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Health & Dental Plans

A wide selection of Core plans provide coverage for varying levels of drug and dental benefits

Flexcare plans are specifically designed to offer flexibility and choice. A wide selection of Core plans provide coverage for varying levels of drug and dental benefits, along with vision care, extended health care, travel insurance and more.

FollowMeTM Health is specially designed to offer health and dental coverage when group health benefits come to an end. If your client applies within 60 days of their group health benefit end date, no medical questionnaire is required.

Please remember that the FollowMeTM Health insurance plan is not intended to provide and will not provide the exact same coverage that you may have had under your group health insurance plan.

ComboPlusTM Plans - A combination of prescription drug and dental plans.

Combo PlusTM Starter Plan

No medical questionnaire required

Prescription Drugs

Generic drug plan (name brands are allowed, but Manulife will pay the generic equivalent price).

Shared dispensing fee to a maximum of $6.50.

70% of the first $750 of eligible prescription costs (including the shared dispensing fee) to a maximum of $525 in coverage per person per anniversary year.

Vision – $150 every 2 years

Travel – $5 million in emergency health coverage for first 9 days of each trip

Exclusions: smoking cessation drugs, birth control drugs, fertility drugs, erectile dysfunction drugs, over-the-counter 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 per person per anniversary year.
Recall visits every 9 months, per person.
Coverages are designed to coincide with the current provincial Dental Association Fee Guide for General Practitioners.

The following Core benefits are also included with ComboPlus Starter:

Vision (Starter)

$150 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and laser eye surgery.
$60 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable).
Preferred Vision Services (PVS) – Take advantage of discounts available through a network of providers and retailers. Your client can save up to 20% on eyewear purchases, which include lenses, frames and contact lenses, made at participating optical retailers. PVS discounts are also available for laser eye surgery. Get the complete listing of participating retailers and practitioners across Canada online or over the phone.

Extended Health Care (Starter)

Lifetime maximum – $250,000 per person
Health Service Navigator® – With Health Service Navigator, your client can quickly and easily get answers to questions and access to support services. Easily accessible on the web or with a simple call to a dedicated toll-free line, Health Service Navigator can provide information, medical coordination services and resources on how to navigate the Canadian health care system. Health Service Navigator will also help get a second opinion from a world-class hospital.
Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist – $20 maximum per visit, 20 visit maximum per person per discipline per anniversary year.
Chiropractic X-ray – $35 maximum per person per anniversary year.
Psychologist – $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per person per anniversary year
Physiotherapist – $250 maximum per person per anniversary year
Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment – maximum per person per anniversary year for each of these 3 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

Custom-made Orthotics – $225 maximum per person per anniversary year.
Speech Pathologist/Therapist – $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per person per anniversary year.
Lifeline® Personal Response Service – maximum of 6 months of service per person per 3 anniversary years.
Accidental Dental – $2,000 maximum per person per anniversary year.
Ambulance – unlimited ground and air transportation.
Hearing Aid – $400 maximum per person per 4 consecutive benefit years. Preferred Vision Services (PVS) discounts offer the added advantage of a 10% deduction, depending on the province of residence and whether the hearing practitioner is part of the PVS network.
Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.

Travel

$5,000,000 emergency health coverage per person 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: Coverage may be limited or excluded for any illness or condition that first manifested itself within the 9-month period immediately before each departure date. Not available to persons age 65 and over.

Accidental Death & Dismemberment (Basic)

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 65 and over, 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.

FollowMeTM Health - Coverage that begins when group coverage ends*

Prescription Drugs

Provides coverage for generic* prescription drugs.

No maximum on shared dispensing fee.

Percentage paid To a maximum of (per anniversary year)

Reimbursement for first amount 80%     $450

Exclusions: smoking cessation drugs, birth control drugs, fertility drugs, erectile dysfunction drugs, over-the-counter drugs and drugs not requiring a prescription.

*Generic drug – Generally a 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 no generic brand exists, payment of the brand-name price will be made at the co-payment level of your plan.

Vision Care

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

Note: This benefit does not include industrial safety glasses.

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

Preferred Vision Services (PVS) – Take advantage of discounts available through a specific network of providers and retailers. Your client can save up to 20% on eyewear purchases, which include lenses, frames and contact lenses, made at participating optical retailers. PVS discounts are also available for laser eye surgery. Get the complete listing of participating retailers and practitioners across Canada online or over the phone

Extended Health Care Benefits

$100,000 lifetime maximum per person
Registered Specialists and Therapists – includes visits to Acupuncturists, Chiropractors, Osteopaths, Podiatrists, Naturopaths, Chiropodists, Registered Massage Therapists, Physiotherapists – $15 maximum per visit, 20 visit maximum per specialist per anniversary year.
Chiropractic X-ray – $35 maximum per anniversary year.
Psychologist – $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per anniversary year.
Speech Therapist – $65 maximum first visit, $45 maximum subsequent visits, 10 visit 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+
$500 $750 $1,250
Custom-made Orthotics – $250 maximum per year.
Lifeline® Personal Response Service – lifetime maximum of 6 months of service.
Accidental Dental – 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 maximum per anniversary year.
Ambulance -unlimited ground transportation to hospital and $4,000 maximum for air ambulance. transportation per anniversary year.
Hearing Aid – $300 maximum per 5 consecutive benefit years. Preferred Vision Services (PVS) discounts offer the added advantage of a 10% deduction, depending on the province of residence and whether the hearing practitioner is part of the PVS network.
Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.

