British Columbia - Repsource - Manulife Financial
British Columbia - Repsource - Manulife Financial
British Columbia - Repsource - Manulife Financial
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DrugPlus TMBasicPrescription Drugs> Generic drug plan (brand-name allowed, benefit paid will be the generic equivalent price)> Full coverage of reasonable and customary dispensing feesPrescription Drug coveragePercentage paidCalendar yearmaximum per personOn your first $750 of eligible prescription costs 70% $525On your next $4,972 of eligible prescription costs 90% $4,475Total benefits payable per person per calendar year $5,000✖Medical UnderwritingRequiredExclusions – Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, erectile dysfunction drugs and drugs not requiringa prescription.The following core benefits are also included with DrugPlus Basic:Vision (Basic)> $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and lasereye surgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.Extended Health Care (Basic)Lifetime Maximum $250,000Health Service Navigator ®Registered Specialists and Therapists: Chiropractor, Chiropodist,Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances, Durable Medical EquipmentCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing AidOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 15-visit maximum per personper anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 10-visit maximum per personper anniversary year$3,500 maximum per person per anniversary year for each of these 3 categoriesof benefits separately$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearExtended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Unlimited ground transportation to hospital and $4,000 maximum for air ambulancetransportation per person per anniversary year$400 maximum per person per 4 consecutive benefit years. PVS discounts offer theadded advantage of a 10% deduction, depending on the province of residence andhearing practitioner participation in the PVS network.Travel> $5,000,000 emergency health coverage per person 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 immediatelypreceding each departure date. Not available to persons age 65 and over.Accidental Death & Dismemberment (Basic)> Up to $25,000 upon the Accidental Death or Dismembermentof an adult under 65 or up to $10,000 for a dependent child.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year, following the death of an adult policyholder.Anniversary Year means the consecutive 12 months following theEffective Date of the Agreement, and each 12-month period thereafter.Benefit Year means the 12-month period following the date a claim fora specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencingJanuary 1 and ending December 31.4
DrugPlus TM Basic – For Seniors 65+Prescription Drugs> Generic drug plan (brand-name allowed, benefit paid will be the generic equivalent price)> Full coverage of reasonable and customary dispensing feesPrescription Drug coverageExclusions – Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, erectile dysfunction drugs and drugs not requiringa prescription.The following core benefits are also included with DrugPlus Basic:✖✖Renewable Coveragefor a LifetimeMedical UnderwritingRequiredVision (Basic)> $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and lasereye surgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.Extended Health Care (Basic)Lifetime Maximum $260,000Health Service Navigator ®Registered Specialists and Therapists: Chiropractor, Chiropodist,Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances, Durable Medical EquipmentCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing AidPercentage paidOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 15-visit maximum per personper anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 15-visit maximum per personper anniversary year$4,000 maximum per person per anniversary year for each of these 3 categoriesof benefits separately$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearExtended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Accidental Death & Dismemberment (Basic)> Up to $10,000 upon the Accidental Death or Dismemberment of an adult 65 and over.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year, following the death of an adult policyholder.Calendar yearmaximum per personOn your first $750 of eligible prescription costs 70% $525On your next $4,972 of eligible prescription costs 90% $4,475Total benefits payable per person per calendar year $5,000Unlimited ground transportation to hospital and $4,000 maximum for air ambulancetransportation per person per anniversary year$500 maximum per person per 4 consecutive benefit years. PVS discounts offer theadded advantage of a 10% deduction, depending on the province of residence andhearing practitioner participation in the PVS network.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-month period following the date a claim for a specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencing January 1 and ending December 31.5
DrugPlus TMEnhancedPrescription Drugs> Brand-name or generic drugs, including birth control and fertility drugs> Full coverage of reasonable and customary dispensing feesPrescription Drug coveragePercentage paidExclusions – Smoking cessation drugs, over-the-counter drugs, erectile dysfunction drugs and drugs not requiring a prescription.Calendar yearmaximum per personOn your first $2,222 of eligible prescription costs 90% $2,000On your next $8,000 of eligible prescription costs 100% $8,000Total benefits payable per person per calendar year $10,000✖Medical UnderwritingRequiredThe following core benefits are also included with DrugPlus Enhanced:Vision (Basic)> $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and lasereye surgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.Extended Health Care (Basic)Lifetime Maximum $250,000Health Service Navigator ®Registered Specialists and Therapists: Chiropractor, Chiropodist,Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances, Durable Medical EquipmentCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing AidOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 15-visit maximum per personper anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 10-visit maximum per personper anniversary year$3,500 maximum per person per anniversary year for each of these 3 categoriesof benefits separately$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearExtended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Unlimited ground transportation to hospital and $4,000 maximum for air ambulancetransportation per person per anniversary year$400 maximum per person per 4 consecutive benefit years. PVS discounts offer theadded advantage of a 10% deduction, depending on the province of residence andhearing practitioner participation in the PVS network.Travel> $5,000,000 emergency health coverage per person 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 immediatelypreceding each departure date. Not available to persons age 65 and over.Accidental Death & Dismemberment (Basic)> Up to $25,000 upon the Accidental Death or Dismembermentof an adult under 65 or up to $10,000 for a dependent child.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year, following the death of an adult policyholder.Anniversary Year means the consecutive 12 months following theEffective Date of the Agreement, and each 12-month period thereafter.Benefit Year means the 12-month period following the date a claim fora specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencingJanuary 1 and ending December 31.6
DrugPlus TM Enhanced – For Seniors 65+Prescription Drugs> Brand-name or generic drugs, including birth control and fertility drugs> Full coverage of reasonable and customary dispensing feesPrescription Drug coverageExclusions – Smoking cessation drugs, over-the-counter drugs, erectile dysfunction drugs and drugs not requiring a prescription.Medical UnderwritingThe following core benefits are also included with DrugPlus Enhanced:RequiredVision (Basic)> $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and lasereye surgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.Extended Health Care (Basic)Lifetime Maximum $260,000Health Service Navigator ®Registered Specialists and Therapists: Chiropractor, Chiropodist,Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances, Durable Medical EquipmentCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing AidPercentage paidOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 15-visit maximum per personper anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 15-visit maximum per personper anniversary year$4,000 maximum per person per anniversary year for each of these 3 categoriesof benefits separately$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearExtended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Accidental Death & Dismemberment (Basic)> Up to $10,000 upon the Accidental Death or Dismemberment of an adult 65 and over.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year, following the death of an adult policyholder.Calendar yearmaximum per personOn your first $2,222 of eligible prescription costs 90% $2,000On your next $8,000 of eligible prescription costs 100% $8,000Total benefits payable per person per calendar year $10,000✖✖Renewable Coveragefor a LifetimeUnlimited ground transportation to hospital and $4,000 maximum for air ambulancetransportation per person per anniversary year$500 maximum per person per 4 consecutive benefit years. PVS discounts offer theadded advantage of a 10% deduction, depending on the province of residence andhearing practitioner participation in the PVS network.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-month period following the date a claim for a specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencing January 1 and ending December 31.7
DentalPlus TMBasicDental> Dental coverage for fillings, cleanings, scalings, examinations, polishing and select extractions> Recall visits every 9 months, per personYear 1Percentage paidAnniversary yearmaximum per personOn your first $1,150 of eligible services 50% $575Total benefits payable per person in your first anniversary year $575Year 2 and beyondOn your first $400 of eligible services 80% $320On your next $860 of eligible services 50% $430Total benefits payable per person in your second and subsequentanniversary years$750Guaranteed to Issue PlanNO MEDICAL UNDERWRITINGREQUIREDCoverages are designed to coincide with your current provincial Dental Association Fee Guide for General Practitioners.The following core benefits are also included with DentalPlus Basic:Vision (Basic)> $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and lasereye surgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.Extended Health Care (Starter)Lifetime Maximum $250,000Health Service Navigator ®Registered Specialists and Therapists: Chiropractor, Chiropodist,Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances, Durable Medical EquipmentCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing AidOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 10-visit maximum per personper anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 10-visit maximum per personper anniversary yearFor each of Homecare & Nursing, Prosthetic Appliances and Durable Medical Equipment:Year 1 Year 2 Year 3 Year 4 Year 5+$1,000 $1,300 $1,500 $1,700 $3,000$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearExtended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Unlimited ground transportation to hospital and $4,000 maximum for air ambulancetransportation per person per anniversary year$400 maximum per person per 4 consecutive benefit years. PVS discounts offer theadded advantage of a 10% deduction, depending on the province of residence andhearing practitioner participation in the PVS network.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-month period following the date a claim for a specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencing January 1 and ending December 31.8
DentalPlus TMBasicTravel> $5,000,000 emergency health coverage per person 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 withinthe 9-month period immediately preceding each departure date. Not available to persons age 65 and over.Accidental Death & Dismemberment (Basic)> Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65 or up to $10,000 fora dependent 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.Guaranteed to Issue PlanNO MEDICAL UNDERWRITINGREQUIRED9
DentalPlus TM Basic – For Seniors 65+Dental> Dental coverage for fillings, cleanings, scalings, examinations, polishing and select extractions> Recall visits every 9 months, per personYear 1Percentage paidAnniversary yearmaximum per personOn your first $1,150 of eligible services 50% $575Total benefits payable per person in your first anniversary year $575Year 2 and beyondOn your first $400 of eligible services 80% $320On your next $860 of eligible services 50% $430Total benefits payable per person in your second and subsequentanniversary yearsCoverages are designed to coincide with your current provincial Dental Association Fee Guide for General Practitioners.$750✖Renewable Coveragefor a LifetimeGuaranteed to Issue PlanNO MEDICAL UNDERWRITINGREQUIREDThe following core benefits are also included with DentalPlus Basic:Vision (Basic)> $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and laser eye surgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.Extended Health Care (Starter)Lifetime Maximum $260,000Health Service Navigator ®Registered Specialists and Therapists: Chiropractor, Chiropodist,Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances, Durable Medical EquipmentCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing AidOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 10-visit maximum per personper anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 15-visit maximum per personper anniversary yearFor each of Homecare & Nursing, Prosthetic Appliances and Durable Medical Equipment:Year 1 Year 2 Year 3 Year 4 Year 5+$1,100 $1,500 $1,700 $2,000 $3,500$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearExtended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Accidental Death & Dismemberment (Basic)> Up to $10,000 upon the Accidental Death or Dismemberment of an adult 65 and over.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year,following the death of an adult policyholder.> Available 1 year after policy effective date.Unlimited ground transportation to hospital and $4,000 maximum for air ambulancetransportation per person per anniversary year$500 maximum per person per 4 consecutive benefit years. PVS discounts offer theadded advantage of a 10% deduction, depending on the province of residence andhearing practitioner participation in the PVS network.Anniversary Year means the consecutive 12 months following theEffective Date of the Agreement, and each 12-month period thereafter.Benefit Year means the 12-month period following the date a claim fora specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencingJanuary 1 and ending December 31.10
DentalPlus TMEnhancedDental> Dental coverage for fillings, cleanings, scalings, examinations, polishing and select extractions> Recall visits every 6 months, per personYear 1Percentage paidAnniversary yearmaximum per personOn your first $1,200 of eligible services 70% $840Total benefits payable per person in your first anniversary year $840Guaranteed to Issue PlanNO MEDICAL UNDERWRITINGREQUIREDYear 2 and beyondOn your first $500 of eligible services 100% $500On your next $700 of eligible services 60% $420Total benefits payable per person in your second and subsequentanniversary years$920The following 6 dental services have a combined maximum of $1,250 per person per 3-year period. For oral surgery, periodontics andendodontics (root canal), benefits are available beginning Year 2; for orthodontics, crowns, bridges and dentures, no benefit is availableuntil Year 3. The payment percentage increases from the effective date of the contract as follows:AnniversaryYear 1AnniversaryYear 2AnniversaryYear 3 & beyondOral 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 coincide with your current provincial Dental Association Fee Guide for General Practitioners.The following core benefits are also included with DentalPlus Enhanced:Vision (Basic)> $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and laser eyesurgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.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-month period following the date a claim for a specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencing January 1 and ending December 31.11
DentalPlus TMEnhancedExtended Health Care (Starter)Lifetime Maximum $250,000Health Service Navigator ®Registered Specialists and Therapists:Chiropractor, Chiropodist, Osteopath, Naturopath,Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances,Durable Medical EquipmentCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing AidOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 10-visit maximumper person per anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 10-visit maximumper person per anniversary yearFor each of Homecare & Nursing, Prosthetic Appliances and Durable MedicalEquipment: Year 1 Year 2 Year 3 Year 4 Year 5+$1,000 $1,300 $1,500 $1,700 $3,000$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearUnlimited ground transportation to hospital and $4,000 maximum for airambulance transportation per person per anniversary year$400 maximum per person per 4 consecutive benefit years. PVS discountsoffer the added advantage of a 10% deduction, depending on the province ofresidence and hearing practitioner participation in the PVS network.Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Guaranteed to Issue PlanNO MEDICAL UNDERWRITINGREQUIREDTravel> $5,000,000 emergency health coverage per person 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 immediatelypreceding each departure date. Not available to persons age 65 and over.Accidental Death & Dismemberment (Basic)> Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65 or up to $10,000 for a dependent child.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year, following the death of an adult policyholder.> Available 1 year after policy effective date.12
