OPTION ONE DRUG 1 & DENTAL 1
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1 OPTION ONE DRUG & DENTAL An ideal plan for occasional prescriptions dental visits Highlights of Option One: Basic prescription drug coverage (70%) Basic dental coverage (70%) No medical questionnaire is required. DRUG Drug is a great choice if you are looking to cover basic important needs not covered by your provincial health insurance plan. This plan may be sufficient to cover basic or occasional prescription drugs. Drug benefits cover 70% of the cost of eligible generic* prescription drugs, up to a maximum of $350 in Year $400 in Year 2 beyond. This plan has a $6.50 dispensing fee cap (also subject to 70% coverage). No medical questionnaire is required for this plan. DENTAL If you are looking for a basic dental care protection plan, Dental may be the perfect fit for you. Dental benefits cover 70% of the total cost for basic services, such as examinations, fillings, scaling, cleanings, select extractions diagnostic services. Benefits also include recall visits once every nine months. Maximum coverage is $350 in Year, $550 in Year 2, $700 in Year 3 beyond, per person per anniversary year. Birth control, fertility drugs, smoking cessation aids erectile dysfunction drugs are not covered under Drug Plan or Drug Plan 2.
2 OPTION TWO DRUG & DENTAL 2 Ideal for basic prescriptions enhanced dental services Highlights of Option Two: Basic prescription drug coverage (70%) Enhanced dental coverage (up to 80%) No medical questionnaire is required. DRUG Drug is a great choice if you are looking to cover basic important needs not covered by your provincial health insurance plan. This plan may be sufficient to cover basic or occasional prescription drugs. Drug benefits cover 70% of the cost of eligible generic* prescription drugs, up to a maximum of $350 in Year $400 in Year 2 beyond. This plan has a $6.50 dispensing fee cap (also subject to 70% coverage). No medical questionnaire is required for this plan DENTAL 2 This plan offers coverage for basic services includes access to supplementary services such as periodontal endodontic services, denture repair oral surgery. Dental 2 benefits cover 80% of the total cost for basic services, such as examinations, fillings, scaling, cleanings, select extractions diagnostic services, 60% of the total cost for supplementary services. Benefits also include recall visits once every nine months. The combined maximum for all services covered is $500 in Year, $700 in Year 2, $900 in Year 3 beyond, per person per anniversary year. Birth control, fertility drugs, smoking cessation aids erectile dysfunction drugs are not covered under Drug Plan or Drug Plan 2.
3 OPTION THREE DRUG 2 & DENTAL 2 DRUG 2 Providing you with the added protection you need Drug 2 offers higher yearly benefit amounts for prescription drugs the added value of Hospital benefits, which covers semi-private or private room accommodation, with no restriction on the number of days you stay. Drug 2 benefits cover 75% of the cost of eligible generic* prescription drugs, up to a maximum of $3,000 in Year, $4,000 in Year 2 $5,000 in Year 3 beyond. There is no dispensing fee cap. A medical questionnaire is required. Highlights of Option Three: Enhanced prescription drug coverage (75%) Enhanced dental coverage (up to 80%) Medical questionnaire is required. DENTAL 2 This plan offers coverage for basic services includes access to supplementary services such as periodontal endodontic services, denture repair oral surgery. Dental 2 benefits cover 80% of the total cost for basic services, such as examinations, fillings, scaling, cleanings, select extractions diagnostic services, 60% of the total cost for supplementary services. Benefits also include recall visits once every nine months. The combined maximum for all services covered is $500 in Year, $700 in Year 2, $900 in Year 3 beyond, per person per anniversary year. Birth control, fertility drugs, smoking cessation aids erectile dysfunction drugs are not covered under Drug Plan or Drug Plan 2. Please see the Extended Health Care (EHC) page for full details.
4 All of your plan options include the following Extended Health Care benefits: EXTENDED HEALTH CARE BENEFITS (EHC) Registered Specialists Therapists Vision Care Hearing Aids Orthotics Homecare Nursing, Prosthetic Appliances Durable Medical Equipment Ambulance $250,000 lifetime coverage per person Includes visits to Acupuncturists, Chiropractors, Osteopaths, Podiatrists, Naturopaths, Chiropodists, Registered Massage Therapists Physiotherapists. Maximum each specialist/therapist: Year 2: $300/year, Years 3+: $400/year. Maximum per visit: $20 Chiropractic X-rays $35 maximum per year Speech Therapist $65 first visit, $40 subsequent visits, 0 visits per person, per year Psychologist $80 first visit, $60 subsequent visits, 0 visits per person, per year Vision Care covers the costs towards prescription lenses frames, contact lenses or laser eye surgery. Hearing Aid coverage is provided for its purchase /or repair. Vision Care Maximum for every 2 years: Years 2: $00, Years 3 4: $50, Years 5+: $200 Includes Preferred Vision Services which provides discounts for vision hearing aid products services through participating optical outlets service providers. Hearing Aids Maximum for every 4 years: Years 4: $400, Years 5+: $450 Covers charges for the purchase of custom-made orthotics (plaster cast or computer topography). Maximum $225 per person, per year Maximums for each of these three categories: Year : $,000, Year 2: $,300, Year 3: $,500, Year 4: $2,000, Years 5+: $3,000 Unlimited ground transportation to a hospital. Air Ambulance: Years 3: $4,000/year, Years 4+: $5,000/year Accidental Dental Services Maximum per year: Year : $2,000, Year 2: $2,500, Years 3 4: $3,000, Years 5+: $3,500 Accidental Death Dismemberment Survivor Benefit Hospital Benefits Included with Drug 2 only Adult maximum up to: Year : $0,000, Year 2: $5,000, Year 3: $5,000, Year 4: $20,000, Years 5+: $25,000 For children (0 20): Maximum up to $0,000/year Provides for continuous coverage for year following the death of an adult policyholder. With Drug, available year after policy effective date. With Drug 2, no waiting period. Unlimited semi-private or private room accommodation (up to a maximum of $200/day for Ontario residents; $50/day for all other provinces) Cash Benefit: $50/day if a preferred room is not obtainable from first day (up to $,200/year) Lifetime Maximum excludes Vision Care Accidental Death Dismemberment benefit maximums. Year refers to anniversary year, unless otherwise stated.
