Worry less with health and dental coverage

Prescriptions, visits to the optician or chiropractor, even a stay in the hospital can add up. SunAffinity Extended Health Care (EHC) & Dental Insurance helps cover these health costs and many more.


You’ll use your coverage when you:

  • need prescription drugs1
  • buy new glasses or contacts
  • see a variety of medical practitioners, including:
    • registered massage therapists
    • physiotherapists
    • chiropractors
    • naturopaths
    • psychologists
    • speech therapists
  • stay in the hospital (in a semi-private room)
  • visit the dentist (if you choose an option with dental care coverage)

Who’s eligible?

You

Spouse2

Child(ren)

You are eligible to apply for coverage if you:

  • are between the ages of 18 to 70 (renewable at age 70 and over)
  • have provincial health coverage and
  • are a resident of Canada, except Quebec.

Your spouse is eligible to apply for coverage if they:

  • are under age 70
  • have provincial health coverage and
  • are a resident of Canada, except Quebec.

Your dependent child is eligible for coverage if they are:

  • your or your spouse’s child or adopted by you (other than a foster child)
  • unmarried and entirely dependent on you and:
    • is under age 21, or
    • is under age 25 and attending college or university full-time, or
    • became incapable of self-support while they were entirely dependent on you.

Why choose SunAffinity EHC and Dental Insurance?

  • Three plans available: Basic, Standard or Enhanced plans, so you can choose the level of insurance that fits your needs.
  • The my Sun Life mobile app, to claim and check coverage when and where it’s convenient for you.

    The app lets you:
    • 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.
  • You have access to Best Doctors® This is a valuable service available to you, your spouse, dependent children, parents and parents-in-law at any point during the lifetime of the policy. You can access Best Doctors to get answers to any of your medical questions (they do not need to be questions relating to an illness covered under this policy). In addition, if you get critically ill, you will be connected with a leading expert that will review your diagnosis and your treatment plan and provide you with recommendations for moving forward. What’s more, you can still use Best Doctors’ services up to 4 months from the time your claim is paid.

Three coverage options

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

Plan details

The information found in this chart shows a summary of the coverage only. Full benefit details can be found in the group insurance policy.

The maximums are for each insured person.

Note: SunAffinity insurance coverage, including EHC and Dental Insurance, isn’t available in Quebec.

OPTIONS

Basic plan

Standard plan

Enhanced plan

Prescription drugs3

Reimbursement

60%

100% of dispensing fee up to $5

70% of the first $7,000 of expenses

100% on the next $93,000

80% of the first $5,000 of expenses

100% on the next $95,000

Annual maximum

$750

$100,000

$100,000

Deductible (the amount you pay)

No

No

No

Fertility drugs/Contraceptives

No

No

Yes

(oral contraceptives only)

Smoking cessation medication

Up to $250 lifetime maximum

Pay-Direct Drug card

 

Yes

Yes

Yes

Exclusions

  • Drugs used to treat infertility, erectile dysfunction, or obesity
  • Dietary supplements, vitamins and infant foods
  • Cost of giving injections, serums, vaccines
  • Contraceptives (other than oral in the Enhanced plan)
  • Over-the-counter products to help with quitting smoking.

Extended Health Care

These services must be medically necessary and within reasonable and customary charges. A provincially authorized medical professional must prescribe them.

Reimbursement

60%

$25 per visit and calendar year

maximum of $250 for each practitioner.

100%

Up to $300 each calendar year for each practitioner.

100%

Up to $400 each calendar year for each practitioner.

Deductible

No

No

No

Accidental dental

$2,000 for each fracture or injury

Air ambulance services

Yes

Yes

Yes

Hearing aids

$400 every five years

In home nursing (by RNs, RPNs, RNAs, CNAs or LPAs)

