Health and Benefits coverage – Greenshield

Health and Benefits coverage – Greenshield

Healthcare is expensive. In a report posted by the Canadian Institute for Health, total health spending was expected to reach $242 billion in Canada by the end of 2017, $6,604 per Canadian. This was an increase of almost $200 per person over 2016.  

Are we fully protected to cover all our healthcare costs? The answer to this question would be both yes and no.

There are two elements to healthcare coverage. Part one is the provincial/territory coverage, part two is your private healthcare. For the purpose of this article let’s focus on Medical Services Plan (MSP) here in British Columbia. Other provinces and territories in Canada may provide different coverage and services. Some employers will provide private healthcare options for their workforce. Self-employed people or those working for smaller organizations may be required to purchase their own private healthcare coverage.

In BC, as long as you’re a Canadian resident and over the age of 18, you are eligible for the provincial healthcare plan – MSP (Medical Services Plan).

What does MSP cover?

  • Medically required services provided by a physician with MSP
  • Maternity care provided by a physician or a midwife
  • Medically required eye examinations provided by an ophthalmologist or optometrist
  • Diagnostic services, including x-rays, provided at approved diagnostic facilities, when ordered by a registered physician, midwife, podiatrist, dental surgeon or oral surgeon
  • Dental and oral surgery, when medically required to be performed in hospital (excluding restorative services i.e. fillings, caps, crowns, root canals, etc.)
  • Orthodontic services related to severe congenital facial abnormalities

While you’re outside of BC, MSP will cover you for $75 per day (in Canadian funds) for emergency hospital care only. If you travel to the United States, the $75 limit would barely put a dent in to the overall costs. The average cost of a heart attack and other related complications is around $20,000 per stay. Non-surgical treatments like broken arms or legs can range from $2,500 – $3,500 with surgical treatments increasing to $17,000 – $35,000.  Costs in one US state can vary substantially from others.

What isn’t covered by MSP? The list is as follows:

  • Services that are deemed to not be medically required, such as cosmetic surgery
  • Dental services, except as outlined under benefits
  • Routine eye examinations for persons 19 to 64 years of age
  • Prescription drugs
  • Acupuncture, chiropractic, massage, therapy, naturopathy, physical therapy and non-surgical podiatry services
  • Preventative services and screening tests not supported by evidence  of medical effectiveness
  • Services of counsellors or psychologists
  • