Extended health care
Our group extended health insurance pays for eligible expenses not usually covered by government health insurance plans and includes comprehensive travel health coverage.
Coverage details
Prescription drugs
The prescription drugs benefit covers drugs, sera, injectables and compounds/mixtures with a drug identification number (DIN) that require a prescription from a physician, dentist or practitioner and are dispensed by a licensed pharmacist.
- $0 annual deductible
- 85% reimbursement of ingredient costs
- $3,400 annual maximum per person
- Reimbursement of government health insurance plan deductibles for prescription medications
- Sexual dysfunction treatments and diabetic supplies for glucometers and insulin pumps are included
- Option to arrange for a second 100-day drug supply if you’re taking an extended vacation
- Express Scripts Canada Pharmacy, an optional online pharmacy with 24/7 pharmacist access and free home delivery
Paramedical
Paramedical coverage includes non-surgical and surgical services. You don’t need a physician referral for services to be covered.
- 80% reimbursement
- $1,300 annual maximum per person for all practitioners combined
- Covers 18 practitioners: acupuncturist, chiropodist, chiropractor, Dietician, herbalist, homeopath, naturopath, nutritionist, occupational therapist, osteopath, physiotherapist, podiatrist, psychotherapist, registered clinical psychologist, registered massage therapist, shiatsu therapist, social worker, speech therapist
- Includes acupuncture and foot care services when provided by a registered nurse
- Reflexology services are eligible when performed by one of the covered paramedical practitioners within their scope of practice
Vision
Prescription glasses and contact lenses, laser eye surgery and corneal incision are included. Plus, support is available for vision training or remedial exercises not covered by government plans.
- 80% reimbursement
- $400 per person for prescription eyewear and laser surgery in any two consecutive years
- $150 per person for eye exams in any two consecutive years, and per calendar year for dependent children
- An additional lifetime limit of $400 per person for new lenses required within six months of eye surgery
- Lifetime maximum of $300 per eye for cataract surgery costs that aren’t covered elsewhere in the extended health care plan
Aids and appliances
The plan covers the costs of aids and appliances prescribed by a physician. Government plans can help offset costs. Our claims team will review your quote to help you determine what will be covered so you understand expenses before making a purchase.
- 80% reimbursement
- Includes trusses, splints, braces, casts, crutches, canes, walkers, wheelchairs and hospital beds
- Covers artificial limbs or eyes and breast prosthesis, including three mastectomy bras per year
- $640 per year for wigs
- Medical supplies including $400 per person, per year for surgical stockings, $750 per person, per year for incontinence supplies and up to $200 per person every two consecutive calendar years for post-surgical comfort and convenience items
- $500 per person for custom-made orthopedic shoes every two consecutive calendar years
- $1,100 per person for purchase or repair of hearing aids every three successive calendar years
Diagnostic services
The coverage helps offset the costs of diagnostic lab tests, including screening tests, not covered by government plans.
- 80% reimbursement
- $250 annual maximum per person
Private duty nursing
The plan covers medically necessary out-of-hospital nursing services. Additional related coverage available through the hospital plan.
- 80% reimbursement
- $2,000 per person every two consecutive calendar years
Transportation
Medically necessary ground and air transportation to a hospital is covered.
- 80% reimbursement
- Includes one round trip per person per year for air transportation from your hospital to the nearest hospital able to provide treatment
Education programs
The plan covers certain education programs recommended by your healthcare provider.
- 80% reimbursement
- Includes medically-related program(s) recommended by a physician to an annual maximum of $200 per person
Accidental dental
The plan covers dental treatment required because of an accidental blow to natural or artificial teeth. Additional coverage available through the dental plan.
- 80% reimbursement
- Up to $1,000 per person per calendar year
Travel
Comprehensive travel medical and trip cancellation and interruption insurance is included at no additional cost.
