Preventative Scaling | Standard: 14 units/12 months Options: 10 units or 6 units, 12 months |
| Major Treatment | Crowns, Onlays, Dentures, Bridgework & Denture Related Surgery |
| Orthodontics (Children under 18 years) | Diagnostic services/Orthodontic appliances |
| Adult Orthodontics | Optional: 20+ lives |
| Oral Hygiene Instruction | Optional |
| Prior Extraction Limitation | Optional |
| Deductibles | Single: $0, $25, $50, $100, $250 Family: 1x or 2x single |
| Coinsurance | Basic: 50%, 60%, 70%, 80%, 90% or 100% Major: 50%, 60%, 70%, 80% Orthodontic: 50%, 60% |
| Maximums | Per person, calendar year (s) |
| Basic Only | $1,000, $1,500, $2,000, $2,500, Unlimited |
| Basic and Major | Combined: $750, $1,000, $1,500, $2,000, $2,500 or Unlimited basic and $750, $1,000, $2,000, $2,500 Major or Unlimited basic and Major |
| Bridge and Denture (Optional) | 5 - 9 lives - $750/5 year 10+ lives - $750, $1,000, $1,500, $2,000, $2,500/5 years |
| Orthodontic | $1,000, $1,500, $2,000, $2,500/lifetime |