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Manulife Financial

FlexCare Health & Dental Insurance Plans

Manulife FlexCare Health & Dental Core Plans let you choose between dental coverage, drug coverage or a combination of both. With each Core Plan you'll also receive coverage for registered specialists, travel emergencies, accidental death & dismemberment and more. Your provincial plan doesn't cover all this. You can enhance your Flexcare Core plan coverage using Add-Ons riders.

Hospitalization benefits and unlimited prescription drugs coverage is available with Flexcare Stand-Alone options.

 

 

Flexcare Core Plans : Summary of Benefits

Health & Dental Plans

ComboPlus  Starter (no medical questionnaire)

ComboPlus  Basic

ComboPlus  Enhanced

Drug Plans

DrugPlus  Basic

DrugPlus  Enhanced

Dental Plans (no medical questionnaire)

DentalPlus  Basic

DentalPlus  Enhanced

 


 

ComboPlusTM Starter
(No medical questionnaire required)
 

  

  

  

  

Prescription Drugs

  

  

 

  

  

  • Generic drug plan (name brand allowed but price paid will be deemed to be the generic equivalent price)

  • Shared dispensing fee to a maximum of $6.50

  • 70% on the first $750 of eligible prescription cost to a maximum of $525 in coverage (70% of $750) per anniversary year

  

  

  

  

Exclusions - Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, and drugs not requiring a 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 (70% of $575) per anniversary year

  • Recall visits every 9 months

  

  

  

  

Coverages are designed to concur with your current provincial Dental Association Fee Guide for General Practitioners. The Flexcare ComboPlus Dental coverage will be adjusted to match any increases in the fee guide.

 

The following Core benefits are also included with ComboPlus Starter:

  

  

  

  


Extended Health Care (Starter)

  

  

 

  

  

  • $250,000 lifetime maximum

  • Health Service Navigator® - With Health Service Navigator, you and your eligible family members can quickly and easily get answers to your questions and access to support services. Easily accessible on the web or with a simple call to a dedicated toll-free line, you will be connected to Health Service Navigator where you can receive information, medical coordination services and resources on how to navigate the Canadian health care system. And, if you want a second opinion from a world-class hospital, Health Service Navigator will help you get it.

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $25 maximum per visit, 20 visit maximum per discipline per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable).

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Psychologist or Psychotherapist - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment - maximum per anniversary year for each of these three categories of benefits separately, is according to the following table:

  Year 1  

  Year 2  

  Year 3  

  Year 4  

  Year 5+  

$1,000

$1,300

$1,500

$1,700

$3,000


Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.

  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable).

  • Hearing Aid - $400 maximum per 4 consecutive benefit years

Vision Care

  • $150 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery

  • $60 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.

No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.

 

  

  

  

  

Travel

  

  

 

  

  

  • $5 million emergency health coverage for trips lasting a maximum of 9 days. (A $100 deductible applies per clai.

  • 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 preceding the effective date of coverage. Not available to persons age 70 and over.

  

  

  

  


Accidental Death & Dismemberment

  

  

 

  

  

  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a 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.

  

  

  

  

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 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.

 

Back to Top

 

 

ComboPlusTM Basic
(Medical questionnaire required)
 

  

  

  

  

Prescription Drugs

  

  

 

  

  

  • Generic drug plan (name brand allowed but price paid will be deemed to be the generic equivalent price)

  • Full coverage of reasonable and customary dispensing fees

 

Percentage Paid

To a maximum of
(per anniversary year)

On your first $750 of eligible prescription costs

70%

$525

On your next $4,972 of eligible prescription costs

90%

$4,475

Total benefits payable per anniversary year

$5,000

 

  

  

  

  

Exclusions - Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, and drugs not requiring a prescription.

  

  

 

  

  


Dental

  

  

 

  

  

  • Dental coverage is for fillings, cleanings, scalings, examinations, polishing and certain extractions

  • Recall visits every 9 months

 

Percentage Paid

To a maximum of
(per anniversary year)

On your first $400 of eligible services

80%

$320

On your next $860 of eligible services

50%

   $430

Total benefits payable per anniversary year

$750

 

  

  

  

  

Coverages are designed to concur with your current provincial Dental Association Fee Guide for General Practitioners. The Flexcare ComboPlus Dental coverage will be adjusted to match any increases in the fee guide.

 

The following Core benefits are also included with ComboPlus Basic:

  

  

  

  


Vision (Basic)

  

  

 

  

  

  • $250 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery

  • $60 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.

  

  

  

  

No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.