DentalPlus TM Enhanced – For Seniors 65+Dental> Dental coverage for fillings, cleanings, scalings, examinations, polishing and select extractions> Recall visits every 6 months, per personYear 1Percentage paidAnniversary yearmaximum per personOn your first $1,200 of eligible services 70% $840Total benefits payable per person in your first anniversary year $840Year 2 and beyondOn your first $500 of eligible services 100% $500On your next $700 of eligible services 60% $420Total benefits payable per person in your second and subsequentanniversary years$920✖Renewable Coveragefor a LifetimeGuaranteed to Issue PlanNO MEDICAL UNDERWRITINGREQUIREDThe following 6 dental services have a combined maximum of $1,250 per person per 3-year period. For oral surgery, periodontics andendodontics (root canal), benefits are available beginning Year 2; for orthodontics, crowns, bridges and dentures, no benefit is availableuntil Year 3. The payment percentage increases from the effective date of the contract as follows:AnniversaryYear 1AnniversaryYear 2AnniversaryYear 3 & beyondOral 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 coincide with your current provincial Dental Association Fee Guide for General Practitioners.The following core benefits are also included with DentalPlus Enhanced:Vision (Basic)> $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and laser eyesurgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.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-month period following the date a claim for a specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencing January 1 and ending December 31.13
DentalPlus TM Enhanced – For Seniors 65+Extended Health Care (Starter)Lifetime Maximum $260,000Health Service Navigator ®Registered Specialists and Therapists:Chiropractor, Chiropodist, Osteopath, Naturopath,Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances,Durable Medical EquipmentCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing AidOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 10-visit maximumper person per anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 15-visit maximumper person per anniversary yearFor each of Homecare & Nursing, Prosthetic Appliances and Durable MedicalEquipment: Year 1 Year 2 Year 3 Year 4 Year 5+$1,100 $1,500 $1,700 $2,000 $3,500$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearUnlimited ground transportation to hospital and $4,000 maximum for airambulance transportation per person per anniversary year$500 maximum per person per 4 consecutive benefit years. PVS discountsoffer the added advantage of a 10% deduction, depending on the province ofresidence and hearing practitioner participation in the PVS network.Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.✖Renewable Coveragefor a LifetimeGuaranteed to Issue PlanNO MEDICAL UNDERWRITINGREQUIREDAccidental Death & Dismemberment (Basic)> Up to $10,000 upon the Accidental Death or Dismemberment of an adult 65 and over.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year, following the death of an adult policyholder.> Available 1 year after policy effective date.14
ComboPlus TMStarterPrescription Drugs> Generic drug plan (brand-name allowed, benefit paid will be the generic equivalent price)> Shared dispensing fee to a maximum of $6.50Prescription Drug coverage15PercentagepaidCalendar yearmaximum per personOn your first $750 of eligible prescription costs (shared dispensing fee inclusive) 70% $525Guaranteed to Issue PlanExclusions – Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, erectile dysfunction drugs and drugs not requiringa prescription.NO MEDICAL UNDERWRITINGREQUIREDDental> 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 per person per anniversary year> Recall visits every 9 months, per personCoverages are designed to coincide with your current provincial Dental Association Fee Guide for General Practitioners.The following core benefits are also included with ComboPlus Starter:Vision (Starter)> $150 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and laser eye surgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.Extended Health Care (Starter)Lifetime Maximum $250,000Health Service Navigator ®Registered Specialists and Therapists: Chiropractor, Chiropodist,Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances, Durable Medical EquipmentCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing AidOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 10-visit maximum per personper anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 10-visit maximum per personper anniversary yearFor each of Homecare & Nursing, Prosthetic Appliances and Durable Medical Equipment:Year 1 Year 2 Year 3 Year 4 Year 5+$1,000 $1,300 $1,500 $1,700 $3,000$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearExtended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Unlimited ground transportation to hospital and $4,000 maximum for air ambulancetransportation per person per anniversary year$400 maximum per person per 4 consecutive benefit years. PVS discounts offer theadded advantage of a 10% deduction, depending on the province of residence andhearing practitioner participation in the PVS network.Travel> $5,000,000 emergency health coverage per person 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 immediatelypreceding each departure date. Not available to persons age 65 and over.Accidental Death & Dismemberment (Basic)> Up to $25,000 upon the Accidental Death or Dismemberment of anadult under 65 or up to $10,000 for a dependent child.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year, following the deathof an adult policyholder.> Available 1 year after policy effective date.Anniversary Year means the consecutive 12 months following theEffective Date of the Agreement, and each 12-month period thereafter.Benefit Year means the 12-month period following the date a claim fora specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencingJanuary 1 and ending December 31.
