Hospitalization and Extended Health Care without prescription drug coverage |
Medical and hospital expenses incurred in Quebec and relating to
an illness, pregnancy, or injury are covered. Coverage also applies
elsewhere in Canada if expenses are incurred due to an emergency.
All of these expenses are covered, up to the limits
indicated.
With the exception of hospitalization expenses, an annual
deductible is applied to eligible expenses before issuing a
reimbursement.
For individual coverage, the deductible is $50; for single-parent
and family coverage, the deductible is $100.
Hospitalization expenses
Reimbursement at 100%, 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 day
, if you have to stay in a ward due to the unavailability of a
private or semi-private room.
The 3-day waiting period applies to any new admission in a
hospital.
Medical and paramedical expenses
Reimbursement at 100%, with deductible, of the following
expenses:
- $500 per 36-month period for purchase and repair of hearing
aids
- $300 for initial purchase of a capillary prosthesis after
chemotherapy
- $200 per 36-month period for glasses, contact lenses or soft
intraocular lenses following a cataract operation
- $200 per year for orthopedic shoes or podiatric ortheses
- $150 for initial purchase of an internal mammary prosthesis
after a mastectomy
- $100 per year for purchase of elastic stockings
Services of health professionals
Reimbursement at 80%, with deductible, of the following expenses,
with a maximum of:
- $1,000 for dental care after an accident
- $500 per year for each of the following professionals:
acupuncturist, audiologist, audioprosthetist, chiropractor,
dietitian, occupational therapist, kinotherapist, massage therapist
(with medical recommendation), speech therapist, osteopath,
physiotherapist or physical rehabilitation therapist,podiatrist and
psychologist; plus $25 per year for X-rays needed for chiropractic
treatment
- $50 per 24-month period for eye examination by an optometrist
or ophthalmologist
- 20 8-hour shifts per year for home care by a registered
nurse
- Ambulance transportation
Purchase and rental expenses
Reimbursement at 80%, with deductible, of the following expenses,
with a maximum of:
- $500 per year for purchase or rental of a TENS therapeutic
device
- $75 per 24-month period for purchase of an intrauterine device
(IUD)
- Purchase cost of syringes, hypodermic needles, and reagent
strips needed by diabetics, as well as devices and accessories for
ostomy patients
- Rental or purchase of crutches, walkers, canes, casts, trusses,
orthopedic braces, and oxygen
- Rental of a respirator, non-motorized wheelchair, and manual
hospital bed
Analysis and examination expenses
Reimbursement at 80%, with deductible, of the following expenses,
with a maximum of:
- $540 per year of eligible expenses for magnetic resonance
imaging
- $300 per year for varicose vein injections
- $200 per year of eligible expenses for CAT scans
- $400 per period of 24 months for polysomnography
- $60 per year for a medical examination to obtain Blue Cross
travel insurance
- $50 per year for ultrasound scans performed in a private
office
- During pregnancy, medical visits beyond the 10 visits covered
by Québec Medicare
- Laboratory tests due to an accident or for the diagnosis or
treatment of an illness, like blood test, urine test, throat
culture.
Travel coverage
When you travel outside of Quebec, this coverage reimburses
expenses and services arising from an emergency due to an accident
or a sudden illness.
The maximum reimbursement is $5 million per insured per trip of 14
days or less.
Hospital, medical and paramedical expenses
- Cost of hospitalization
- Physicians' fees
- Nurse's services
- Professional services by a physiotherapist, chiropractor,
osteopath or podiatrist, prescribed as part of an emergency
treatment, up to a maximum of $300 per profession
- $2,000 per accident for dental care after an accident
- $500 for a dental surgeon's fees for any other emergency
treatment
- $100 per hospitalization for hospital-related expenses
- Laboratory tests and X-rays
- Drugs prescribed by a physician, in case of an emergency
- Purchase or rental of crutches, canes, and splints
- Rental of wheelchairs, orthopedic devices, and other medical
devices
Subsistence allowance
$3,000 (maximum $300 per day) for accommodation and meals when
return must be delayed.
Transportation expenses
- Transportation costs to the nearest medical facility
- Repatriation to Quebec
- Round-trip for a family member or a friend to visit the insured
hospitalized outside Quebec
- Baggage return when the insured is repatriated for medical
reasons, up to a maximum of $300
- Return of a pet when the insured is repatriated for medical
reasons, up to a maximum of $500
- $5,000 for returning a personal or rental vehicle
- $10,000 for preparation and repatriation of the deceased or for
cremation or burial at place of death
Medical Follow-up in Canada
When the insured is repatriated in Canada for medical reasons, the
following expenses are covered:
- Cost of a semi-private room in a hospital or a rehabilitation
centre or a convalescent home up to a maximum of $1,000
- Fees for home nursing care, up to a maximum of $50 per day,
maximum 10 days
Cost for the rental of medical devices such as crutches, standard
walkers, canes, up to a maximum of $150
- Cost for transportation by an ambulance or taxi in order to
receive medical care up to a maximum of $250
Travel cancellation or interruption
You are covered when an unforeseeable event keeps you from making
your trip as planned. The expenses are reimbursed, up to $2,500 per
trip and per insured, if:
- A trip is cancelled before departure
- A trip is cancelled after departure
- A trip is interrupted
- Return is delayed
Travel assistance
Telephone service available 24 hours a day, 7 days a week, offering
the following services:
- Referral to a physician, hospital or to a lawyer in case of
accident
- Follow-up on medical file and settlement of certain
formalities
- Coordination for repatriation or transportation of a family
member
- Assistance in the event of loss or theft of identity papers and
services of an interpreter for emergency calls
- Information on embassies and consulates
Hospitalization and Extended Health Care with prescription drug coverage |
Medical and hospital expenses incurred in Quebec and relating to
an illness, pregnancy, or injury are covered. Coverage also applies
elsewhere in Canada if expenses are incurred due to an emergency.