  

  

  

  


Extended Health Care (Basic)

  

  

 

  

  

  • $250,000 lifetime maximum

  • Health Service Navigator® - With Health Service Navigator, you and your eligible family members can quickly and easily get answers to your questions and access to support services. Easily accessible on the web or with a simple call to a dedicated toll-free line, you will be connected to Health Service Navigator where you can receive information, medical coordination services and resources on how to navigate the Canadian health care system. And, if you want a second opinion from a world-class hospital, Health Service Navigator will help you get it.

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $25 maximum per visit, 20 visit maximum per discipline per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Psychologist or Psychotherapist - $80 maximum first visit, $65 maximum subsequent visits, 15 visit maximum per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment : under age 65 - $4,000 maximum and age 65 and over - $4,500  per anniversary year, for each of these three categories of benefits separately

Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.

  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)

  • Hearing Aid - $400 maximum per 4 consecutive benefit years

  

  

  

  

Travel

  

  

 

  

  

  • $5 million emergency health coverage 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: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 70 and over.

  

  

  

  


Accidental Death & Dismemberment

  

  

 

  

  

  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a 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.

  

  

  

  

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 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.

  

  

 

Back to Top

  

  

 

ComboPlusTM Enhanced
(Medical questionnaire required)

  

  

  

  


Prescription Drugs

  

  

 

  

  

  • Name brand or generic drugs, including birth control and fertility drugs

  • Full coverage of reasonable and customary dispensing fees

 

Percentage Paid

To a maximum of
(per anniversary year)

On your first $2,222 of eligible prescription costs

90%

$2,000

On your next $8,000 of eligible prescription costs

100%

$8,000

Total benefits payable per anniversary year

$10,000

 

  

  

  

  

Exclusions - Smoking cessation drugs, over-the-counter drugs, and drugs not requiring a prescription.

  

  

  

  


Dental

  

  

 

  

  

  • Dental coverage is for fillings, cleanings, scalings, examinations, polishing and certain extractions

  • Recall visits every 6 months

 

Percentage Paid

To a maximum of
(per anniversary year)

On your first $500 of:
examinations, diagnostic services

100%*

$500

On your next $700 of:
ALL Ongoing Maintenance Services

60%

$420

Total benefits payable per anniversary year

$920

 

The following six dental services have a combined first anniversary year maximum of $400, and a combined 3 consecutive years maximum of $1,250. For orthodontics, crowns, bridges and dentures, no benefit is available until Year 3. The payment percentage increase from the effective date of the contract is as follows:

 

  Year 1  

  Year 2  

  Year 3 & beyond  

Oral 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 concur with your current provincial Dental Association Fee Guide for General Practitioners. The Flexcare ComboPlus Dental coverage will be adjusted to match any increases in the fee guide.

 

The following Core benefits are also included with ComboPlus Enhanced:

  

  

  

  


Vision (Basic)

  

  

 

  

  

  • $250 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery

  • $60 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.

  

  

  

  

No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.

  

  

  

  


Extended Health Care (Basic)

  

  

 

  

  

  • $250,000 lifetime maximum

  • Health Service Navigator® - With Health Service Navigator, you and your eligible family members can quickly and easily get answers to your questions and access to support services. Easily accessible on the web or with a simple call to a dedicated toll-free line, you will be connected to Health Service Navigator where you can receive information, medical coordination services and resources on how to navigate the Canadian health care system. And, if you want a second opinion from a world-class hospital, Health Service Navigator will help you get it.

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $25 maximum per visit, 20 visit maximum per discipline per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)

  • Psychologist or Psychotherapist - $80 maximum first visit, $65 maximum subsequent visits, 15 visit maximum per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment : under age 65 - $4,000 maximum and age 65 and over - $4,500  per anniversary year, for each of these three categories of benefits separately

Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.

  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)

  • Hearing Aid - $400 maximum per 4 consecutive benefit years

  

  

  

  

Travel

  

  

 

  

  

  • $5 million emergency health coverage 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: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 70 and over.

  

  

  

  


Accidental Death & Dismemberment

  

  

 

  

  

  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a 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.

  

  

  

  

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 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.

  

  

 

Back to Top

  

  

 

DrugPlusTM Basic
(
Medical questionnaire required)

  

  

  

  


Prescription Drugs

  

  

 

  

  

  • Generic drug plan (name brand allowed, but price paid will be deemed to be the generic equivalent price)

  • Full coverage of reasonable and customary dispensing fees

 

Percentage Paid

To a maximum of
(per anniversary year)

On your first $750 of eligible prescription costs

70%

$725

On your next $4,972 of eligible prescription costs

90%

$4,4750

Total benefits payable per anniversary year

$5,000

  

  

  

  

Exclusions - Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, and drugs not requiring a prescription.

The following Core benefits are also included with DrugPlus Basic:

  

  

  

  


Vision (Basic)

  

  

 

  

  

  • $250 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery.

  • $50 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.

  

  

  

  

No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.