ComboPlus TM Starter – For Seniors 65+Prescription Drugs> Generic drug plan (brand-name allowed, benefit paid will be the generic equivalent price)> Shared dispensing fee to a maximum of $6.50Prescription Drug coveragePercentagepaidCalendar yearmaximum per personOn your first $750 of eligible prescription costs (shared dispensing fee inclusive) 70% $525Exclusions – Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, erectile dysfunction drugs and drugs not requiringa 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 per person per anniversary year> Recall visits every 9 months, per personCoverages are designed to coincide with your current provincial Dental Association Fee Guide for General Practitioners.✖Renewable Coveragefor a LifetimeGuaranteed to Issue PlanNO MEDICAL UNDERWRITINGREQUIREDThe following core benefits are also included with ComboPlus Starter:Vision (Starter)> $150 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and laser eye surgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.Extended Health Care (Starter)Lifetime Maximum $260,000Health Service Navigator ®Registered Specialists and Therapists: Chiropractor, Chiropodist,Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances, Durable Medical EquipmentCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing AidOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 10-visit maximum per personper anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 15-visit maximum per personper anniversary yearFor each of Homecare & Nursing, Prosthetic Appliances and Durable Medical Equipment:Year 1 Year 2 Year 3 Year 4 Year 5+$1,100 $1,500 $1,700 $2,000 $3,500$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearExtended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Unlimited ground transportation to hospital and $4,000 maximum for air ambulancetransportation per person per anniversary year$500 maximum per person per 4 consecutive benefit years. PVS discounts offer theadded advantage of a 10% deduction, depending on the province of residence andhearing practitioner participation in the PVS network.Accidental Death & Dismemberment (Basic)> Up to $10,000 upon the Accidental Death or Dismemberment ofan adult 65 and over.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year, following the death ofan adult policyholder.> Available 1 year after policy effective date.Anniversary Year means the consecutive 12 months following theEffective Date of the Agreement, and each 12-month period thereafter.Benefit Year means the 12-month period following the date a claim fora specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencingJanuary 1 and ending December 31.16
ComboPlus TMBasicPrescription Drugs> Generic drug plan (brand-name allowed, benefit paid will be the generic equivalent price)> Full coverage of reasonable and customary dispensing feesPrescription Drug coveragePercentagepaidCalendar yearmaximum per personOn your first $750 of eligible prescription costs 70% $525On your next $4,972 of eligible prescription costs 90% $4,475Total benefits payable per person per calendar year $5,000Exclusions – Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, erectile dysfunction drugs and drugsnot requiring a prescription.Dental> Dental coverage is for fillings, cleanings, scalings, examinations, polishing and select extractions> Recall visits every 9 months, per personDental coveragePercentagepaidAnniversary yearmaximum per personOn your first $400 of eligible services 80% $320On your next $860 of eligible services 50% $430Total benefits payable per person per anniversary year $750Coverages are designed to coincide with your current provincial Dental Association Fee Guide for General Practitioners.✖Medical UnderwritingRequiredThe following core benefits are also included with ComboPlus Basic:Vision (Basic)> $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and lasereye surgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.Extended Health Care (Basic)Lifetime Maximum $250,000Health Service Navigator ®Registered Specialists and Therapists: Chiropractor, Chiropodist,Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances, Durable Medical EquipmentCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing AidOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 15-visit maximum per personper anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 10-visit maximum per personper anniversary year$3,500 maximum per person per anniversary year for each of these 3 categoriesof benefits separately$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearExtended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Unlimited ground transportation to hospital and $4,000 maximum for air ambulancetransportation per person per anniversary year$400 maximum per person per 4 consecutive benefit years. PVS discounts offer theadded advantage of a 10% deduction, depending on the province of residence andhearing practitioner participation in the PVS network.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-month period following the date a claim for a specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencing January 1 and ending December 31.17
