Extended Health Care Plan
& Dental Care Plan
These Plans help you cope with unexpected expenses that would otherwise be paid out of your pocket. The Extended Health Care Plan is designed to cover eligible health care expenses your government health insurance doesn't pay for, while the Dental Care Plan covers expenses for regular dental checkups as well as preventative and restorative dental care, crowns, dentures and bridgework.
You can choose coverage for yourself or add coverage for your spouse and eligible dependent children too.
What the Extended Health Care Plan covers
80% of eligible expenses incurred for:
- Semi-private convalescent hospital rooms, for up to 180 days' stay
- Out-of-Canada emergency medical care (including hospital accommodation and reasonable and customary fees of a physician or surgeon)
- Prescription drugs and medicines (plan pays for generic drugs or, if no generic exists, the plan pays for brand name drugs)
- Emergency transport by ambulance and air ambulance
- Emergency dental care due to an accident
- Home nursing care
- Services of accredited medical practitioners (including acupuncturists, chiropractors, osteopaths, chiropodists, podiatrists, naturopaths, psychologists, physiotherapists, speech therapists and massage therapists)
- Hearing aids (not including batteries)
- Orthotics and orthopaedic shoes
- Provincial or territorial user fees, where permitted by law
- Repatriation to home province or territory in Canada
- Medical supplies and equipment (including artificial limbs and eyes; casts, crutches and braces; oxygen and related equipment; blood and plasma; wheelchairs and hospital beds)
- Diagnostic lab and X-ray expenses
What the Dental Care Plan covers
80% of eligible expenses incurred for Basic Dental Care, including:
- Diagnostic services (e.g., examinations, X-rays)
- Preventive services (e.g., fluoride treatment, cleaning and polishing)
- Minor restorative expenses (e.g., fillings, stainless steel crowns)
- Endodontic services (e.g., root canals)
- Periodontic services (e.g., treatment for gum diseases)
- Oral surgery (e.g., extraction of impacted wisdom teeth)
All the above are subject to applicable maximums, exclusions and limitations.
|Receiving your benefits|
|Under both the Extended Health Care Plan and the Dental Care Plan, there is a $50 deductible per person per calendar year, up to a maximum of $100 per family. Once you have paid the deductible, benefits are payable as follows: more...|
The Extended Health Care Plan pays 100% of the remaining eligible expenses for your hospital accommodation, anywhere in Canada, and 80% of the remainder of all your other eligible expenses. Once eligible expenses of $2,500 have been submitted for any one insured person within a calendar year, the Extended Health Care Plan will pay 100% of that person's eligible expenses for the rest of the year.
The Dental Care Plan pays 80% of the remaining eligible expenses for Basic Dental Care, and 50% of the remaining eligible expenses for Major Dental Care.
- Extended Health Care Plan benefits are subject to a lifetime maximum of $1,000,000 per person, whether incurred inside or outside Canada, so long as that person is not yet age 65; or $50,000 of that person's expenses incurred inside Canada, plus $12,500 of that person's expenses incurred outside Canada, if that person is age 65 or over.
- Dental Care Plan benefits are also subject to an annual maximum of $1,500 for each insured person, per calendar year.
- Eye examinations are not subject to the deductible or to coinsurance.
|All applicants must be resident in Canada and must be covered by a provincial or territorial government health insurance plan. All Dental Care Plan applicants must be under 65 years of age. All Health Care Plan applicants must be under 66 years of age. The following individuals are eligible to apply: more...|
Members and employees participating in the Health Care Plan are eligible to apply for Health Care Plan coverage for their Spouse and eligible children who are covered by a provincial or territorial government health insurance plan. Members and employees participating in the Dental Care Plan are eligible to apply for Dental Care Plan coverage for their Spouse and eligible children. To be eligible, children must be under age 21 at the time of application and, once insured, benefits will be extended to age 25 for full-time students. Covered children who are incapacitated and dependent on you for support will be covered up to any age.
- Members of the 11 provincial and territorial engineering licensing associations excluding l'Ordre des ingénieurs du Québec, and including members in training. Also, student engineers who are members of a student section (in those associations where a student section exists) and who are within 24 months of expected graduation from a program accredited by the Canadian Engineering Accreditation Board.
- Members of the 8 participating provincial associations of technicians and technologists.
- Members of l'Ordre des Géologues du Québec.
- Members of the Association of Professional Geoscientists of Nova Scotia.
- Members of the Association of Professional Geoscientists of Ontario.
- Members of the Manitoba Association of Architects.
- Members of the Architects' Association of New Brunswick.
- Members of the Nova Scotia Association of Architects.
- Members of the Architects Association of Prince Edward Island.
- A full-time employee of Engineers Canada, or of one of Engineers Canada provincial/territorial constituent associations/ordre, or of one of the participating organizations, or of The Youth Science Foundation Canada.
- Limited licensees.
- Provincial licensees.
Quebec residents must contact their local representative to apply. You can locate your local representative here.
Your authorized insurance representative is always ready to discuss this Plan with you, to help you determine what coverage best suits your needs and to help you complete your application. You can get in touch with your local representative today.