Chances are, the cost of everyday health care won’t ruin you financially. The escalating expenses associated with a catastrophic accident, a chronic medical condition or a critical illness, on the other hand, could do just that. That’s where your CPA Select Catastrophic Health Insurance comes into play. It’s like having an emergency back-up fund when medical bills get out of hand.
CPA Select Catastrophic Health Insurance will "top up" your existing health insurance and/or CPA Select Critical Illness Insurance coverage. If you don’t have private insurance coverage, the CPA Select Catastrophic Health Insurance Plan can help protect your assets from being drained by significant medical costs.
You continue to cover your health care costs as usual, through an existing health plan or out of your pocket. But when your expenses grow to exceed the preset maximums, CPA Select Catastrophic Health Insurance kicks in to help you cover the remainder of your medical bills!
|You, your spouse and your adult children, aged 21 to 64, are eligible to apply for coverage – and stay covered for life.|
An individual who is covered (or applying for coverage) under this Plan can apply to extend coverage to their dependent children aged 0 to 20 years, as well. All applicants must be covered under a government health plan. Coverage is not available to members who reside in Quebec or Bermuda.
CPA Select Catastrophic Health Insurance pays the following benefits: More
Benefits Are Paid
Benefit Is Paid
What the Limits Are
After the first
have been paid
Homecare / Private Nursing, Durable Medical Equipment, Prosthetic Appliances
After the first
have been paid
Physiotherapy / Chiropractor
receiving proof of
requiring 24-hour hospitalization
continue for 12
consecutive months following the date
of the accident
requiring 24-hour hospitalization
Benefit payments are coordinated with payments by your existing insurance, including your government health plan. The total payments you receive will not exceed 100% of the eligible expenses you incur.
|Prescription Drug Benefit|
Homecare and Nursing, Durable Medical Equipment and Prosthetic Appliances Benefits
- Unlimited coverage up to 100% after your drug costs exceed $4,500 per Anniversary Year.*
- To satisfy the deductible and for reimbursement, covered charges include eligible brand-name or generic drugs and medicines, sera and insulin** (but exclude smoking cessation drugs, fertility drugs, over-the-counter drugs, and drugs that don’t require a prescription).
- Drugs covered by a provincial health plan are not eligible under this plan.
- Up to $25,000 per year when annual costs exceed $7,500 per Anniversary Year.*
- Lifetime maximum of $100,000.
Chiropractor and Physiotherapist Benefits
- Unlimited coverage up to 100% for one full benefit year following the date of an accident requiring a 24-hour hospital stay.
* Anniversary Year means each successive 12-month period following the effective date of the policy. For insured individuals resident in British Columbia and Saskatchewan, the Prescription Drug Benefit refers to the Calendar Year.
** Includes all drugs listed in Manulife Financial’s Formulary.
Health Service Navigator® (included at no extra cost)
With Health Service Navigator(HSN), you and your family members can quickly and easily get answers to your medical questions and access to support services. And access isn’t dependent upon making a claim – it’s available immediately not only for you the insured, but for all of your eligible family members too!
Available on-line or by calling a dedicated representative - You can receive information, medical coordination services and resources on how to navigate the Canadian health care system. And, if you want a second opinion from a world-class hospital, Health Service Navigator will help you get it too.
Health Service Navigator is managed by a team of professionals, so you can be sure that the information and resources it provides are credible and current.
How Health Service Navigator can help you and your family
- Your doctor has made a diagnosis, but you want a second opinion.
- You want to know how long will you have to wait for surgery and whether there a faster way to get it
- You want more information about a prescription drug.
- You need to find a family doctor.
- You want to make the most of your appointment with a new specialist.
- You need to know what health resources are available in your area.
- You can find out what health expenses are covered under your provincial health plan.
- You want to understand a medical condition and treatment options.
|World-Class Medical Second Opinions|
Medical Coordination Services
|The second-opinion provider, WorldCare International, Inc. (WorldCare), specializes in medical advisory assistance. Your diagnosis and treatment plans are evaluated confidentially and securely by world-class specialists at top-ranked hospitals – all without you having to leave your home.|
|If you or an eligible dependant receive a second opinion and decide to travel to the United States for medical treatment, WorldCare® provides help with the arrangements and coordination of appointments. |
Health Service Navigator is offered through The Manufacturers Life Insurance Company (Manulife Financial).
For more information, visit www.manulifehealth.ca
Coverage That Goes Where You Go
CPA Select Catastrophic Health Insurance is not tied to any employer or other benefit plan – so it can go with you from job to job.
