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Year-by-Year Step-Ups

Year-by-year step-ups describe a benefit structure where maximum coverage amounts increase the longer you stay enrolled in the plan. This feature rewards loyalty and encourages continuous membership.

For example, a plan may pay up to $250 for vision care in the first year, $300 in the second year, and $400 in the third year and beyond. Step-ups are common in extended health and dental benefits, particularly for paramedical and dental categories.

Example:

If your plan’s step-up schedule for paramedical coverage is $300 in year one, $400 in year two, and $500 in year three, your maximum increases automatically each renewal year.

What to Watch For:

Step-ups usually reset if coverage lapses or is canceled. Maintain continuous enrollment to keep higher benefit levels active.

Related Terms

Benefit Period (Vision)

The benefit period for vision refers to how often your vision care coverage renews and allows you to make new claims for eligible expenses such as glasses, contact lenses, or eye exams. Unlike other benefits that reset each year, vision care often renews every two benefit periods, which can mean every 24 consecutive months rather than every calendar year.

Waiting Period

A waiting period is the amount of time you must be covered under a plan before certain benefits become available. Insurers use waiting periods to prevent individuals from joining a plan solely to claim an expensive procedure immediately. Waiting periods vary by benefit type and plan.

Ambulance (Ground/Air)

Ambulance coverage provides reimbursement for emergency transportation to a hospital by ground or air when medically necessary. In health insurance plans, this benefit ensures that if you experience a sudden illness or accident, you can access appropriate care without paying the full transportation cost yourself.

Coverage / Benefit

Coverage, sometimes referred to as a benefit, is the range of health or dental services, supplies, or treatments that your insurance plan agrees to pay for under its terms and conditions. Each benefit represents a category of care, such as prescription drugs, dental services, vision care, or paramedical treatments.

Extended Health Care Insurance

Extended health care insurance (EHC) is supplemental coverage that helps pay for medical expenses not covered by your provincial or territorial health plan. It protects you from out-of-pocket costs associated with services such as prescription drugs, vision care, medical equipment, hospital upgrades, emergency travel medical care, and paramedical services like physiotherapy or chiropractic treatments.

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