Extended Health Care and Dental Insurance

Health and Dental insurance that keeps your wallet healthy too

The cost of prescription drugs, a visit to the optician, a paramedical appointment or even a stay in the hospital can all add up. Extended Health Care (EHC) Insurance covers many basic health costs. You can even make trips to the dentist less painful by choosing a plan with dental care.

You’ll use your coverage when you:

  • need prescription drugs1
  • buy new glasses or contacts
  • see a variety of medical practitioners, including massage therapists, physiotherapists, chiropractors and more
  • have a stay in the hospital (where you’ll want a semi-private or private room)
  • visit the dentist (if you choose an option with dental care coverage)

Why choose EHC and Dental Insurance?

  • Choice of five plans, so you get the best solution for your needs
  • Savings, thanks to group pricing

Extra advantages

Access your EHC and Dental benefit and claims information quickly and easily.

By visiting mysunlife.ca or using our mobile app, if you have coverage, you can:

  • Find out what your health and medical plans cover
  • Submit claims for instant processing
  • Submit a copy of a receipt by snapping a photo 
  • Easily check the status of your claims
  • Get help faster by calling us from within the app – we’ll have your plan details ready to go
  • Have your coverage cards handy wherever you go in the app and Apple Wallet
  • Use the drug-look-up tool to find out how much of your prescription drug costs are covered – we may even be able to suggest a less-expensive generic equivalent
  • Find healthcare providers in your area
  • Keep up with product and service updates, special offers and helpful reminders by viewing ‘My Notifications’

To learn more about the my Sun Life mobile app visit sunlife.ca/mobile.

You're eligible if you are:

  • a member in good standing, working a minimum of 25 hours a week,
  • between the ages of 18 and 65 (coverage ends on member’s 75th birthday),
  • a resident of Canada, and
  • covered under your provincial health insurance (plus RAMQ in Quebec).

Meet the criteria? You can get Extended Health Care and Dental Insurance for:

  • You

  • Couple
    (You + spouse)2

  • Child(ren)

What’s the cost?

Check out the rate sheets for a quick estimate.

What are the coverage options?

There are five health care plans available. Choose the plan that’s right for you.

Benefit details

OPTIONS Basic Standard Standard Plus Enhanced Enhanced Plus
Extended Heath Care
Prescription drugs
  70% 70% of the first $1,000 of expenses, 80% of the excess 70% of the first $800 of expenses, 80% of the excess 80% of the first $3,000 of expenses, 90% of the excess 80% of the first $3,000 of expenses, 90% of the excess
Dispensing fee maximum 100% up to $6.50 per prescription or refill 100% up to $6.50 per prescription or refill 100% up to $6.50 per prescription or refill 80%
No maximum
80%
No maximum
Oral contraceptives No No No Yes Yes
Plan year maximum $750 per person $5,000 per person $3,500 per person $12,000 per person $12,000 per person
Paramedical Services
Registered Specialists Paramedical services: Covers the services of licensed acupuncturist, audiologist, chiropractors, occupational therapist, physiotherapist or social workers, psychologist, massage therapist, naturopaths, osteopaths or speech language pathologist 70% 80% 80% 90% 90%
Plan year maximum per specialty $350 per person $480 per person $480 per person $600 per person $600 per person
Plan year combined maximum $600 per person $800 per person $800 per person $1,000 per person $1,000 per person
Travel Expenses
Expenses out of your province No 100% 100% 100% 100%
Emergency Travel Assistance No First 15 days First 20 days First 30 days First 30 days
Hospital Expenses
Hospital expenses in your province No 80% 80% 90% 90%
Convalescent hospital No No No No Yes
Private Duty Nursing
  70% 80% 80% 90% 90%
Plan year maximum $2,500 per person $5,000 per person $5,000 per person $7,500 per person $7,500 per person
Lifetime maximum $10,000 per person $15,000 per person $15,000 per person $20,000 per person $20,000 per person
Ambulance
  70% 80% 80% 90% 90%
Medical Services, Equipment, Supplies and other services
  70% 80% 80% 90% 90%
Wigs (maximum
per person)
$100 per plan year $500 lifetime $500 lifetime $500 lifetime $500 lifetime
Wheelchairs
(lifetime maximum)
$1,000 per person $1,000 per person $1,000 per person $1,200 per person $1,200 per person
MRI and other services (plan year maximum) - Quebec only $750 per person $1,000 per person $1,000 per person $1,200 per person $1,200 per person
Orthotic inserts and orthopedic shoes (plan year maximum) $250 per person $250 per person $250 per person $300 per person $300 per person
Glucometers (maximum in any 5-year period) $150 per person $300 per person $300 per person $300 per person $300 per person
Casts, splints, trusses, canes and crutches
(plan year maximum)
Up to the Plan year combined maximum shown below $500 per person $500 per person $500 per person $500 per person
Breast prosthesis
(plan year maximum)
Up to the Plan year combined maximum shown below $200 per person $200 per person $200 per person $200 per person
Hospital beds
(lifetime maximum)
Up to the Lifetime maximum shown below $1,000 per person $1,000 per person $1,200 per person $1,200 per person
Plan year combined maximum $1,000 per person $1,500 per person $1,500 per person $2,000 per person $2,000 per person
Lifetime maximum $20,000 $20,000 $20,000 $20,000 $20,000
Hearing aids
  70% with a maximum in any 5-year period of $350 per person 80% with a maximum in any 5-year period of $400 per person 80% with a maximum in any 5-year period of $450 per person 90% with a maximum in any 5-year period of $550 per person 90% with a maximum in any 5-year period of $550 per person
Vision care
  100% 100% 100% 100% 100%
Waiting period None 1 year 1 year 1 year 1 year
Maximum in any 2 plan years Eye exam only $150 per person $150 per person $250 per person $250 per person
EHC lifetime maximum per person
Out-of-province emergencies No $3,000,000 $3,000,000 $3,000,000 $3,000,000
All other expenses $100,000 $300,000 $300,000 $500,000 $500,000
Preventive and
Basic Services included: Oral Examinations, X-Rays, Testing and labs, Polishing, Scaling and root planning, Consultation, Space Maintainers, Oral hygiene instruction once every 9 months, Emergency or palliative services, Pit and fissure sealants. Only children under 19 are covered for this treatment, Fillings and retentive pins, Prefabricated metal or plastic restorations
No No 70%
3 month waiting period
No 80%
3 month waiting period
Major Services included: Endontics - root canal, Oral surgery, Related surgical services (anaesthesia), Periodontics, Repairing, relining or rebasing dentures, Major restoration, Prosthodontics No No No No 50%
6 month waiting period

