Deductible: Nil

Coinsurance - Prescription Drugs: 80%

Coinsurance - Other Eligible Expenses (except where noted): 100%

Vision Care: 100%

Lifetime Maximum: $15,000

Prescription Drugs

The Member or Dependent Spouse over 65 must file a claim with the Ontario Drug Benefit (ODB) first.  A Dependent Spouse under age 65 is covered under the active plan.

Paramedical

Chiropractor, Osteopath, Naturopath or Podiatrist/Chiropodist: $300 per specialist per calendar year

Licensed Clinical Psychologist: $35 initial visit and $20 per hour thereafter, $200 per calendar year

Physiotherapist: $12.50 per visit, $250 per calendar year

Registered Massage Therapist: $7 per visit, maximum 12 visits per calendar year

Speech Therapist: $200 per calendar year

Major Medical

Rehabilitation Hospital: Semi-private, $3 per day, maximum 120 days

Ambulance Benefit: $100 per disability

Out-of-Hospital Nursing Services:  $1,000 per calendar year

Accidental Dental: Work must be completed within 12 months of accident to a maximum of $5,000 per accident

X-ray & Lab Tests: $500 calendar year maximum

Blood & Blood Plasma: Covered

Durable Medical Equipment (purchase or rental): Covered

Surgical Brassieres:  2 per 12 consecutive months

Breast Prosthesis: Once every 5 years 

Surgical Stockings: 1 pair every 12 consecutive months

Wigs &  Glucometer: Once per lifetime

Hearing Aid (purchase or replacement): $2,000 per person in any 60 month period, including repairs and replacement.

Oxygen: Covered

Orthopaedic Shoes or Orthotics: 1 pair of either orthopaedic shoes or orthotics to a combined maximum of $500 every 
3 years (based on reasonable and customary fees)

Lenses & Frames or Contact Lenses in lieu of glasses: $250 (lenses and frames combined) every 24 months, eye exam included for a Dependent Spouse under age 65

Retinal Eye Exams
Covered for eligible members and their dependents, effective November 1, 2022

Laser Eye Surgery 
50% up to $1,000.00 every 5 years, effective January 1, 2020