No

$5,000 each calendar year

$25,000 lifetime maximum

$10,000 each calendar year

$30,000 lifetime maximum

Medical services & equipment

$2,500 each calendar year

$20,000 lifetime maximum

$5,000 each calendar year

Wigs and/or hair pieces

$100 each calendar year

$500 lifetime maximum

Orthopedic shoes and orthotics

$150 each calendar year

$200 each calendar year

Blood glucose monitor

$150 every 5 years

$300 every 5 years

Splints and crutches, braces and/or casts

Yes

Yes

Yes

Wheelchairs, walkers, traction kits

$1,000 lifetime maximum only for wheelchair

$4,000 lifetime maximum only applicable for wheelchair

Hospital bed

Yes

$1,500 lifetime maximum

Prosthetic appliances

Yes

Yes

Yes

Breast prosthesis

No

$200 each calendar year

Exclusions

  • Services of a homemaker or home service worker
  • Items solely for athletic use
  • Dental expenses that aren’t accidental or aren’t to natural teeth
  • User fees

Semi-private hospital room (in Canada)

Reimbursement

No

85%

$200 each day

$5,000 annual maximum

 

Convalescent hospital:

$20 daily maximum; 180 days for each incident

 

If you are pregnant when you apply, we will pay up to two days of hospitalization due to pregnancy

Major exclusions

n/a

Expenses that aren’t medically necessary

Emergency travel medical

Eligibility

No

Up to age 80

Reimbursement

No

100%

$1 million lifetime maximum

Pre-existing conditions not included

Trip length

No

60 days each trip

Travel assistance

No

Toll-free number for emergency assistance services

Emergency payment assistance

No

Yes

Repatriation

No

Yes

Vehicle return

No

Yes

Major exclusions

n/a

  • Services that are not immediately required or which could wait until return home
  • Related illness or injury after the emergency has ended
  • Services rendered after you could have returned home (based on medical evidence)
  • Injury, illness or complications if you refused recommended medical services
  • Injury or illness related to or resulting from travel for medical treatment
  • Emergencies more than 60 days after leaving your home province
  • Regular treatment of a chronic injury or illness
  • Pre-existing medical condition. This means that you had symptoms or needed treatment in the nine months before you left your home province.) This includes changes in medication or doses
  • Due to pregnancy and incurred within four weeks of the expected delivery date
  • For a child born outside of Canada, until their coverage is in effect or they return to Canada (whichever is later)
  • Incurred on an non-emergency referral basis

Vision care

(Prescription eyeglasses, contact lenses, prescription sun glasses, laser eye surgery)

Reimbursement

No

100%

Maximum

No

$150 every 2 years; every year for dependents under 18

$200 every 2 years; every year for dependents under 18

Eye exams

No

$50 every 2 years; every year for dependents under 18

Waiting period

No

1 year

Dental – preventive

Reimbursement

60%

70%

80%

Annual maximum

$750 each calendar year

Waiting period

3 months

Exclusions

  • Lost, stolen, misplaced appliances, dentures and space maintainers
  • Full mouth reconstructions for vertical dimension correction or for correction of temporomandibular joint dysfunction
  • Expenses incurred for the treatment of malocclusion or for orthodontic treatment
  • Services rendered in conjunction with surgical services payable under a government plan
  • Services needed due to congenital malformation
  • Charges for missed appointments
  • Charges for completing claims forms

Dental – restorative

Reimbursement

No

No

50%

Annual maximum

No

No

$500 annual maximum

Waiting period

No

No

1 year

Dental – orthodontics

Reimbursement

No

No

60%

Lifetime maximum

No

No

$1,500

Waiting period

No

No

2 years

For some benefits, we pay when the insurance person shows they have applied for the applicable government funding. For further details, please see a sample policy.


Things to know

All coverage becomes effective upon date of approval and receipt of premium payment.

General Exclusions:

Your coverage will not cover expenses for:

  • costs related to civil disorder or war, whether declared or not
  • that we are not legally allowed to pay
  • cosmetic services
  • experimental services
  • delivery, transportation and administration charges
  • services or products that are self-prescribed, or prescribed or serviced by a family member or somebody you live with
  • services or supplies provided by the government (even if there’s a waiting list)
  • unapproved (by Health Canada or other regulators)
  • services or supplied that are not generally recognized by the Canadian medical standards
  • services or supplies that don’t qualify as medical expenses under the Income Tax Act (Canada)
  • elective (non-emergency) medical treatment or surgery outside of your home province

Protect what’s important – apply today

Get a quote and apply using the quote tool