ComboPlus TMBasicTravel> $5,000,000 emergency health coverage per person 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 withinthe 9-month period immediately preceding each departure date. Not available to persons age 65 and over.✖Medical UnderwritingRequiredAccidental Death & Dismemberment (Basic)> Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65 or up to $10,000 for adependent child.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year, following the death of an adult policyholder.18
ComboPlus TM Basic – For Seniors 65+Prescription Drugs> Generic drug plan (brand-name allowed, benefit paid will be the generic equivalent price)> Full coverage of reasonable and customary dispensing feesPrescription Drug coveragePercentagepaidCalendar yearmaximum per personOn your first $750 of eligible prescription costs 70% $525On your next $4,972 of eligible prescription costs 90% $4,475Total benefits payable per person per calendar year $5,000Exclusions – Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, erectile dysfunction drugs and drugsnot requiring a prescription.Dental> Dental coverage is for fillings, cleanings, scalings, examinations, polishing and select extractions> Recall visits every 9 months, per personDental coveragePercentagepaidAnniversary yearmaximum per personOn your first $400 of eligible services 80% $320On your next $860 of eligible services 50% $430Total benefits payable per person per anniversary year $750Coverages are designed to coincide with your current provincial Dental Association Fee Guide for General Practitioners.✖✖Renewable Coveragefor a LifetimeMedical UnderwritingRequiredThe following core benefits are also included with ComboPlus Basic:Vision (Basic)> $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and laser eye surgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.Extended Health Care (Basic)Lifetime Maximum $260,000Health Service Navigator ®Registered Specialists and Therapists: Chiropractor, Chiropodist,Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances, Durable Medical EquipmentCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing AidOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 15-visit maximum per personper anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 15-visit maximum per personper anniversary year$4,000 maximum per person per anniversary year for each of these 3 categoriesof benefits separately$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearExtended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Unlimited ground transportation to hospital and $4,000 maximum for air ambulancetransportation per person per anniversary year$500 maximum per person per 4 consecutive benefit years. PVS discounts offer theadded advantage of a 10% deduction, depending on the province of residence andhearing practitioner participation in the PVS network.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-month period following the date a claim for a specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencing January 1 and ending December 31.19
ComboPlus TM Basic – For Seniors 65+Accidental Death & Dismemberment (Basic)> Up to $10,000 upon the Accidental Death or Dismemberment of an adult 65 and over.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year, following the death of an adult policyholder.✖Renewable Coveragefor a Lifetime✖Medical UnderwritingRequired20
ComboPlus TMEnhancedPrescription Drugs> Brand-name or generic drugs, including birth control and fertility drugs> Full coverage of reasonable and customary dispensing feesPrescription Drug coveragePercentagepaidCalendar yearmaximum per personOn your first $2,222 of eligible prescription costs 90% $2,000On your next $8,000 of eligible prescription costs 100% $8,000Total benefits payable per person per calendar year $10,000Exclusions – smoking cessation drugs, over-the-counter drugs, erectile dysfunction drugs and drugs not requiring a prescription.✖Medical UnderwritingRequiredDental> Dental coverage is for fillings, cleanings, scalings, examinations, polishing and select extractions> Recall visits every 6 months, per personDental coveragePercentagepaidAnniversary yearmaximum per personOn your first $500 of eligible services 100% $500On your next $700 of eligible services 60% $420Total benefits payable per person per anniversary year $920The following 6 dental services have a combined first anniversary year maximum of $400, and a combined 3 consecutiveyears maximum of $1,250 per person. For orthodontics, crowns, bridges and dentures, no benefit is available until Year 3.The payment percentage increases from the effective date of the contract as follows:AnniversaryYear 1AnniversaryYear 2AnniversaryYear 3 & beyondOral 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 coincide with your current provincial Dental Association Fee Guide for General Practitioners.The following core benefits are also included with ComboPlus Enhanced:Vision (Basic)> $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and lasereye surgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.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-month period following the date a claim for a specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencing January 1 and ending December 31.21