  

  

  

  


Extended Health Care (Basic)

  

  

 

  

  

  • $250,000 lifetime maximum

  • Health Service Navigator® - With Health Service Navigator, you and your eligible family members can quickly and easily get answers to your questions and access to support services. Easily accessible on the web or with a simple call to a dedicated toll-free line, you will be connected to Health Service Navigator where you can receive information, medical coordination services and resources on how to navigate the Canadian health care system. And, if you want a second opinion from a world-class hospital, Health Service Navigator will help you get it.

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $25 maximum per visit, 20 visit maximum per discipline per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)

  • Psychologist or Psychotherapist - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment : under age 65 - $4,000 maximum and age 65 and over - $4,500  per anniversary year, for each of these three categories of benefits separately

Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.

  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)

  • Hearing Aid - $400 maximum per 4 consecutive benefit years

  

  

  

  

Travel

  

  

 

  

  

  • $5 million emergency health coverage 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: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 70 and over.

  

  

  

  


Accidental Death & Dismemberment

  

  

 

  

  

  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a 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.

  

  

  

  

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 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.

  

  

 

Back to Top

  

  

 

DrugPlusTM Enhanced
(
Medical questionnaire required)

  

  

  

  


Prescription Drugs

  

  

 

  

  

  • Name brand or generic drugs, including birth control and fertility drugs

  • Full coverage of reasonable and customary dispensing fees

 

Percentage Paid

To a maximum of
(per anniversary year)

On your first $2,222 of eligible prescription costs

90%

$2,000

On your next $8,000 of eligible prescription costs

100%

$8,000

Total benefits payable per anniversary year

$10,000

 

  

  

  

  

Exclusions - Smoking cessation drugs, over-the-counter drugs, and drugs not requiring a prescription.

The following Core benefits are also included with DrugPlus Enhanced:

  

  

  

  


Vision (Basic)

  

  

 

  

  

  • $250 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery.

  • $60 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.

  

  

  

  

No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.

  

  

  

  


Extended Health Care (Basic)

  

  

 

  

  

  • $250,000 lifetime maximum

  • Health Service Navigator® - With Health Service Navigator, you and your eligible family members can quickly and easily get answers to your questions and access to support services. Easily accessible on the web or with a simple call to a dedicated toll-free line, you will be connected to Health Service Navigator where you can receive information, medical coordination services and resources on how to navigate the Canadian health care system. And, if you want a second opinion from a world-class hospital, Health Service Navigator will help you get it.

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $25 maximum per visit, 20 visit maximum per discipline per anniversary year. (payable only after Government Health Insurance Plan maximums have been reached, if applicable)

  • Psychologist or Psychotherapist - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment : under age 65 - $4,000 maximum, and age 65 and over - $4,500  per anniversary year, for each of these three categories of benefits separately

Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.

  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)

  • Hearing Aid - $400 maximum per 4 consecutive benefit years

  

  

  

  

Travel

  

  

 

  

  

  • $5 million emergency health coverage 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: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 70 and over.

  

  

  

  


Accidental Death & Dismemberment

  

  

 

  

  

  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a 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.

  

  

  

  

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 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.

  

  

 

Back to Top

 

 

  

  

DentalPlusTM Basic
(
No medical questionnaire required)

  

  

  

  


Dental

  

  

 

  

  

  • Dental coverage is for fillings, cleanings, scalings, examinations, polishing and certain extractions

  • Recall visits every 9 months

 

Percentage Paid

To a maximum of
(per anniversary year)

Year 1

On your first $1,150 of eligible services

50%

$575

Total benefits payable for the first anniversary year

$575

 

Year 2 and beyond

 

On your first $400 of eligible services

80%

$320

On your next $860 of eligible services

50%

   $430

Total benefits payable for your second and subsequent anniversary years

$750

 

  

  

  

  

Coverages are designed to concur with your current provincial Dental Association Fee Guide for General Practitioners. The Flexcare DentalPlus coverage will be adjusted to match any increases in the fee guide.

 

The following Core benefits are also included with DentalPlus Basic:

  

  

  

  


Vision (Basic)

  

  

 

  

  

  • $250 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery

  • $60 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.

  

  

  

  

No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.

  

  

  

  


Extended Health Care (Basic)

  

  

 

  

  

  • $250,000 lifetime maximum

  • Health Service Navigator® - With Health Service Navigator, you and your eligible family members can quickly and easily get answers to your questions and access to support services. Easily accessible on the web or with a simple call to a dedicated toll-free line, you will be connected to Health Service Navigator where you can receive information, medical coordination services and resources on how to navigate the Canadian health care system. And, if you want a second opinion from a world-class hospital, Health Service Navigator will help you get it.

