PERSONAL INSURANCE
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Health Benefit Plan
Government healthcare funding is being continually reassessed and as governments reduce coverage for some healthcare services and cease to provide others, more and more financial responsibility is placed on individuals or their group health plans to pay for routine and unexpected health-related services.
If you are one of the millions of Canadians not covered by a group health plan, you will have to pay yourself for many common healthcare expenses such as dental work, prescription drugs, prescription eyewear, private and semi-private hospital room accommodation and etc.
If you are not fully covered by a group plan, these expenses are paid out of your own pocket. Individually purchased Health Benefit Plan will give you peace-of-mind, since you will know that you and your family is covered for both the routine and the unexpected expenses that may occur due to accident or illness.
Whether you're self-employed, an established business owner, an independent consultant, a seasonal/contract employee, an entrepreneur or temporary project specialist… with or without access to a group or spousal health plan, Health Benefit Plan can be customized to work for you.
- 100% reimbursement, no deductible, subject to a $50,000 lifetime maximum per insured person for all services combined, except for travel insurance
- Alternative Practitioners: Chiropractor, Acupuncturist, Podiatrist, Homeopath, Naturopath, Massage - $300/yr per insured person and $600/yr for family
- Psychologist, social worker and guidance counselor - $400/yr per insured person
- Physiotherapist - $250/yr per insured person
- Orthopedic shoes - $150/yr per insured person and Plantar orthosis - $300/yr per insured person with combined maximum $300/yr
- Hearing aids - $300/36 months per insured person
- Speech & Hearing Therapists - $400/yr per insured person
- Assistive devices - $500/yr per insured person
- Analysis and exams - $200/yr per insured person
- Accidental dental care - $1,000/per accident per insured person
- Ambulance services - $1,000/yr per insured person
- Home nursing care - $2,500/yr per insured person
- Medical Equipment - $1,000/yr per insured person
- Travel coverage – first 9 days of a trip, lifetime maximum $1,000,000 per insured person
Andrew, 45 years old, and his two children Daniel, 8 years old and Michelle, 12 years old have Basic Health Benefit. The plan costs $20.50 a month or $300 a year. They can get care from alternative practitioners for $600 during the year; physiotherapy for $250*3persons=$750 a year; orthopedic for $300*3=$900 a year; psychologist $400*3=$1,200 a year; tests and examination - $200*3=$600 a year; etc. if they need. If they go on vacation for 9 days they are covered for emergency medical service for up to $1,000,000 each.
- 100% reimbursement, no deductible, subject to a $50,000 lifetime maximum per insured person for all services combined, except for travel insurance
- Alternative Practitioners: Chiropractor, Acupuncturist, Podiatrist, Homeopath, Naturopath, Massage - $500/yr per insured person and $1,000/yr for family
- Psychologist, social worker and guidance counselor - $600/yr per insured person
- Physiotherapist - $375/yr per insured person
- Orthopedic shoes - $300/yr per insured person and Plantar orthosis - $500/yr per insured person with combined maximum $300/yr
- Hearing aids - $500/36 months per insured person
- Speech & Hearing Therapists - $480/yr per insured person
- Assistive devices - $1000/yr per insured person
- Analysis and exams - $500/yr per insured person
- Accidental dental care - $2,000/per accident per insured person
- Ambulance services - $2,000/yr per insured person
- Home nursing care - $5,000/yr per insured person
- Medical Equipment - $2,500/yr per insured person
- Travel coverage – first 30 days of a trip, lifetime maximum $1,000,000 per insured person
- Plus vision care coverage - $150 every 2 years per insured person
Bob, 45 years old, and Sandra, 43 years old, have 3 children - 4, 10 and 12 years old. They decided to buy Enhanced Health plan. The monthly cost is $52.50 which comes to $630 a year. They can receive service from alternative practitioners for $1000 during the year; physiotherapy for $375*5 persons = $1,875 a year; orthopedic for $500*5 = $2,500 a year; psychologist $600*5 = $3,000 a year; tests and examination - $500*5 = $2,500 a year; glasses $150*5 = $750 every two years; etc. if they need. If they go on vacation for up to 30 days they are covered for emergency medical service for up to $1,000,000 each.
Hospital Coverage Benefit - 100% coverage up to $175 per day for semi-private accommodations in a public general hospital.
Dental Care Benefit - 70% reimbursement, no deductible on diagnostic, preventive services, basic restorations, periodontal benefits, surgical services, adjunctive services, and denture services. Subject to a 3-month waiting period.
Annual maximums:
- 1st year= $500
- 2nd year= $750
- Each subsequent year= $1,000
Prescription Drug Benefit - 80% reimbursement for eligible prescribed medications with a $5 per prescription co-payment on drugs. Reimbursement is based on the lowest-cost generic equivalent.
- Annual maximum payable: $2,000 per insured
- Eligible Drugs: prescription drugs and life-sustaining products
Gary, 47 years old, is a self-employed. He bought an Enhanced Health plan with Dental Care and Prescription Drug Benefits. The cost of this plan is $85.62 a month and $1,027.44 a year. He can receive service from alternative practitioners for $500 during the year physiotherapy for $375 a year; orthopedic for $500 a year; psychologist $600 a year; tests and examination - $500 a year; glasses $150every two years; etc. if he needs. Plus he is eligible for the Dental Care for $500 for the first year, $750 for the second year and $1,000 for each consecutive year. Also he can get prescribed drugs for $2,000 a year. If he goes on vacation for 30 days he is covered for emergency medical service for up to $1,000,000.