ComboPlus TMEnhancedExtended Health Care (Basic)Lifetime Maximum $250,000Health Service Navigator ®Registered Specialists and Therapists:Chiropractor, Chiropodist, Osteopath, Naturopath,Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances,Durable Medical EquipmentOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 15-visit maximumper person per anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 10-visit maximumper person per anniversary year$3,500 maximum per person per anniversary year for each of these 3 categoriesof benefits separately✖Medical UnderwritingRequiredCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing Aid$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearUnlimited ground transportation to hospital and $4,000 maximum forair ambulance transportation per person per anniversary year$400 maximum per person per 4 consecutive benefit years. PVS discountsoffer the added advantage of a 10% deduction, depending on the province ofresidence and hearing practitioner participation in the PVS network.Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Travel> $5,000,000 emergency health coverage per person 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 immediatelypreceding each departure date. Not available to persons age 65 and over.Accidental Death & Dismemberment (Basic)> Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65 or up to $10,000 for a dependent child.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year, following the death of an adult policyholder.22
ComboPlus TM Enhanced – For Seniors 65+Prescription Drugs> Brand-name or generic drugs, including birth control and fertility drugs> Full coverage of reasonable and customary dispensing feesPrescription Drug coveragePercentagepaidCalendar yearmaximum per personOn your first $2,222 of eligible prescription costs 90% $2,000On your next $8,000 of eligible prescription costs 100% $8,000Total benefits payable per person per calendar year $10,000Exclusions – smoking cessation drugs, over-the-counter drugs, erectile dysfunction drugs and drugs not requiring a prescription.Dental> Dental coverage is for fillings, cleanings, scalings, examinations, polishing and select extractions> Recall visits every 6 months, per personDental coveragePercentagepaidAnniversary yearmaximum per personOn your first $500 of eligible services 100% $500On your next $700 of eligible services 60% $420Total benefits payable per person per anniversary year $920✖✖Renewable Coveragefor a LifetimeMedical UnderwritingRequiredThe following 6 dental services have a combined first anniversary year maximum of $400, and a combined 3 consecutiveyears maximum of $1,250 per person. For orthodontics, crowns, bridges and dentures, no benefit is available until Year 3.The payment percentage increases from the effective date of the contract as follows:AnniversaryYear 1AnniversaryYear 2AnniversaryYear 3 & beyondOral 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 coincide with your current provincial Dental Association Fee Guide for General Practitioners.The following core benefits are also included with ComboPlus Enhanced:Vision (Basic)> $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and lasereye surgery.> $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after the Government Health Insurance Planmaximum has been reached, if applicable).> Preferred Vision Services (PVS) – allows you to take advantage of discounts available through a specific network of providers and retailers. Youcan save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames and contact lenses, dependingon where you shop. PVS discounts are also available for laser eye surgery. The complete listing of participating retailers and practitioners acrossCanada is easily accessible online or over the phone.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-month period following the date a claim for a specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencing January 1 and ending December 31.23
ComboPlus TM Enhanced – For Seniors 65+Extended Health Care (Basic)Lifetime Maximum $260,000Health Service Navigator ®Registered Specialists and Therapists:Chiropractor, Chiropodist, Osteopath, Naturopath,Podiatrist, Registered Massage Therapist, AcupuncturistChiropractic X-rayRegistered PsychologistRegistered PhysiotherapistRegistered Speech Pathologist/TherapistHomecare and Nursing, Prosthetic Appliances,Durable Medical EquipmentOffers evaluation of medical records upon diagnosis of serious illness or injury$20 maximum per visit20-visit maximum per person per discipline per anniversary year$35 maximum per person per anniversary year$80 maximum first visit, $65 maximum subsequent visits, 15-visit maximumper person per anniversary year$250 maximum per person per anniversary year$65 maximum first visit, $45 maximum subsequent visits, 15-visit maximumper person per anniversary year$4,000 maximum per person per anniversary year for each of these 3 categoriesof benefits separately✖✖Renewable Coveragefor a LifetimeMedical UnderwritingRequiredCustom-Made OrthoticsLifeline ®† Personal Response ServiceAccidental DentalAmbulanceHearing Aid$225 maximum per person per anniversary yearMaximum of 6 months of service per person per 3 anniversary years, not includinginstallation fee$2,000 maximum per person per anniversary yearUnlimited ground transportation to hospital and $4,000 maximum forair ambulance transportation per person per anniversary year$500 maximum per person per 4 consecutive benefit years. PVS discountsoffer the added advantage of a 10% deduction, depending on the province ofresidence and hearing practitioner participation in the PVS network.Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.Accidental Death & Dismemberment (Basic)> Up to $10,000 upon the Accidental Death or Dismemberment of an adult 65 and over.> Additional coverage can be purchased as an Add-On.Survivor Benefit> Provides continued coverage for 1 year, following the death of an adult policyholder.24
