| Vision |
- |
- 100% of the cost of one eye examination. The exam must be by an ophthalmologist or optometrist.
- $150 for eyeglasses or contact lenses. The eyeglasses frame is not covered by the plan.
The vision coverage is every 24 months from the initial date of service based on reasonable and customary charges.
|
| Paramedical Practitioners |
80% |
Student benefits are payable after any Provincial Health Care benefits have been exhausted. This plan does not cover user fees.
The services of the following practitioners are covered to a maximum of $500 based on reasonable and customary charges, per practitioner, per benefit year.
Practitioners must be registered and licensed in their field of practice.
Practitioners:
- Registered dietician*
- Physiotherapist
- Licensed massage therapist
- Chiropractor, including 1 x-ray examination per benefit year
- Osteopath, including 1 x-ray examination per benefit year
- Naturopath
- Audiologist
- Cardiac rehabilitation*
- Certified Athletic Therapy*
*physician's prescription/referral required for indicated services.
|
| Mental Health Practitioners |
80% |
A combined maximum of $1,000 per benefit year based on reasonable and customary charges.
Practitioners must be registered and licensed in their field of practice.
| Eligible psychotherapists |
Eligible counsellors |
- Registered psychotherapist
- Licensed psychotherapist
- Psychotherapist
- Counselling psychotherapist
- Psychoeducator
|
- Canadian certified counsellor
- Certified clinical counsellor
- Registered counsellor
- Registered clinical counsellor
- Registered professional counsellor
- Registered therapeutic counsellor
- Licensed counsellor
- Clinical counsellor
- Clinical therapist
- Certified counsellor
- Counselling therapist
- Mental health therapist
- Marriage and family therapist
- Psychoanalyst
- Psychologist
- Sexologist
- Registered Social Worker
|
|
| Podiatrist/chiropodist |
80% |
Up to $20 per visit to a maximum of $500 based on reasonable and customary charges, per benefit year. One x-ray examination is included per benefit year.
|
| Medical Equipment & Supplies |
80% |
The plan covers a lifetime maximum of $1,000 based on reasonable and customary charges for eligible equipment when prescribed by a physician, podiatrist, chiropodist, or chiropractor.
Prescription and pre-authorization may be required. Not solely for athletic use.
Eligible durable equipment includes, but is not limited to, items such as:
- Wheelchair
- Hospital beds
- Iron lung
- Respirator
- Braces, crutches, splints & trusses
- Other approved prosthetic devices
- Walkers
- Artificial limbs & eyes
|
| Ambulance |
80% |
To a maximum of $250 per occurrence. This coverage is applied after the provincial deduction.
To a maximum of $500 per occurrence for a licensed ambulance or emergency service that transports the patient to the nearest hospital equipped to provide the required treatment when the physical condition of the patient prevents the use of another means of transportation.
|
| Orthopaedics |
80% |
To a maximum of $150 limited to one pair, per benefit year for custom-made orthopaedic shoes, repairs and modifications when required for the correction of deformity of the bones and muscles. Provided the orthopaedics are not solely for athletic use and are prescribed by a physician, podiatrist, chiropodist, or chiropractor. Modifications, repairs and adjustments to custom-made orthopaedic shoes do not require a prescription.
|
| Hearing Aids |
80% |
To a maximum of $500 during a 4-year period for hearing aids and repairs, including batteries.
|
| Breast Prosthesis |
80% |
After a mastectomy, your plan covers reasonable and customary charges for breast prostheses. Replacement(s) every two benefit years. Two surgical bras per benefit year.
|
| Wigs and Hairpieces |
80% |
To a lifetime maximum of $100 for wigs and hairpieces.
|
| Out of the province Referral |
80% |
The following hospital and medical services provided in Canada or the United States which are not offered in the province of residence and are performed following written referral by the attending physician in the patient's province of residence are covered by the plan to a maximum of $10,000 per lifetime:
- Hospital room and board at ward rate
- Hospital services and supplies
- Diagnosis and treatment by physicians
The physician must give full details of the treatment and must be approved by the insurer in advance. You must apply and provide the insurer with a statement from your provincial health plan that describes what it will cover.
|