Hospitalization
and Diagnostic Services
Hospitalization
100% reimbursement (no deductible) of expenses for semi-private
room accommodation:
- In a hospital for short-term medical care, unlimited number of
days
- In a public or private convalescent home, or in a
rehabilitation centre, combined maximum of 90 days per year
- Compensation of $25 per day of hospitalization from the 4th to
18th day inclusive, if you have to stay in a ward due to the
unavailability of a private or semi-private room.
Diagnostic Services
80% reimbursement, after the annual deductible of $50, of the
following eligible expenses :
- laboratory tests : blood and urine tests, throat culture and
cytology
- Scanner (CT scans), up to $250 per calendar year
- magnetic resonance imaging (MRI), up to $675 per calendar
year
- ultrasound, up to $100 per calendar year
- polysomnography, up to $500 per period of 24 months
- home nursing care by a registered nurse, up to 20 8-hour
periods, maximum 160 hours per calendar year
- purchase or rental of non-motorized wheelchair or manual
hospital bed
- emergency ambulance transportation (for people under the age of
65)
Hospitalization
and Extended Health Care
Hospitalization
100% reimbursement (no deductible) of expenses for semi-private
room accommodation:
- In a hospital for short-term medical care, unlimited number of
days
- In a public or private convalescent home, or in a
rehabilitation centre, combined maximum of 90 days per year
- Compensation of $25 per day of hospitalization from the 4th to
18th day inclusive, if you have to stay in a ward due to the
unavailability of a private or semi-private room.
Extended Health Care
Covers eligible expenses, subject to a lifetime maximum of
$15,000 per insured person.
100% reimbursement (no deductible) of the following expenses due to
illness or injury:
Professional health services
Medical recommendation not required for the following professional
services:
- Acupuncturist, audiologist or audioprosthetist, naturopath,
occupational therapist, osteopath, physiotherapist or
rehabilitation therapist,
$25 per visit, maximum 20 visits per calendar year, per
specialist
- Chiropractor or podiatrist, $25 per visit, combined maximum of
20 visits per calendar year,
- chiropractor’s X-rays, up to $25 per calendar year
Eye care
- Glasses or contact lenses or soft intraocular lenses following
a cataract surgery,
maximum $200 per period of 36 consecutive months
80% reimbursement (annual deductible of $50) of the following
eligible medical and paramedical expenses:
Private clinic exams
- Scanner (CT scans), up to $250 per calendar year
- Magnetic resonance imaging (MRI), up to $675 per calendar
year
- Ultrasound, up to $100 per calendar year.
- Polysomnography, up to $500 per period of 24 months.
Private accommodation in a hospital, for short-term
medical care
Laboratory tests
- Blood and urine tests, throat culture and cytology.
Registered nurse for in-home nursing care
- Maximum 20 8-hour periods, maximum 160 hours per calendar
year
Various medical devices and accessories
- Devices and accessories for ostomy patients
- Syringes, needles, and reagent strips for diabetics
- Purchase or rental of a manual hospital bed, non-motorized
wheelchair, and respiration therapy equipment
- Accessories such as walkers, canes, crutches, hernia straps,
and oxygen supply, etc.
- Elastic stockings, up to $100 per calendar year
Prostheses and accessories
- Purchase and repair of auditory prostheses, up to $500 per
period of 36 consecutive months
- Purchase of a mammary prosthesis, up to $150 per calendar
year
- Purchase of a first capillary prosthesis following
chemotherapy, up to $300 of eligible expenses
- Purchase and adjustment of orthopaedic shoes or podiatric
ortheses, up to $200 per calendar year
Dental care following an accident, up to $1,000
per accident, per insured.
Medical questionnaire filled by your physician to
obtain Blue Cross travel insurance, up to $75 per calendar year
For people under 65
- eye exam, up to $50 per period of 24 consecutive months,
- emergency ambulance transportation
Home Health
Care (optional)
This optional coverage reimburses eligible
expenses incurred following hospitalization in an active care
hospital, a day surgery or a medical consultation. There is no
limit to the number of hospitalization or day surgery, but as for
medical consultation the eligible expenses are limited to
one consultation per calendar year.
