View your EHC and dental benefits and claims information quickly and easily.
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In Quebec, you are required to have RAMQ drug coverage or an equivalent group/association plan to purchase Health and Drug coverage through the CAPIC insurance program. A person not covered under a group benefit plan or through RAMQ, is not eligible for coverage under this policy.
Our rate sheets can provide you with a quick estimate.
For more information about this coverage, please refer to your CAPIC booklet EHC and dental insurance section.
You can choose single or family coverage. For more detailed descriptions of the benefits offered, please see your benefits booklet, but here is a summary showing coverage per family member covered:
|EHC benefit details|
|January 1 to December 31|
|Maximum benefit||Unlimited, unless otherwise specified.|
|Proof of good health||Required on the initial request for coverage for you and your spouse|
Drug card plan
Included (except for Quebec residents)
For Quebec residents, the reimbursement percentage is increased to 100% once the out-of-pocket maximum is reached
We’ll cover the following drugs and supplies prescribed by a doctor
There are drugs and treatments that aren’t covered, even when prescribed.
Please refer to your plan booklet for more information.
|Other health professionals allowed to prescribe drugs||
We reimburse certain drugs prescribed by other qualified health professionals the same way as if the drugs were prescribed by a doctor or a dentist if the applicable provincial legislation allows them to prescribe those drugs
|Québec drug insurance Plan||
Any conditions under this plan that don’t meet the requirements under the Québec drug insurance plan are automatically adjusted to meet those Requirements
|In-province hospital||100% of the difference between the cost of a ward and a semi-private room, up to a maximum of $100 per day, multiplied by the number of days of the hospital stay|
100% of the difference between the cost of a ward and a semi-private room, up to $20 per day for a maximum of 180 days. This includes for all periods of treatment of an illness due to the same or related causes
Emergency Travel Assistance included
Time limit – 60 days after the date the person leaves the province where the person lives
Lifetime maximum of $1,000,000 per person for out-of-Canada services
|Medical services and equipment||
For the services of an ophthalmologist or licensed optometrist – 100%
For orthopaedic shoes – 50%
For all other eligible expenses – 80%
80% up to a maximum of $375 per person per calendar year per specialty for the qualified paramedical practitioners listed below:
|When you retire or reach age 65, whichever is earlier|
|Dental benefit details|
|Calendar year||January 1 to December 31|
|Fee Guide||The current fee guide for general practitioners in the province where you live, regardless of where the treatment is received|
Calendar year maximum
All dental procedures – combined maximum of $500 per person for the first calendar year of coverage
Preventive and Basic dental procedures – combined maximum of $1,200 per person for each subsequent calendar year
Major dental procedures – $500 per person for each subsequent calendar year
|Late applicant limitation||
If you and your dependents do not apply for Dental benefits within 31 days of applying for other benefits, you’ll need to wait for one year before you or your dependent are eligible for Dental care benefits. Premiums for this benefit aren’t required during the one-year waiting period
|Termination||When you retire or reach age 65, whichever is earlier|
Learn more by taking a look at your CAPIC benefits booklet.
No benefits are payable when the claim is for an illness resulting from:
No benefits are payable for the following, even when prescribed:
Extended Health Care:
No benefits are payable for the costs of:
No benefits are payable for:
1 Charges greater than the lowest-priced equivalent drug aren’t covered unless specifically approved by Sun Life. To assess the medical necessity of a higher-priced drug, Sun Life requires you, your spouse, or your dependent child and the attending physician to complete and submit an exception form.
2 Spouse: Your spouse by marriage or under any other formal union recognized by law, or a partner of the opposite sex or of the same sex who is living with you and has been living with you in a conjugal relationship for at least 12 months. For Québec residents, there is no minimum cohabitation period for common-law spouses if a child is born out of their relationship.
Only one person at a time can be covered as your spouse.
Call us at 1-800-669-7921
Mon to Fri 8:00 a.m. to 8:00 p.m. ET
Sun Life Assurance Company of Canada is the insurer of this product, and is a member of the Sun Life group of companies.