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Dental Services |
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Benefits |
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Coverage
Maximums |
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Are paid at a percentage
of the current Dental Association Fee Schedule
or the reasonable and customary charge in
your province of residence. |
|
70% co-payment on Dental
Services. |
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| Reimbursement on examinations,
cleanings, fillings scaling, polishing, root
planing, diagnostic and other basic dental
services. |
No waiting period for coverage |
| Reimbursement on extensive
services including endodontics, periodontics
and denture services. |
|
| Anniversary year maximums |
$245 per year |
| Recall |
9 months |
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| Prescription Drugs |
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Benefits |
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Coverage
Maximums |
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Generic coverage |
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Shared Dispensing Fee |
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$6.50 maximum dispensing
fee |
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Reimbursement on first amount
per anniversary year. |
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70% on first $350 |
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| Vision Care |
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Benefits |
|
Coverage
Maximums |
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Covers the cost towards
prescription lenses and frames and/or contact
lenses. This benefit does not include industrial
safety glasses. |
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$100 per 2 benefit years
plus $30 for Optometrist visits. |
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| Accidental Death and Dismemberment
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Benefits |
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Coverage
Maximums |
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Payment for a loss directly
resulting from accidental bodily injury or
accidental loss of life occurring within a
year of the date of the accident. |
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· $10,000 per adult
· $4,000 per child or senior over 65 |
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| Survivor Benefit |
|
Benefits |
|
Coverage
Maximums |
|
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Provides for coverage to
be continued for 1 year,
following the death of an adult policyholder. |
|
Available 1 year after policy
effective date. |
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| Extended Health Care |
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Benefits |
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Coverage
Maximums |
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Lifetime maximum |
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$50,000 |
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| Registered Specialists and Therapists |
|
Benefits |
|
Coverage
Maximums |
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– includes visits to: |
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|
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| Acupuncturists, Chiropractors,
Osteopaths, Podiatrists, Naturopaths,Chiropodists,
Registered Massage Therapists, Physiotherapists,
Psychologists and Speech Therapists. |
|
| Registered Specialists and
Therapists |
|
Maximum claims paid |
$300 per specialist/therapist |
Per visit maximum |
$15 |
Chiropractic x-rays |
$35 per year |
| Psychologist |
|
Maximum per first
visit |
$75 |
Maximum per subsequent
visits |
$60 |
Maximum visits per
year |
10 |
| Speech Therapist |
|
Maximum per first
visit |
$60 |
Maximum per subsequent
visits |
$40 |
Maximum visits per
year |
10 |
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| Lifeline® Response Service |
|
Benefits |
|
Coverage
Maximums |
|
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| |
Provides 24-hour monitoring
service for people coping with medical problems
at home. |
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3 months per lifetime |
|
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| Homecare and Nursing, Prosthetic
Appliances and Durable Medical Equipment |
|
Benefits |
|
Coverage
Maximums |
|
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| |
Covers the service
of registered health professionals including
Registered Nurse, Registered Nursing Assistant
or healthcare aid; includes surgical bandages
and dressings and the purchase or rental of
medically necessary equipment such as crutches,
non-electric wheelchairs and hospital beds,
oxygen and other equipment recommended by
your physician and approved by Maritime Life.
Also includes prosthetic appliances such as
artificial limbs, eyes, splints, casts and
breast prostheses following mastectomies.
Payment will be co-ordinated where benefits
are available through the Assistive Devices
Program. |
|
| For each
of Homecare & Nursing, Prosthetic
Appliances and Durable Medical Equipment: |
Year 1: $500 |
Year 2: $800 |
Year 3: $1,000 |
Year 4: $1,500 |
Year 5: $2,000 |
| Custom-made Orthotics:
$225 per year as part of Durable Medical
Equipment |
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| Hearing Aids |
|
Benefits |
|
Coverage
Maximums |
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| |
Covers the cost to purchase
and/or repair up to the
allowed amount. |
|
$300 per 4 year period. |
|
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| Ambulance Services |
|
Benefits |
|
Coverage
Maximums |
|
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| |
Covers trips to hospitals
in a licensed ground ambulance. Covers charges
up to the amount between what your provincial
health plan covers and what is reasonable
and customary. Air ambulance is payable only
after provincial plan maximum is reached,
if applicable. |
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· Unlimited ground transport
· $4,000 maximum air ambulance |
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| Accidental Dental |
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Benefits |
|
Coverage
Maximums |
|
|
| |
Covers dental treatment required
as a result of an
accidental blow to the head or mouth. Treatment
must be sought within the
90 day period following the accident. |
|
$2,000 per year |
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All reference to “year” refer
to anniversary year. When it relates to Hearing
Aids & Vision benefits, year refers to benefit
year. Prescription drugs for the province of British
Columbia are based on calendar year.
* Generic drug – A generally
less expensive alternative to an interchangeable
brand-name drug product. Please note: not all
drugs have a generic equivalent. If a non-generic
drug is purchased, payment will be based on the
lowest generic drug cost equivalent, if applicable.
If no generic brand exists, payment of the brand
-name price will be made at the co-payment level
of your plan.
** Birth Control medication
and fertility drugs are not covered under this
plan.
*** Benefits are only payable
after yearly maximums allowed under your provincial
health insurance plan have been reached, if applicable.
Benefits are payable up to Reasonable and Customary
charges for similar services, as defined in the
Policy |
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