Benefit Information

Deductible

None

Benefits

Reimbursement

Amount per visit/service

Maximum

Deductible applies

Paramedical

CHIROPRACTOR

100%

R&C

$400.00 per insured person per calendar year(s)

No

MASSAGE THERAPIST

100%

R&C

$400.00 per insured person per calendar year(s)

No

NATUROTHERAPIST

100%

R&C

$400.00 per insured person per calendar year(s)

No

OSTEOPATH

100%

R&C

$400.00 per insured person per calendar year(s)

No

SPEECH THERAPIST

100%

R&C

$400.00 per insured person per calendar year(s)

No

PHYSIOTHERAPIST

100%

R&C

$400.00 per insured person per calendar year(s)

No

PODIATRIST

100%

R&C

$400.00 per insured person per calendar year(s)

No

PSYCHOLOGIST

100%

R&C

$400.00 per insured person per calendar year(s)

No

Medical

HEARING AIDS

100%

R&C

$400.00 per 60 months

No

FOOT ORTHOSES

- available from chiropractors, foot stores, etc - ask a senior steward for information

* orthotics can not be used with orthopedic shoes

* must be custom made ie. can not be dispensed on same day of visit

* medical note required with diagnosis and reasons

*

100%

R&C

$300.00 per calendar year(s)

No

ORTHOPEDIC SHOES

100%

R&C

$300.00 per calendar year(s)

No

EMERGENCY OUT OF PROVINCE MEDICAL FEES

Covered

Overall yearly maximum

Unlimited

Overall lifetime maximum

$5,000,000.00

Deductible

$25.00 per calendar year for individual coverage
$50.00 per calendar year for family coverage

Benefits

Reimbursement

Maximum

Deductible applies

ANTI SMOKING DRUG

100%

$1,000.00 lifetime

Yes

DRUGS - IA uses system called EVA - drug D.I.N. number will be required determine if drug covered - Call IA for more info

* Generic drugs covered

* Original drugs covered

100%

Unlimited

Yes

FERTILITY DRUGS * Does Not Include IUD, etc

100%

$3,000.00 combined maximum  Lifetime

Yes

Overall yearly maximum

Unlimited

Overall lifetime maximum

$5,000,000.00

Prescription Rule

Covered drugs under your group plan are drugs that, by law or convention, require a prescription and which have been dispensed by a pharmacist

Deductible

None

Benefits

Reimbursement

Maximum

Deductible applies

CONTACT LENSES

100%

$250.00 combined maximum per 24 months

** Can be applied towards laser eye surgery (see notes below)

No

EYE EXAMINATION

100%

No

FRAMES

100%

No

GLASSES

100%

No

Overall yearly maximum

Unlimited

Overall lifetime maximum

$5,000,000.00

Deductible

$25.00 per calendar year for individual coverage
$50.00 per calendar year for family coverage

Benefits

Reimbursement

Maximum

Deductible applies

ENDODONTICS - ie. root canals

100%

$2,000.00 combined maximum per calendar year(s)

Yes

PERIODONTICS - ie. scaling

100%

Yes

PREVENTIVE TREATMENTS - ask your dentist- acronym P.R.E.V.- predetermination required

100%

Yes

BASIC TREATMENTS: RESTORATIONS

100%

Yes

MAJOR DENTAL CARE

50%

$2,000.00 combined maximum per calendar year(s)

No

Applicable fee guide

General Practitioner - Current less 1 year(s)

Frequencies

Procedure

Frequency/Maximum

RECALL EXAM

ADULTS: 1 occurence(s) every 9 month(s)
CHIDLREN: Up to 18 years old, 2 occurence(s) every 1 calendar year(s) regardles of how many months in between