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Health Insurance - What Might Be Covered?
Plans cover eligible expenses over and above those paid by your
provincial or territorial government health plan.
Benefits are usually subject to a calendar year deductible or
a coinsurance normally 80% but these are issues that can be tailored
to suit or situation and need. Benefits most times are subject
to an overall limit per lifetime for each insured person of:
- $1,000,000 of expenses incurred in and out of Canada combined
for those up to age 65
This a sample of what a plan may cover:
100% of the cost of:
- Semi-private/private hospital room (in Canada)
80% of the cost of:
- Semi-private convalescent hospital room (maximum 180 days)
- Out-of-Canada emergency care including hospital accommodation
and reasonable and customary fees of a physician or surgeon
- Prescription drugs/medicines. Includes a "pay-direct"
drug card, which allows the insurer to pay the pharmacy directly.
You only have to pay the portion of the cost not covered by
the plan.
- Ambulance/air ambulance for emergency transport
- Emergency dental care due to an accident
- Home nursing care
- Services of an acupuncturist, chiropractor, osteopath, chiropodist,
podiatrist, naturopath, psychologist, physiotherapist, speech
therapist, and massage therapist
- Hearing aids (not batteries)
- Orthotics (shoes and inserts)
- Provincial/territorial user fees (where permitted by law)
- Repatriation to home province/territory in Canada
- Medical supplies and equipment such as artificial limbs or
eyes, casts, crutches/braces, oxygen/equipment, blood/plasma,
wheelchair, hospital bed
- Diagnostic lab and x-ray expenses
Health Care coverage for trips outside of Canada is usually limited
to the first 60 consecutive days per trip. Where more than one
trip occurs within a six-month period, coverage is often limited
to the first 75 days of travel outside Canada, in total.
The Health Care plan may include an emergency travel assistance
program. These programs are designed to provide on-the-spot help
in case of a medical, legal or personal emergency while traveling
outside your home province. The service is available 24 hours
a day, 365 days a year worldwide.
Some limitations, maximums, and exclusions apply. Contact your
insurance representative Wise Financial Group Inc. @ 1-877-779-4731.
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