Extended Health Care (EHC) and Dental Care Insurance

Extended Health Care (EHC) Insurance coverage is available to help cover a number of important medical expenses that may not be paid by provincial health insurance plans. Choose a plan with Dental Care to help cover routine and unexpected dental care costs.

As an added convenience, you can access your claims/benefit information with your mobile device or online at mysunlife.ca.

Definitions and exclusions

Detailed features

Coverage available for: You, you and your spouse, or coverage for your family
You can apply for coverage if you are: Under 75-years-old
An Association member working a minimum of 25 hours a week
Residing in Canada
An eligible spouse
Coordination of benefits: If you are covered for Extended Health Care and/or Dental Care under this plan and another plan, your benefits will be coordinated with the other plan following insurance industry standards. However, if you and your spouse are both active members of the Association, coordination of benefits does not apply.
Your coverage ends: To learn when your coverage ends click here.
Coverage limitations: Please refer to Definitions and exclusions.
Rates: Please refer to the Rate Card.

* Quebec residents must also have and continue to have health and drug coverage through a group benefit plan or through Régie de l’assurance maladie du Québec (RAMQ). A person not covered under a group benefit plan or through RAMQ, is not eligible for coverage under this policy.

Coverage details

Basic plan

High level plan summary: note disclaimer the policy provisions apply.

Benefit Reimbursement
Drug
  • 70% up to $750 per covered person in a plan year
  • Fully reimbursed up to $6.50 dispensing fee
Extended health

Eligible expenses
  • reasonable and customary charges for the services or supplies listed
  • 70% subject to limits outlined in the benefit
Paramedical $350 per practitioner per plan year ; $600 per plan year for all categories combined
Hearing Aids $350 per five years
Accidental Dental $2,000 per plan year maximum per fracture or injury
Nursing $2,500 per plan year ($10,000 lifetime maximum)
Orthopaedic shoes $250 per plan year; includes orthotics
Vision
  • 100%, $50 per 24 months for eye-exam
Lifetime maximum
  • $100,000 per covered person

Standard plan

High level plan summary: note disclaimer the policy provisions apply.

Benefit Reimbursement
Drug
  • 70% on first $1,000 ($700) and 80% on next $5,375 ($4,300)
    Total coverage: $5,000 ($700+$4,300) per plan year
  • Fully reimbursed up to $6.50 dispensing fee
Extended health

Eligible expenses
  • reasonable and customary charges for the services or supplies listed
  • 80% subject to limits outlined in the benefit
Paramedical $480 per practitioner per plan year ; $800 per plan year for all categories combined
Hearing Aids $400 per five years
Accidental Dental $2,500 per plan year maximum per fracture or injury
Nursing $5,000 per plan year ($15,000 lifetime maximum)
Orthopaedic shoes $250 per plan year; includes orthotics
Vision
  • 100%, $50 per 24 months for eye-exam
  • 100% up to $150 every two plan years for glasses
Emergency travel medical coverage
  • 100%
  • Maximum duration of 15 days per trip
  • Unstable pre-existing medical conditions that existed during the nine-month period prior to your trip are not covered
Semi-private hospital room
  • 80% up to $200 per day of hospitalization up to a plan year maximum of $5,000
Lifetime maximum
  • $300,000 per covered person and
  • $3,000,000 lifetime maximum per covered person for Emergency travel medical coverage

Standard plus plan

High level plan summary: note disclaimer the policy provisions apply.

Benefit Reimbursement
Drug
  • 70% on first $800 ($560) and 80% on next $3,675 ($2,940)
    Total coverage: $3,500 ($560+$2,940) per plan year
  • Fully reimbursed up to $6.50 dispensing fee
Extended health

Eligible expenses
  • reasonable and customary charges for the services or supplies listed
  • 80% subject to limits outlined in the benefit
Paramedical $480 per practitioner per plan year ; $800 per plan year for all categories combined
Hearing Aids $450 per five years
Nursing $5,000 per plan year ($15,000 lifetime maximum)
Orthopaedic shoes $250 per plan year; includes orthotics
Vision
  • 100%, $50 per 24 months for eye-exam
  • 100% up to $150 every two plan years for glasses
Emergency travel medical coverage
  • 100%
  • Maximum duration of 20 days per trip
  • Unstable pre-existing medical conditions that existed during the nine-month period prior to your trip are not covered
Semi-private hospital room
  • 80% up to $200 per day of hospitalization up to a plan year maximum of $5,000
Preventive Dental
  • 70% up to a maximum of $750 per plan year
Lifetime maximum
  • $300,000 per covered person and
  • $3,000,000 lifetime maximum per covered person for Emergency travel medical coverage

Enhanced plan

High level plan summary: note disclaimer the policy provisions apply.

Benefit Reimbursement
Drug
  • 80% on first $3,000 ($2,400) and 90% on next $10,667 ($9,600)
    Total coverage: $12,000 ($2,400+$9,600) per plan year
  • Coinsurance applies to dispensing fees as well
Extended health

Eligible expenses
  • reasonable and customary charges for the services or supplies listed
  • 90% subject to limits outlined in the benefit
Paramedical $600 per practitioner per plan year ; $1000 per plan year for all categories combined
Hearing Aids $550 per five years
Nursing $7,500 per plan year ($20,000 lifetime maximum)
Orthopaedic shoes $300 per plan year; includes orthotics
Vision
  • 100%, $50 per 24 months for eye-exam
  • 100% up to $250 every two plan years for glasses
Emergency travel medical coverage
  • 100%
  • Maximum duration of 30 days per trip
  • Unstable pre-existing medical conditions that existed during the nine-month period prior to your trip are not covered
Semi-private hospital room
  • 90% up to $200 per day of hospitalization up to a plan year maximum of $5,000
Lifetime maximum
  • $500,000 per covered person and
  • $3,000,000 lifetime maximum per covered person for Emergency travel medical coverage

Enhanced plus plan

High level plan summary: note disclaimer the policy provisions apply.

Benefit Reimbursement
Drug
  • 80% on first $3,000 ($2,400) and 90% on next $10,667 ($9,600)
    Total coverage: $12,000 ($2,400+$9,600) per plan year
  • Coinsurance applies to dispensing fees as well
Extended health

Eligible expenses
  • reasonable and customary charges for the services or supplies listed
  • 90% subject to limits outlined in the benefit
Paramedical $600 per practitioner per plan year ; $1000 per plan year for all categories combined
Hearing Aids $550 per five years
Nursing $7,500 per plan year ($20,000 lifetime maximum)
Orthopaedic shoes $300 per plan year; includes orthotics
Vision
  • 100%, $50 per 24 months for eye-exam
  • 100% up to $250 every two plan years for glasses
Emergency travel medical coverage
  • 100%
  • Maximum duration of 30 days per trip
  • Unstable pre-existing medical conditions that existed during the nine-month period prior to your trip are not covered
Semi-private hospital room
  • 90% up to $200 per day of hospitalization up to a plan year maximum of $5,000
Dental Preventative 80% up to a maximum of $750 per plan year
Restorative 50% up to a maximum of $500 per plan year
Orthodontia 60% up to a lifetime maximum of $1,500
Lifetime maximum
  • $500,000 per covered person and
  • $3,000,000 lifetime maximum per covered person for Emergency travel medical coverage

This website is intended only as an outline of the insurance policy. The complete terms, conditions, exclusions and limitations governing the insurance coverage are found in the group insurance policy issued by Sun Life Assurance Company of Canada.