All of these expenses are covered, up to the limits
indicated.
With the exception of hospitalization expenses, an annual
deductible is applied to eligible expenses before issuing a
reimbursement.
For individual coverage, the deductible is $50; for single-parent
and family coverage, the deductible is $100.
Hospitalization expenses
Reimbursement at 100%, 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 day
, if you have to stay in a ward due to the unavailability of a
private or semi-private room.
The 3-day waiting period applies to any new admission in a
hospital.
Medical and paramedical expenses
Reimbursement at 100%, with deductible, of the following
expenses:
- $500 per 36-month period for purchase and repair of hearing
aids
- $300 for initial purchase of a capillary prosthesis after
chemotherapy
- $200 per 36-month period for glasses, contact lenses or soft
intraocular lenses following a cataract operation
- $200 per year for orthopedic shoes or podiatric ortheses
- $150 for initial purchase of an internal mammary prosthesis
after a mastectomy
- $100 per year for purchase of elastic stockings
Services of health professionals
Reimbursement at 80%, with deductible, of the following expenses,
with a maximum of:
- $1,000 for dental care after an accident
- $500 per year for each of the following professionals:
acupuncturist, audiologist, audioprosthetist, chiropractor,
dietitian, occupational therapist, kinotherapist, massage therapist
(with medical recommendation), speech therapist, osteopath,
physiotherapist or physical rehabilitation therapist,podiatrist and
psychologist; plus $25 per year for X-rays needed for chiropractic
treatment
- $50 per 24-month period for eye examination by an optometrist
or ophthalmologist
- 20 8-hour shifts per year for home care by a registered
nurse
- Ambulance transportation
Purchase and rental expenses
Reimbursement at 80%, with deductible, of the following expenses,
with a maximum of:
- $500 per year for purchase or rental of a TENS therapeutic
device
- $75 per 24-month period for purchase of an intrauterine device
(IUD)
- Purchase cost of syringes, hypodermic needles, and reagent
strips needed by diabetics, as well as devices and accessories for
ostomy patients
- Rental or purchase of crutches, walkers, canes, casts, trusses,
orthopedic braces, and oxygen
- Rental of a respirator, non-motorized wheelchair, and manual
hospital bed
Analysis and examination expenses
Reimbursement at 80%, with deductible, of the following expenses,
with a maximum of:
- $540 per year of eligible expenses for magnetic resonance
imaging
- $300 per year for varicose vein injections
- $200 per year of eligible expenses for CAT scans
- $400 per period of 24 months for polysomnography
- $60 per year for a medical examination to obtain Blue Cross
travel insurance
- $50 per year for ultrasound scans performed in a private
office
- During pregnancy, medical visits beyond the 10 visits covered
by Québec Medicare
- Laboratory tests due to an accident or for the diagnosis or
treatment of an illness, like blood test, urine test, throat
culture.
Travel coverage
When you travel outside of Quebec, this coverage reimburses
expenses and services arising from an emergency due to an accident
or a sudden illness.
The maximum reimbursement is $5 million per insured per trip of 14
days or less.
Hospital, medical and paramedical expenses
- Cost of hospitalization
- Physicians' fees
- Nurse's services
- Professional services by a physiotherapist, chiropractor,
osteopath or podiatrist, prescribed as part of an emergency
treatment, up to a maximum of $300 per profession
- $2,000 per accident for dental care after an accident
- $500 for a dental surgeon's fees for any other emergency
treatment
- $100 per hospitalization for hospital-related expenses
- Laboratory tests and X-rays
- Drugs prescribed by a physician, in case of an emergency
- Purchase or rental of crutches, canes, and splints
- Rental of wheelchairs, orthopedic devices, and other medical
devices
Subsistence allowance
$3,000 (maximum $300 per day) for accommodation and meals when
return must be delayed.