Hospital Benefits

Preferred hospital accommodation in excess of the standard ward room rate of a general (acute care) hospital. Also included is a cash benefit in lieu of the room cost for each day preferred accommodation is not obtained.

Semi-private room

$175 maximum per day.

Reimbursement per anniversary year – 50% for 150 days.

Cash Benefit

$25 per day if semi-private room is not obtained, to a maximum of $1,500 per anniversary year.

Survivor Benefit

Provides for coverage to be continued for 1 year following the death of an adult policyholder.

Accidental Death and Dismemberment

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.

Up to $10,000 for adults.

Up to $5,000 for children and persons aged 65 years or over.

Health Service Navigator®

With Health Service Navigator, your client can quickly and easily get answers to questions and access to support services. Easily accessible on the web or with a simple call to a dedicated toll-free line, Health Service Navigator can provide information, medical coordination services and resources on how to navigate the Canadian health care system. Health Service Navigator will also help get a second opinion from a world-class hospital.

*The FollowMe Health individual insurance plan does not duplicate the coverage of previous group health plans.

All references to “year” refer to anniversary year. When it relates to Hearing Aids and Vision benefits, “year” refers to benefit year.

Following are usually not covered by government health insurance plans:

  • Prescription drugs*
  • Dental check-ups and treatment
  • Hospital stays
  • Specialized care, including speech therapists or pathologists, physical therapists, chiropractors, and many more
  • Homecare and nursing
  • Medical supplies and equipment
  • Emergency medical health treatment for travellers
  • Personal emergency response
  • Hearing aids
  • Accidental death and dismemberment
  • Catastrophic coverage

Your province may outline coverage on their website.

No one likes to think about the possibility of having serious health issues

No one likes to think about the possibility of having serious health issues. Unfortunately, if an accident or illness were to happen to you or a member of your family, the cost of medication, treatment and other expenses could add up to a considerable amount. Even treatment for common illnesses, like medication for back pain or therapy for a sprain, can be costly. Supplemental health insurance can help cover medical costs that may not be covered by your provincial health plan.

While critical illnesses such as cancer1, stroke and heart attacks2 are the serious causes of death in Canada, there are many common illnesses such as back problems, diabetes, epilepsy or high cholesterol that may also have significant financial consequences.

Unexpected medical and dental expenses if you don't have a health plan.

Every year, you could pay thousands of dollars in unexpected medical and dental expenses if you don’t have a health plan. You could also be especially financially vulnerable in the event you suffer a serious illness or injury. Or you could end up having to use up your savings on private care, because your government health insurance plan, unfortunately, may only offer limited coverage for home nursing care and in-home assistance.

From just dollars a day, you can have comprehensive coverage that you and your family simply shouldn’t be without. And, if you’re self-employed or are an employee of your own business, health and dental premiums may be a non-taxable benefit and a tax-deductible expense. For others, the premiums may qualify as a medical expense and create a tax credit.

Llong-term value lies in the comfort of knowing that you have supplemental health insurance

Although the dental, drug and vision components of a health plan are typically the most used benefits, the long-term value lies in the comfort of knowing that you have supplemental health insurance that may help beyond what the government health system provides.

Wisdom teeth removal falls under oral surgery

Wisdom teeth removal falls under oral surgery (extensive services). Procedures related to oral surgery require x-rays and a treatment plan to be submitted to Manulife for assessment by your dentist before any work or treatment begins. You will then be advised of the eligibility of the treatment.

Five of the eight plans require no medical questionnaire at the time of application.

Five of the eight plans require no medical questionnaire at the time of application. These plans include the Base Health and Dental Plan and the four Dental (with basic health) Plans. When you apply, your acceptance is guaranteed provided that you meet the eligibility criteria.

Our medical marijuana program is available under the Association Health & Dental Plan

Our medical marijuana program is available under the Association Health & Dental Plan as a part of drug benefits (plan limitations apply, refer to schedule of benefits).

 

Contact

For an appointment to discuss your needs, contact me.

I will set up a time which is best suitable for you and will personally come to your workplace to discuss all of your insurance needs.

leonlevi@insureitgroup.com

toronto insurance olutions

Leon Levi (R.I.B LLQP)
Commercial Insurance Account Executive
INSUREIT GROUP INC
leonlevi@insureitgroup.com
800 Denison St, Suite 200
Markham, Ontario L3R 5M9
416-388-8918

 

 

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