Coverage You Can Keep for Life
Once insured under CPA Select Catastrophic Health Insurance, you can keep your coverage – regardless of your age or changes in your health.
Coverage for Your Children and Grandchildren
You can extend CPA Select Catastrophic Health coverage to your dependent children. As long as you remain eligible to apply for coverage under the Plan, your adult children (over age 20), whether or not they reside with you, can apply for coverage too. In fact, your adult children can extend coverage, in turn, to their dependent children.
If you are self-employed or own your own business, the premiums you pay for CPA Select Catastrophic Health Insurance may qualify as tax-deductible business expenses under Canada Revenue Agency (CRA) guidelines or you may be able to claim them as medical expenses on your personal income tax return.
When any two adults apply for coverage at the same time, they could save up to 17% per person, thanks to the special Couple Rate!
See the rates that apply to you.
|All applicants for CPA Select Catastrophic Health Insurance must be 21 to 64 years of age, be resident in Canada but not resident in Quebec, and be covered under a government health plan. More|
To apply, you must be a member of one of the following participating bodies:
- Chartered Professional Accountants of New Brunswick
- Chartered Professional Accountants of Newfoundland and Labrador
- Institute of Chartered Accountants of Nova Scotia
- Chartered Professional Accountants of Ontario
- Chartered Professional Accountants of Prince Edward Island
- Chartered Professional Accountants of Bermuda
Your spouse (to whom you are legally married or with whom you had cohabited in a conjugal relationship for at least 12 consecutive months) and your adult children (who are over age 20) may also apply.
Anyone covered by (or applying for) CPA Select Catastrophic Health Insurance can apply to extend coverage to their dependent child(ren). A dependent child means a child of the insured who is listed on the application; is a natural child, adopted child, stepchild, foster child or a child for whom the insured is by law responsible; is unmarried, unemployed and dependent on the insured for financial support; and is under 21 years of age.
|Limitations and Exclusions|
|Any benefits paid to individuals covered under CPA Select Catastrophic Health Insurance are subject to the following limitations and exclusions: More|
Benefits are not payable for:
- charges which result, directly or indirectly, from – or are in any manner or degree associated with or occasioned by – any self-inflicted injury while sane or insane;
- charges which are payable under any government health insurance plan or available manufacturer rebate program;
- charges for care, services or supplies which are for cosmetic purposes, except when in connection with reconstructive surgery to repair or replace tissue damaged by disease or bodily injury;
- charges for drugs, tests, services, treatment or supplies which are not medically necessary, or which are experimental as determined by the insurer;
- charges in excess of those deemed by the insurer to be usual, reasonable and customary charges in the geographic region of the insured’s residence;
- charges for hospitalization;
- charges for services, equipment and supplies provided in a chronic care or psychiatric hospital or institution, chronic care unit of a hospital, or psychiatric unit of a hospital – or when a patient is confined to a long-term care facility or a transition ward of an acute care hospital;
- charges incurred for which payment under the policy is not permissible by law;
- charges for duplicate or replacement prosthetic appliances, devices or durable medical equipment, except where replacement is required because the existing item can no longer be made serviceable due to normal wear, or as a result of a pathological change in the patient’s condition;
- charges for eligible services provided outside the province or territory of residence of the insured which are in excess of the amount the insurer would have paid for such services if they were provided in the province or territory of residence determined as of the date the last service was provided outside the province or territory of residence;
- charges incurred for care, services or supplies due to sickness or injury resulting from war, invasion, acts of foreign enemies, hostilities, warlike operations (whether war be declared or not), civil war, rebellion, revolution, insurrection, civil commotion assuming the proportions of, or amounting to, an uprising, military or usurped power, hijacking, any act of terrorism or any action taken in controlling, preventing or suppressing any of the foregoing, including claims which are as a result of or in any way connected or associated with such events or causes and regardless of any other cause or event contributing concurrently or in any other sequence thereto. For the purpose of this exclusion, “act of terrorism” means an act including, but not limited to, the use of force or violence and/or the threat thereof, by any person or groups of persons, whether acting alone or on behalf of or in connection with any organization or government, committed for political, religious, ideological, or similar purposes including the intention to influence any government and/or to put the public, or any section of the public in fear, or an act that has been determined by the appropriate federal authority to have been an act of terrorism;
- charges or benefits, or part thereof, which, after the effective date, cease to be payable under any government program;
- charges for drugs, medicines, services or supplies which have been self-prescribed, or prescribed by or for family members; or
- charges incurred in relation to medical conditions or ailments as specified in the counteroffer letter signed and accepted by the insured, where applicable.