Transportation expenses
- Transportation costs to the nearest medical facility
- Repatriation to Quebec
- Round-trip for a family member or a friend to visit the insured
hospitalized outside Quebec
- Baggage return when the insured is repatriated for medical
reasons, up to a maximum of $300
- Return of a pet when the insured is repatriated for medical
reasons, up to a maximum of $500
- $5,000 for returning a personal or rental vehicle
- $10,000 for preparation and repatriation of the deceased or for
cremation or burial at place of death
Medical Follow-up in Canada
When the insured is repatriated in Canada for medical reasons, the
following expenses are covered:
- Cost of a semi-private room in a hospital or a rehabilitation
centre or a convalescent home up to a maximum of $1,000
- Fees for home nursing care, up to a maximum of $50 per day,
maximum 10 days
Cost for the rental of medical devices such as crutches, standard
walkers, canes, up to a maximum of $150
- Cost for transportation by an ambulance or taxi in order to
receive medical care up to a maximum of $250
Travel cancellation or interruption
You are covered when an unforeseeable event keeps you from making
your trip as planned. The expenses are reimbursed, up to $2,500 per
trip and per insured, if:
- A trip is cancelled before departure
- A trip is cancelled after departure
- A trip is interrupted
- Return is delayed
Travel assistance
Telephone service available 24 hours a day, 7 days a week, offering
the following services:
- Referral to a physician, hospital or to a lawyer in case of
accident
- Follow-up on medical file and settlement of certain
formalities
- Coordination for repatriation or transportation of a family
member
- Assistance in the event of loss or theft of identity papers and
services of an interpreter for emergency calls
- Information on embassies and consulates
Extended prescription drug coverage
This protection covers the part not insured by Quebec
Medicare under the Act Respecting Prescription Drug
Insurance:
- Deductible of $8.33 per month
- Coinsurance of 25%
It also covers reimbursement for prescription drugs not on the
Quebec Medicare list.
Dental care Insurance (optional) |
Dental benefits are subject to a $50 deductible per year, per
contract.
For the first complete year, the maximum total reimbursement per
insured person is $500. If your contract comes into force during
the current year, the maximum will be calculated in proportion to
the number of complete months between the effective date of the
contract and December 31 of the current year.
For the subsequent years, the maximum reimbursement per insured
person is $1000 per year.
This coverage offers you top-quality care without hurting your
budget.
Preventive care
These treatments are covered 80%, after deductible:
- Tooth positioners
- Examinations and diagnoses
- X-rays
- Preventive services
- Laboratory tests and examinations
Basic care
These treatments are covered 50%, after deductible:
- Extraction of erupted teeth
- Anesthesia
- Oral surgery
- Endodontics (root canal)
- Polishing of fillings
- Temporary dressings
- Periodontics (scaling)
- Removable prosthodontics (adjustments, cleaning)
- Restoration of crowns
Home health care (optional) |
This coverage reimburses all costs incurred in Canada after
hospitalization when you are unable to perform without assistance
at least 2 out of 5 activities of daily living. Activities of daily
living are defined as: feeding oneself, getting dressed, using the
washroom, moving around, as well as personal care and
hygiene.
In the case of a fracture or cancer, prior hospitalization is not
required to be covered.
Home care
You may choose our Regular Option or our
Extended Option
| |
Regular Option
|
Extended Option
|
| Eligible expenses covered at 100% |
- Expenses of a registered nursing assistant or home health aide,
Maximum $50 per DAY*
- Expenses of a friend or relative who does not reside with the
insured, Maximum $25 per DAY*
|
- Expenses of a registered nursing assistant or home health aide,
Maximum $70 per DAY*
- Expenses of a friend or relative who does not reside with the
insured, Maximum $35 per DAY*
- Payment of a daily hospitalization compensation of $25, also
payable if hospitalized in a long-term care home.
- Child care expenses, $25 per day for dependent
children
- Fees of a registered nurse or nursing assistant for palliative
care provided at the insured's home, up to a lifetime
maximum of $3000.
|
| Eligible expenses covered at 80% |
- Expenses relating to 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 a maximum amount
payable of $500 per calendar year.*
- For insureds suffering from cancer, transportation
expenses for a maximum period of 3 months, up to a maximum of
$1500
- Expenses incurred for the purchase of medical supplies, when
the insured receives registered nursing care at home, if required
for the treatment of an illness or injury, up to $150 of
eligible expenses per calender year.
|
- Expenses relating to 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 a maximum amount payable of $500 per calendar
year.*
- For insureds suffering from cancer, transportation
expenses for a maximum period of 3 months, up to a maximum of
$1500
- Expenses incurred for the purchase of medical supplies, when
the insured receives registered nursing care at home, if required
for the treatment of an illness or injury, up to $150 of
eligible expenses per calender year.
- Expenses for home conversion if the insured is
permanently disabled and unable to perform without
assistance at least 2 daily activities of daily living up to a
lifetime maximum amount of $5000
These expenses must be incurred within 6 months following
discharge from the hospital.
- 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
|
*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.
Number of days covered
The number of days covered is based on the duration of the hospital
stay. Expenses must be incurred within a maximum benefit period
after being discharged from the hospital.
|
Duration of
hospital stay
|
Number of
days covered
|
Maximum period
to incur expenses
|
|
1 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
|