Manulife - FlexCare - ComboPlus Basic

Payments for accidental death or dismemberment directly resulting from an accident, occurring within one year of the date of the accident. Additional coverage can be purchased as an Add-On.

• Up to $25,000 for adults
• Up to $10,000 for children and persons aged 65 years or over

Covers trips to hospital in a licensed ambulance in yourhome province/territory of residence. Covers charges up to the amount betweenwhat your government health insurance plan covers and what is reasonable andcustomary.

Unlimited ground and air transport

Reimbursement (for ongoing maintenance services: fillings,cleanings, scalings, examinations, polishings, and select extractions) per year

• 80% of first $400, 50% of next $860

Anniversary year maximum for basic dental services

• $750

Recall visits

• 9 months

Oral surgery, periodontics, endodontics (root canal)

• Not covered

Major restorative (orthodontics, crowns, bridges, dentures)– benefits commence in year 2

• Not covered

Coverages are designed to coincide with the current provincial Dental Association Fee Guide for General Practitioners.

Covers the costs to purchase and/or repair up to the allowed maximum.

• $400 per 4 benefit years
• Seniors’ Adjustments 65+: $500 maximum per person, per 4 consecutive benefit years

Covers services of:

• Registered Nurse (R.N.)
• Registered Practical Nurse (R.P.N.)
• Licensed Practical Nurse (L.P.N.)
• Personal Support Worker
• Occupational Therapist

Must be medically necessary and provided in the insured’s primary residence.

Prior Authorization required before services begin.

$4,000 per person, per anniversary year

Seniors’ Adjustments 65+: $4,500 per person, per anniversary year

Includes:

• Medically necessary equipment: purchase or rental of items such as hospital beds, wheelchairs, walkers, and other durable medical equipment.
• Surgical bandages and dressings.
• Prosthetic appliances: artificial limbs and eyes, external breast prosthesis following mastectomy, wigs for oncology-related diagnosis, splints, trusses, cervical collars, and braces (excluding dental braces).

Must be medically necessary and prescribed by a physician or nurse practitioner.

Prior Authorization is required for most items, especially those exceeding $300 or listed in the policy.

Payment is coordinated with government programs (e.g., Assistive Devices Program).

• $4,000 maximum per person, per anniversary year
• Seniors’ Adjustments 65+: 4,500 maximum per person, per anniversary year

Registered Specialists and Therapists (Paramedical Services): Chiropractor ($35 chiropractic x-rays per year), Chiropodist, Osteopath, Naturopath, Podiatrist,

Registered Massage Therapist, Acupuncturist, Dietitian (per person per anniversary year)

• Dollar maximum $25/visit, maximum visits 20/specialist

Registered Psychologist/Psychotherapist/Clinical Counsellor(per person per anniversary year)

• Maximum visits 15, First visit $80, Subsequent visits $65

Registered Speech Pathologist/Therapist (per person per anniversary year)

• Maximum visits 10, First visit $65, Subsequent visits $45
• Seniors’ Adjustments 65+: Maximum Visits 15Registered Physiotherapist (per person per anniversary year)
• $250 maximum

Generic drugs vs. brand-name drugs

• Generic

Shared Dispensing Fee (subject to applicable co-payment)

• $6.50 maximum

Exclusions – Smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, erectile dysfunction drugs and drugs not requiring a prescription

• All

Reimbursement of eligible prescription costs per year

• 70% of first $750
• **Seniors’ Adjustments 65+:**100% of first $750, 90% of next $4,722

Anniversary year maximums per person

• $5,000
• Seniors’ Adjustments 65+: $5,000

$5,000,000 emergency health coverage per person for tripslasting a maximum of 9 days. (A $100 deductible applies per claim.)

• Included

Additional coverage for either 8 or 21 days can be purchased as an Add-On.

• 100% reimbursement to a maximum of $250 every 2 years for lenses and frames, contacts or laser eye surgery
• $70 per 2 benefit years for Optometrist visits

This benefit does not include industrial safety glasses.

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