- Up to $10 million per insured, per trip, for eligible medical emergency expenses
- Unlimited number of trips outside of your province or territory of residence of up to 93 days per trip
- Up to $6,000 per insured, per trip for eligible expenses in the event of a cancellation, interruption or delay of your trip due to one of the covered reasons
- Coverage may be available for an emergency caused by a pre-existing medical condition, provided the medical condition was stable during the 90 days prior to departure date or prior to the purchase of travel arrangements
You can supplement the travel coverage by purchasing additional days of coverage for trips exceeding 93 days or by purchasing extra trip cancellation/interruption coverage for a specific trip that exceeds $6,000 per insured by contacting us.
Medical second opinion
Our partnership with CloudMD gives you and your family members access to the best medical minds in the world to help you make medical decisions with confidence.
- Convenience: The program offers a seamless experience, saving you time and effort of trying to find a second opinion. With a dedicated nurse care coordinator gathering your medical records, you can focus on your health, while CloudMD focuses on getting you a second opinion.
- Experience and expertise: CloudMD’s extensive network of physicians and specialists will review your diagnosis. You can be assured you are receiving an expert second opinion you can trust.
- Personalized approach: A nurse care coordinator will work with you throughout the entire medical second opinion journey. They will make sure you understand your diagnosis and care plan. They will also schedule an appointment with the specialist and make sure you understand your next steps.
- Timely service: When you have a serious or complex health condition, every day counts. We gather your medical records and conduct a review. The nurse care coordinator is there to ensure your questions are answered in a timely manner.
- Specialty expertise: CloudMD experts support your diagnosis and care plan with a wide range of health concerns, from cancer and cardiology to digestive diseases and osteoarthritis disorders.
Virtual pharmacy
Express Scripts Canada Pharmacy provides online pharmacy services for maintenance medication 24/7.
- Free home delivery of your medication from Monday to Saturday
- Automatic refills and renewal reminders
- Automatic analysis and alert of potential drug interactions or concerns based on the allergy and health history you’ve shared
- Access to on-call pharmacists 24/7
- A convenient mobile app and website so you can manage your prescriptions in one place, anywhere, anytime
- No more lineups or risks of missed doses
Travel top ups
You can add additional days to your trip or top up the amount you're covered for as needed.
Supplemental travel plan for extra days
You have travel insurance coverage for up to 93 days per insured, per trip through the extended health care plan. If you’re travelling for longer than 93 days outside your province or territory of residence, you can easily add coverage for extra days.
Plan details
- Customizable based on your needs – add five more days of coverage to extend trips up to 98 days or extend your coverage in 15-day blocks.
- Staying longer? Extend coverage while you’re already on vacation.
- Coming home early? Downgrade if needed, and you may receive a partial refund.
- Premiums are added to your regular monthly payment and deducted in equal monthly installments.
- The optional plan is subject to the benefits, conditions and exclusions.
Contact us with questions or to apply for the supplemental travel plan.
Increase trip cancellation and interruption coverage
The travel plan provided with your extended health care plan includes coverage for up to $6,000 per insured per trip for eligible expenses when you cancel, interrupt or delay your trip due to one of the covered reasons. You can supplement your existing coverage when your trip value exceeds $6,000 per insured to get coverage of up to $12,000 per insured for that specific trip.
The premium is a one-time payment based on the coverage level you need for a specific trip:
Single $42.32*
Couple $84.64*
Family $93.10*
*Retail tax will be added, if applicable in your province of residence.
Contact us with questions or to apply for the supplemental travel plan.
Easy claims process
Claims can be submitted by the practitioner and deposited directly in your bank account.
- Email notification of your claim payments
- Annual benefit statement and tax letter
- 24/7, secure, online access to claims and benefit information
Add more value for your members or employees
Facilitated enrollment process
Possibility to avoid medical questionnaires and offer easy transitions from existing group plans.
Coverage that makes sense
Single, couple or family coverage available. Plus, comprehensive travel insurance.
Reliable coverage
More than 100,000 Canadians benefit from our plans.
Interested in exploring group insurance for your members or employees?