5 Understing your coverage Glossary of Terms Accidental Death Dismemberment Payment for a loss directly resulting from accidental bodily injury or accidental loss of life, where the loss occurs within a year of the date of the accident. Accidental Dental Covers dental treatment to natural teeth required as a result of an accidental blow to the head or mouth. Treatment must be sought within the 90-day period following the accident. Ambulance Services Covers trips to hospitals in a licensed ambulance. Covers charges up to the amount between what your provincial health plan covers what is reasonable customary. Anniversary Year Refers to each successive 2-month period following the effective date of the policy. Calendar Year Refers to each successive 2-month period commencing January ending December 3. Dental Services Paid at a percentage of Fee Guide or the reasonable customary charge in your province of residence. Important Notice This is not a contract. Actual terms conditions are detailed in the policy issued by Manulife upon final application approval. It contains important details concerning exclusions, conditions limitations. Please review them carefully upon receipt. Medically Necessary Some benefits will only be payable if they are considered to be Medically Necessary. In order for any care, service, supply or other matter to be considered Medically Necessary, it must be ordered to be provided to an insured person by a physician or registered healthcare professional be one which Manulife determines is appropriate consistent with the symptoms findings or diagnosis treatment of the insured person s illness or injury. It must also be provided in accordance with generally accepted medical practice on a national basis, be the most appropriate supply or level of service which can be provided on a cost-effective basis. Medically Underwritten If/When the plan is Medically Underwritten or requires a medical questionnaire, you must disclose any medical condition, injury or illness that occurred or existed on or before the date of your application, regardless of whether you went to see a doctor about the condition or were given a diagnosis, or whether or not you believe that it is important. The premium charged /or benefits offered could be subject to adjustment or modification of coverage, or declined based on your or your family s medical background. This will be determined after an evaluation of the information provided on the medical questionnaire. Durable Medical Equipment Includes surgical bages dressings the purchase or rental of medically necessary equipment such as crutches, non-electric wheelchairs, hospital beds, oxygen other equipment recommended by a physician. Homecare Nursing The services of registered health professionals including Registered Nurse, Registered Practical Nurse, Certified Home Support Worker, Occupational Therapist, or Registered Dietitian. Hospital Benefits Preferred hospital accommodation in excess of the stard ward room rate made by a general (acute care) hospital. Also included is a cash benefit in lieu of the room cost for each day you are not able to obtain preferred accommodation. Included with Drug 2 only. Prescription Drugs Reimbursement for charges for drugs medicines, plus sera insulin which are purchased on the prescription of a physician or dentist. Prosthetic Appliances Includes artificial limbs, eyes, splints, casts breast prostheses following mastectomies. Payment will be coordinated where benefits are available through the Assistive Devices Program. Hospitalization Manulife cannot guarantee the availability of private or semi-private hospital accommodation. Hospitalization for Pregnancy Full coverage is available for expectant mothers who apply within the first 20 weeks of pregnancy. Hospitalization (for pregnancy) benefit is limited to 2 days. Manulife cannot guarantee the availability of private or semi-private hospital accommodation. Newborns Children born while your policy is in force are automatically added to your policy if an application with appropriate payment is made within 30 days of birth. If application is received after the 30th day following the date of birth, medical information will be required. Maximums All maximums are per person. Any unused portion of benefits cannot be accumulated added to coverage in future months or years. Acceptance Period If your /or your family s medical history is such that a higher premium is required or that special conditions are applied to benefits (see Medically Underwritten), you will be notified in writing prior to your decision to accept the coverage. If at that time you decide not to proceed with the coverage, your initial payment will be returned your application cancelled. Effective Date of Coverage Coverage is effective the first day of the month following final approval of the application. Underwritten by The Manufacturers Life Insurance Company. Manulife the Block Design are trademarks of The Manufacturers Life Insurance Company are used by it, by its affiliates under license. 204 The Manufacturers Life Insurance Company. All rights reserved. CAA CAA logo trademarks owned by, use is granted by, the Canadian Automobile Association
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