Add-On OptionsTrip coverage (per trip)Coverage (per person)Optometrist fees (per person)Preferred Vision Services (PVS)Travel +8 daysCovered up to 17 days,up to $5,000,000 per covered personTravel +21 daysCovered up to 30 days,up to $5,000,000 per covered personTravel coverage may be limited or excluded for any illness or condition which first manifested itselfwithin the 9-month period immediately preceding each departure date.Travel coverage not available to persons age 65 and over.Vision (Enhanced)Total $500 maximum per 3 consecutive benefit years to cover the coststowards prescription lenses, frames and contact lenses,including $100 towards laser eye surgery.$50 maximum per 2 consecutive benefit years (payable only after Government HealthInsurance Plan maximum has been reached, if applicable)Allows you to take advantage of discounts available through a specific network of providersand retailers. You can save up to 20% on eyewear purchases made at participating opticalretailers, which includes lenses, frames and contact lenses, depending on where you shop.PVS discounts are also available for laser eye surgery. The complete listing of participatingretailers and practitioners across Canada is easily accessible online or over the phone.Note – Enhanced coverage describes the total benefits provided in conjunction with the corresponding core coverage benefits.Not available as an Add-On to the ComboPlus Starter plan.Guaranteed to Issue PlanNO MEDICAL UNDERWRITINGREQUIREDAccidental Death & Dismemberment (Enhanced)Adults under 65 The total for both Core and Add-On coverage is up to $50,000.Adults 65 and over & dependent children The total for both Core and Add-On coverage is up to $20,000.Add-On or Stand-Alone OptionsHospital (Basic)Hospital (Enhanced)Room coverage Semi-private Semi-private or privateDaily room coverage maximum,per person per anniversary yearDaily room rate maximum (reasonableand customary provincial room rate)100% coverage during the first 30 days,50% for the next 100 daysPaid up to a maximum of $150 per day100% coveragePaid up to a maximum of $200 per day✖Medical UnderwritingRequiredCash benefit$25 per person per day beginning on the4th day of hospitalization, for a maximum of30 days, if a semi-private room is not obtained.$50 per person per day beginning on the4th day of hospitalization, for a maximumof 60 days, if a semi-private or privateroom is not obtained.CoverageCoverage for Homecare and Nursing,Prosthetic Appliances, and DurableMedical EquipmentAdd onCatastrophic Coverage $4,500 Catastrophic Coverage $10,200Unlimited 100% coverage whenqualifying annual prescription drug expensesexceed $4,500 per person.Additional $25,000 coverage thatcommences when annual expenses exceed$7,500 per person per anniversary year;lifetime maximum $100,000.To the DrugPlus Basic planand ComboPlus Basic plan only.Not available to persons age 65 and over.Unlimited 100% coverage whenqualifying annual prescription drugexpenses exceed $10,200 per person.Additional $25,000 coverage thatcommences when annual expensesexceed $7,500 per person per anniversaryyear; lifetime maximum $100,000.To the DrugPlus Enhanced planand ComboPlus Enhanced plan only.In the event of an accident that requires a hospital stay of at least 24 hours, Catastrophic Coverage provides unlimited Chiropractorand Physiotherapist coverage for 1 year following the accident. All Catastrophic Coverage benefits are paid at the reasonableand customary level, and are coordinated with any other health plan coverage you may have. Once your application is approved,your coverage will continue as long as your premiums are paid, regardless of age or any future changes in your health.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-month period following the date a claim for a specific benefit is first incurred, and each 12-month period thereafter.Calendar Year means the 12-consecutive-month period commencing January 1 and ending December 31.25
Benefits referred to are subject to change without notice and, once coverage is purchased, are subject to the limitations,exclusions and reductions of coverage contained in the Policy and Schedule of Benefits.For more information, contact your agent or broker.Flexcare ® Health and Dental Plans are offered through The Manufacturers Life Insurance Company (<strong>Manulife</strong> <strong>Financial</strong>).Plans underwritten by The Manufacturers Life Insurance Company. <strong>Manulife</strong>, <strong>Manulife</strong> <strong>Financial</strong>, the <strong>Manulife</strong> <strong>Financial</strong> For Your Future logo, the Block Design, the Four Cubes Design, and Strong Reliable Trustworthy Forward-thinking are trademarks of The Manufacturers Life InsuranceCompany and are used by it, and by its affiliates under license. Health Service Navigator and PVS Preferred Vision Services are offered through The Manufacturers Life Insurance Company. /® Trademarks held by The Manufacturers Life Insurance Company. Lifeline®† is a trademarkof Lifeline Systems Inc. © 2013 The Manufacturers Life Insurance Company. All rights reserved.10/13