PHI plan comparison

Prescription drugs	Basic	Standard	Enhanced
*Pay-Direct Drug card unavailable for Quebec residents	Pay direct drug card* 60% reimbursement No deductible $5 dispensing fee cap $750 max/year Includes smoking cessation drugs ($250 lifetime max) Excludes fertility drug and contraceptives	Pay direct drug card* 70% reimbursement on the first $7,000 of eligible expenses 100% on the next $93,000 No deductible Includes smoking cessation drugs ($250 lifetime max) Excludes fertility drug and contraceptives	Pay direct drug card* 80% reimbursement on the first $5,000 of eligible expenses 100% on the next $245,000 No deductible Includes smoking cessation drugs ($250 lifetime max) Includes oral contraceptives Excludes fertility drugs
Supplemental health care	Basic	Standard	Enhanced
*Up to reasonable customary services and charges	60% reimbursement No deductible Paramedical practitioners $25 maximum per visit $250/year per type of practitioner Including: Physiotherapist, Registered Massage Therapist, Psychologist/Social Worker, Chiropractor, Osteopath, Naturopath, Podiatrist, Chiropodist, Speech Therapist, Acupuncturist Hearing aids $400/5 years Accidental dental $2000/per incident Licensed ground ambulance Emergency air ambulance Medical equipment in-home nursing and home care $2500/year combined max. $20,000 combined lifetime max. Includes: prosthetic appliances* wheelchairs, walkers, traction kits ($1000 lifetime max.) orthopedic shoes $150/year blood glucose monitor $150/5 years medically necessary wigs, hairpieces $100/year hospital bed, oxygen* splints, crutches, braces and casts* continuous glucose monitors* For Quebec residents, medically necessary MRI, Ultrasound, CAT and CT scans are covered to a combined yearly maximum of $750.	100% reimbursement No deductible Paramedical practitioners $300/year per type of practitioner Including: Physiotherapist, Registered Massage Therapist, Psychologist/Social Worker, Chiropractor, Osteopath, Naturopath, Podiatrist, Chiropodist, Speech Therapist, Acupuncturist Hearing aids $400/5 years Accidental dental $2000/per incident Licensed ground ambulance Emergency air ambulance Medical equipment with a combined max. $5,000/year Includes: prosthetic appliances* wheel chairs, walkers, traction kits ($4000 lifetime max) hospital bed, oxygen ($1,500 lifetime for bed), orthopedic shoes $200/year blood glucose monitor $ 300/5 years medically necessary wigs, hairpieces $500 lifetime splints, crutches, braces and casts $500/year breast prosthesis $200/year continuous glucose monitors* In-home nursing and home care: combined $5,000 annual max; combined $25,000 lifetime maximum For Quebe For Quebec residents, medically necessary MRI, Ultrasound, CAT and CT scan.	100% reimbursement No deductible Paramedical practitioners $400/year per type of practitioner Including: Physiotherapist/Social Worker, Registered Massage Therapist, Psychologist, Chiropractor, Osteopath, Naturopath, Podiatrist, Chiropodist, Speech Therapist, Acupuncturist Hearing aids $500/5 years Accidental dental $2000/per incident Licensed ground ambulance Emergency air ambulance Medical equipment with a combined max. $5,000/year Includes: prosthetic appliances* wheel chairs, walkers, traction kits ($4000 lifetime max.), hospital bed, oxygen ($1,500 lifetime for bed), orthopedic shoes $200/year blood glucose monitor $300/5 years medically necessary wigs, hairpieces $500 lifetime splints, crutches, braces and casts $500/year breast prosthesis $200/year continuous glucose monitors* In-home nursing and home care: combined $10,000 annual max; combined $30,000 lifetime maximum For Quebec residents, medically necessary MRI, Ultrasound, CAT and CT scan.
Vision	Basic	Standard	Enhanced
Prescription eyeglasses, contact lenses, prescription sunglasses, and laser eye surgery. Eye exams up to $50 included in benefit maximum	No coverage	100% reimbursement 1 year waiting period $250 maximum every 2 years	100% reimbursement 1 year waiting period $300 maximum every 2 years
Emergency travel medical	Basic	Standard	Enhanced
Ambulance, travel assistance, etc.	No coverage	100% reimbursement 1st 60 days of trip $1 million lifetime max 9 month pre-existing condition clause Out of Country / Out of Province Coverage	100% reimbursement 1st 60 days of trip $1 million lifetime max 9 month pre-existing condition clause Out of Country / Out of Province Coverage
Optional benefit Semi-private hospital	85% reimbursement $ 200/day $5,000 max Convalescent hospital - max $20/day for 180 days per incident	85% reimbursement $ 200/day $5,000 max Convalescent hospital - max $20/day for 180 days per incident/year	85% reimbursement $ 200/day $5,000 max Convalescent hospital - max $20/day for 180 days per incident
Dental	Basic	Standard (optional benefit)	Enhanced (optional benefit)
Preventive services - exams, diagnosis, tests, x-rays, lab exams, space maintainers for children under 12 years of age, pit and fissure sealant for children under 19 years of age, white fillings, scaling, 9 month recall visits, minor extractions	3 month waiting period 60% reimbursement $500/year max	3 month waiting period 70% reimbursement $750/year max	3 month waiting period 80% reimbursement $750/year max
Major restorative - endodontics, periodontics, oral surgery, crowns, inlays, bridges, dentures (and repairs)	Not available	Not available	One year waiting period 50% reimbursement $500/year max
Orthodontics	Not available	Not available	Two year waiting period 60% reimbursement $1,500/lifetime max
Overall plan maximum (not including emergency travel benefit	$250,000	$250,000	$300,000