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $25 maximum per visit, 20 visit maximum per discipline per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable).

  • Psychologist or Psychotherapist- $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment - maximum per anniversary year for each of these three categories of benefits separately, is according to the following table:

  Year 1  

  Year 2  

  Year 3  

  Year 4  

  Year 5+  

$1,000

$1,300

$1,500

$1,700

$3,000


Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.

  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)

  • Hearing Aid - $400 maximum per 4 consecutive benefit years

  

  

  

  

Travel

  

  

 

  

  

  • $5 million emergency health coverage 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: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 70 and over.

  

  

  

  


Accidental Death & Dismemberment

  

  

 

  

  

  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a 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.

  

  

  

  

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 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.

  

  

 

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DentalPlusTM Enhanced
(No medical questionnaire required)

  

  

  

  


Dental

  

  

 

  

  

  • Dental coverage is for fillings, cleanings, scalings, examinations, polishing and certain extractions

  • Recall visits every 6 months

 

Percentage Paid

To a maximum of
(per anniversary year)

Year 1

On your first $1,200 of eligible services

70%

$840

Total benefits payable for the first anniversary year

$840

 

Year 2 and beyond

On your first $500 of eligible services

100%

$500

On your next $700 of eligible services

60%

   $420

Total benefits payable for your second and subsequent anniversary years

$920

 

The following six dental services have a combined maximum of $1,250 per 3 year period. For oral surgery, periodontics and endodontics (root canal), benefits are available beginning Year 2; for orthodontics, crowns, bridges and dentures, no benefit is available until Year 3. The payment percentage increase from the effective date of the contract is as follows:

 

  Anniversary Year 1  

  Anniversary Year 2  

  Anniversary Year 3 & beyond  

Oral 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 concur with your current provincial Dental Association Fee Guide for General Practitioners. The Flexcare DentalPlus coverage will be adjusted to match any increases in the fee guide.

 

The following Core benefits are also included with DentalPlus Enhanced:

  

  

  

  


Vision (Basic)

  

  

 

  

  

  • $250 maximum per 2 consecutive benefit years towards the cost of prescription lenses, frames, contact lenses and laser eye surgery

  • $60 maximum for Optometrist fees per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)

  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Flexcare Vision benefit.

  

  

  

  

No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more

  

  

  

  


Extended Health Care (Basic)

  

  

 

  

  

  • $250,000 lifetime maximum

  • Health Service Navigator® - With Health Service Navigator, you and your eligible family members can quickly and easily get answers to your questions and access to support services. Easily accessible on the web or with a simple call to a dedicated toll-free line, you will be connected to Health Service Navigator where you can receive information, medical coordination services and resources on how to navigate the Canadian health care system. And, if you want a second opinion from a world-class hospital, Health Service Navigator will help you get it.

  • Chiropractic X-ray - $35 maximum per anniversary year

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist - $25 maximum per visit, 20 visit maximum per discipline per anniversary year. (payable only after Government Health Insurance Plan maximums have been reached, if applicable).

  • Psychologist or Psychotherapist - $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year

  • Physiotherapist - $250 maximum per anniversary year

  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment - maximum per anniversary year for each of these three categories of benefits separately, is according to the following table:

  Year 1  

  Year 2  

  Year 3  

  Year 4  

  Year 5+  

$1,000

$1,300

$1,500

$1,700

$3,000


Note: $225 maximum per anniversary year for Orthotics, which are included as part of Durable Medical Equipment.

  • Speech Pathologist/Therapist - $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per anniversary year

  • Lifeline® Personal Response Service - 6 months of service for every 3 anniversary years, not including installation fee

  • Accidental Dental - $2,000 maximum per anniversary year

  • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per anniversary year (payable only after Government Health Insurance Plan maximums have been reached, if applicable)

  • Hearing Aid - $400 maximum per 4 consecutive benefit years

  

  

  

  

Travel

  

  

 

  

  

  • $5 million emergency health coverage 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: A 9-month pre-existing condition clause applies to Travel. Not available to persons age 70 and over.

  

  

  

  


Accidental Death & Dismemberment

  

  

 

  

  

  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult over 65 or a 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.

  

  

  

  

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 consecutive months following the incurred date of the claim.

Calendar Year means the 12 consecutive month period commencing January 1 and ending December 31.

  

  

 

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All plans (except those indicated "No medical Questionnaire required") are medically underwritten, which means you will have to answer several medical questions when applying for this insurance. After that, your application has to be approved by the insurance company. If approved, coverage is effective the first day of the month following final approval of the application.

 

 

NOTE: The product related information is for illustration purpose only.  Please Click here for more information and to get a quote & apply ONLINE.

 

Investments:    RESP     RRSP     TFSA     Segregated Funds

                                                       January 29, 2018