Orthodontics Services included: Examinations (including orthodontic diagnostic services and fixed or removable appliances such as braces.); Interceptive, interventive or preventive orthodontic services, other than space maintainers (Preventive dental procedures);Comprehensive orthodontic treatment, using a removable or fixed appliance, or combination of both; This includes diagnostic procedures, formal treatment and retention

 

No No No No 60%
1 year waiting period
Dental Maximum
per plan year
per person
No No $750 for Preventive and Basic combined No $750 for Preventive and Basic combined
$500 for Major
Lifetime per person No No No No $1,500 for Orthodontics
LOCK-IN PERIOD 2 years 2 years 2 years 2 years 2 years
CHANGES IN OPTIONS Subject to the lock-in period indicated above, you can change your option on the Policy Anniversary. Evidence of insurability is required if you are moving up an option.

You can find out more in your plan brochure.

Coverage ends at:

  • Age 75
  • The date that any person who is not entitled to benefits under a provincial medicare plan or federal government plan that provides similar benefits (for Quebec: RAMQ equivalent)

Take these three steps to apply:

Medical underwriting is required

Exclusions:

  • procedures performed primarily to improve appearance
  • replacement of dental appliances that are lost, misplaced or stolen
  • charges for appointments that a person does not keep
  • charges for completing claim forms
  • services or supplies for which no charge would have been made in the absence of this coverage
  • supplies usually intended for sport or home use, such as mouth guards
  • procedures or supplies used in full mouth reconstruction (capping all of the teeth in the mouth), vertical dimension corrections (changing the way the teeth meet) including attrition (worn down teeth), alteration or restoration of occlusion (building up and restoring the bite), or for the purpose of prosthetic splinting (capping teeth and joining teeth together to provide additional support)
  • charges related to implants, including surgery charges
  • charges related to temporomandibular joint (TMJ) treatment
  • transplants and repositioning of the jaw
  • experimental treatments
  • hostile action of any armed forces, insurrection or participation in a riot or civil commotion
  • dental services required due to congenital malformation
  • participation in a criminal offence

This website is intended only as an outline of the insurance policy, which is available upon request. 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. The  policy can be obtained by calling Sun Life Financial at 1-800-669-7921 Monday to Friday, 8 a.m. to 8 p.m. ET or emailing servicecsc@sunlife.com.

Charges in excess of the lowest-priced equivalent drug are not covered unless specifically approved by Sun Life. To assess the medical necessity of a higher-priced drug, Sun Life will require 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 person of the opposite sex or of the same sex who is publicly represented as your spouse for a period of at least 12 months. You can only cover one spouse at a time. Discontinuance of cohabitation terminates the eligibility of a common-law spouse. You must also have coverage in order to obtain spouse coverage.

QUESTIONS?

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.