Health Choice C

Offers the highest level of coverage

Health Choice C is the Health Coverage Choice plan with the highest level of coverage. If you don’t feel you need this much coverage, consider either Health and Dental Choice A or Health Choice B.

Getting Started

  • You should consider this plan if:

  • You’ve lost your group benefits in the last 60 days or will be losing your group benefits coverage soon
  • You want the highest coverage available with Health Coverage Choice for prescription drugs, $2,000 annual maximum and you want emergency travel medical coverage

Learn more about eligibility requirements for this plan.

Support questions

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Plan details:

A combined lifetime maximum of $300,000 applies to all benefits excluding dental and emergency travel medical coverage.

Prescription drugs

  • Pay-direct drug card (except Quebec)
  • 80% reimbursement
  • $2,000 annual maximum
  • Excludes:
    • Contraceptives
    • Fertility drugs
    • Dietary supplements, vitamins
    • Over-the-counter medications, even if prescribed by a physician or nurse practitioner
    • Drugs to treat obesity

Dental

This is an optional benefit combined with restorative dental care and includes:

  • 80% reimbursement
  • Year 1: $750 annual maximum
  • Year 2+: $1,000 annual maximum combined with restorative
  • Recall visits every 9 months
  • Preventive dental coverage includes:
    • Examinations and diagnosis
    • Tests, x-rays and lab exams
    • Space maintainers for children under age 12
    • White fillings
    • Scaling and minor extractions
    • Pit and fissure sealant for children under 19 years of age

This is an optional benefit combined with preventative dental care and includes:

  • 50% reimbursement
  • $1,000 annual maximum combined with preventive
  • 1-year waiting period before coverage begins
  • Restorative dental coverage includes:
    • Endodontics
    • Periodontics
    • Onlays
    • Oral surgery
    • Crowns
    • Bridges
    • Dentures (and repairs)

Supplemental healthcare

  • 100% reimbursement
  • $5,000 lifetime maximum

  • 100% reimbursement
  • Ground air ambulance service
  • Air ambulance $5,000 maximum per incident

  • 100% reimbursement
  • $600 maximum every 5 years

  • 100% reimbursement
  • $5,000 annual maximum
  • The following items have a combined $5,000 annual maximum:
  • Artificial limbs or other prosthetic appliances. Breast protheses are limited to $200 in a calendar year
  • Orthopaedic shoes and orthotics, limited to $250 in a calendar year
  • Splints and crutches, limited to $500 in a calendar year
  • Braces
  • Casts
  • Wigs and hairpieces, limited to $500 in a lifetime
  • Oxygen
  • Continuous glucose monitor
  • Diagnostic laboratory and x-ray examinations
  • Blood glucose monitor, limited to $300 per each 5-year period
  • Rental, or purchase at our option, of durable equipment required for use in the patient's home and is approved by us. Eligible durable equipment includes, but is not limited to, items such as:
    • wheelchairs, limited to a $4,000 lifetime maximum
    • walkers
    • hospital beds, $1,500 lifetime maximum 
    • traction kits
  • For Quebec residents only, medically necessary MRIs, ultrasounds, CAT and CT scans

  • 100% reimbursement
  • $5,000 annual maximum
  • $25,000 lifetime maximum

*Private duty nursing includes services of registered nurses, registered practical nurses or registered nursing assistants

Paramedical practitioners

  • 100% reimbursement
  • $300 per year for each type of practitioner and combined maximum up to $650 per calendar year
  • Paramedical practitioners include: acupuncturists, chiropractors, naturopaths, osteopaths, physiotherapists, podiatrists/chiropodists, registered massage therapists, speech language pathologists
  • Psychologists/social workers: $75 per visit up to 10 visits per year

Vision care

  • 100% reimbursement
  • $300 maximum every 2 years, including $50 maximum per eye exam

Emergency travel medical

  • 100% reimbursement
  • $1 million lifetime maximum
  • Coverage provided for the first 60 days of a trip
  • Covers travel outside of your province or outside of Canada
  • Available until the age of 80
  • If you have a pre-existing medical condition where symptoms have appeared or required medical attention, hospitalization or treatment (this includes changes in medication or dosage), and existed during the 9 months before your trip, expenses related to this condition are not included.

Semi-private hospital room

  • 85% reimbursement
  • $200 daily maximum
  • $5,000 annual maximum
  • Convalescent hospital:* $20 per day up to 180 days per incident

If you are pregnant at the time of application, we will pay for up to 2 days of hospitalization due to pregnancy.

*Convalescent hospitals are facilities licensed to provide convalescent care and treatment for sick or injured patients on an in-patient basis.

Additional services

Age requirements

  • Available for applicants up to age 74 and renewable for customers age 75 and over.

Eligibility

You are eligible for coverage if:

  • You and your family members included on the application are within 60 days of leaving a group benefits plan that had similar health coverage. For example, to include dental coverage, you must have been covered for dental under your group benefits plan
  • You are in Canada when you complete and submit the application
  • You and your family members are residents of Canada and have provincial or territorial health and drug coverage
    • Quebec residents must also have and continue to have group drug coverage provided by an employer, through membership in an order or association or through the 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
  • Your dependent children are under age 25 years. Dependent children aged 21 to 24 must be full-time students
  • There are no medical requirements.

More information

  • You must also apply to your provincial or territorial government health and drug plan first, then submit a claim to us for the unpaid portion.
  • All annual or lifetime maximums are per person and based on a calendar year (January 1 to December 31).
  • We may change rates each year. If we do change the rates, we’ll send you written notice at least 30 days before the change.
  • Waiting periods begin on the date the policy becomes effective.
  • This page does not form part of your policy. If there are any inconsistencies between the content on this page and your policy, the terms of your policy will apply. Your policy includes exclusions and limitations of coverage.

Sample policies

Read examples of text that can appear in a policy. Not all the provisions apply to every policy – it is simply for your reference. When we issue a policy it governs the legal relationship between us and the client. An actual policy can have provisions that are somewhat different from those that you've read here.

 Health and Dental Choice A

 Health Choice B with Dental

 Health Choice C with Dental

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