The number of days covered varies according to the number of days
of hospitalization. In the case of a fracture or cancer, prior
hospitalization is not required.
You may choose our Regular Option or our
Extended Option
| |
Regular Option |
Extended Option |
| Eligible expenses covered at 100%, no
deductible |
- Registered nursing assistant or home health
aide, to help the insured person who is temporarily unable
to perform unassisted 2 of the 5 daily activities. *
Daily maximum $50 **
- Friend or relative who does not reside with the insured,
Daily maximum $25 **
|
- Registered nursing assistant or home health aide , to help the
insured person who is temporarily unable to perform unassisted 2 of
the 5 daily activities. *
Daily maximum $70 **
- Friend or relative who does not reside with the insured,
Daily maximum $35 **
Daily compensation
- payment of a daily hospitalization compensation of $25, also
payable if hospitalized in a long-term care home.
Child care expenses
- for dependent children of the insured aged 64 years and less,
$25 per day
The combined lifetime maximum for the daily compensation
and child care expenses is $9,125.
Palliative care
- Fees of a registered nurse or nursing assistant for palliative
care provided at the insured’s home, if his life expectancy
is limited to 3 months, up to a lifetime maximum of
$3000.
|
| Eligible expenses covered at 80%, no
deductible |
Transportation expenses
- Transportation in order to receive medical care or for a
follow-up.
- $0.25 per kilometre for the use of private automobile
or the cost of a taxi ride, up to an eligible
amount of $50 per day (including parking expenses, if
applicable) and up to $500 per calendar year.
- For insureds suffering from cancer, transportation
expenses for a maximum period of 3 months, up to a maximum of
$1500.
Medical supplies
- Medical supplies required when the insured receives registered
nursing care at home for the treatment of an illness or injury, up
to $150 of eligible expenses per calendar
year.
|
Transportation expenses
- Transportation in order to receive medical care or for a
follow-up.
- $0.25 per kilometre for the use of private automobile
or the cost of a taxi ride, up to an eligible amount of $50 per
day (including parking expenses, if applicable) and up to
$500 per calendar year.
- For insureds suffering from cancer, transportation
expenses for a maximum period of 3 months, up to a maximum of
$1500.
Medical supplies
- medical supplies required when the insured receives registered
nursing care at home for the treatment of an illness or injury, up
to $150 of eligible expenses per calendar
year.
Home conversion
- Expenses for home conversion if the insured is
permanently disabled due to an accident or an
illness, and unable to perform without assistance at least 2 daily
activities of daily living* for a lifetime maximum amount
of $5000.
These expenses must be incurred within 6 months following
discharge from the hospital.
Meals and accommodation
- Expenses for meals and accommodation in a
specialized facility affiliated to a hospital, if the insured must
receive treatments for cancer or following a
transplant, in a different city than his city of
residence, up to a maximum of $500 per calendar
year
|
| |
Monthly benefit
- When the insured person is unable to perform unassisted 2 of
the 5 daily activities*, due to an accident or an illness,
$200 for up to 3 months
The monthly benefit is subject to a 30-day waiting period.
|
Monthly benefit
- When the insured person is unable to perform unassisted 2 of
the 5 daily activities*, due to an accident or an illness,
$500 for up to 6 months
The monthly benefit is subject to a 30-day waiting period.
|
* The daily activities are the following:
eating, dressing, using the toilet, transferring from bed to chair
and bathing/showering.
* * The number of days covered is determined according to the
duration of hospital stay and expenses must be incurred within a
maximum period following discharge from the hospital.
| Hospitalization duration |
Number of days covered |
Maximum period to incur eligible expenses |
| 0 to 3 days |
5 |
7 days |
| 4 to 7 days |
7 |
14 days |
| 8 to 14 days |
14 |
28 days |
| 15 days and over |
21 |
35 days |