MANAGE YOUR MEDICAL EXPENSES
HEALTH (Issue ages 18-64, coverage to age 75)   OPTIONAL UPGRADES
  HEALTH (Guaranteed Issue) DRUG  UPGRADE (Underwritten) HEALTH UPGRADE (Guaranteed Issue)
Prescription Drug      

Maximum (Not available for Quebec residents unless RAMQ Top Up is selected)

Paid at 70%

$400 per person per year

Paid at 90% per person

$1,000 1st year

$1,500 2nd year

$2,000 3rd + years

 
Extended Health Care      

Professional Services/ Registered Therapists:

Acupuncturist, Chiropractor, Chiropodist/Podiatrist, Registered Massasge Therapist, Naturopath, Osteopath, Physiotherapist, Psychologist/ Registered Social Worker, Speech Therapist

$20 per visit, $400 per person per practitioner, per year, combined max $1,000   $40 per visit, $500 per person per practitioner, per year, combined max $1,500
Accidental Dental $3,000 per person per year  

$10,000 per person per year

Ambulance Transportation Includes land and air  

Includes land and air

Hearing Aids Not covered  

$500 every 36 months

Medical Services, Diagnostic tests and x-rays, dialysis equipment, laboratory tests $2,000 per person per year  

$3,000 per person per year

Medical Items and Home Support Services) in home nursing) Separate maximums for MEdical Items and Home Support

Year 1: $1,500

Year 2: $2,000

Year 3: $3,000

Year 4: $4,000 per person per benefit category, per year

  $10,000 per person, per year combined
Travel      
Emergency Medical Travel Coverage Out of Province/Country 15 days per trip; $5,000,000 per person per year  

15 days per trip; $5,000,000 per person per trip

Vision Care      
Prescription eyeglasses, contact lenses, laser eye surgery Not covered  

$250 every 24 months

Eye Examination Not covered  

$65 per person every 24 months

 
 
 
MANAGE YOUR DENTAL EXPENSES

DENTAL  (available if Health is selected)   OPTIONAL UPGRADE
  DENTAL (Guaranteed Issue) Dental Upgrade (Guaranteed Issue)
Maximum

Paid at 70%

$450 per person per year

Paid at 80% per person

$1,000 1st year

$1,000 2nd year

$1,250 3rd + years

Basic Preventative & Restorative Services:

Recall exams, bitewing x-rays, preventative cleaning, fluoride, every 9 months. Complete oral exams and full x-rays every 3 years.

70% 80%
Endodontic and Periodontal treatment and Denture services: Periodontal scaling, occlusal equilibration, 8 units every 12 months; Denture cleaning 1 every 12 months, relining or rebasing dentures every 3 years. 70% 70%
 
 
 
*Quebec Residents: RAMQ Top Up: If the drug is covered on the RAMQ formulary, then 100% of the amount not paid by RAMQ will be reimbursed up to the plan maximum. If the drug is not covered on the RAMQ formulary, then the applicable percentage paid applies.

This is a brief overview of the Benefits, providing some key definitions, exclusions and limitations only. A complete policy booklet will be issued once coverage is purchased, and we suggest you review for details on all policy provisions when received.
 
Green Shield Canada reserves the right to perform a claim audit from time to time to verify the accuracy of the medical information provided. All Health & Dental clients are able to submit claims online.
Note: Except where otherwise indicated, coverage maximums are based on a Benefit Year. Benefit Year means the consecutive 12 month period following the effective date of coverage and each 12 month period thereafter. All maximums shown are per covered person.
Rates are age-banded and will increase in accordance with age-bands during the lifetime of the policy. Rates may also be adjusted annually for the entire group each October. 
 
Please note: Benefits do not include smoking cessation products, medication for the treatment of obesity, erectile dysfunction or fertility. Serums and vitamins are also ineligible unless injected and medically necessary.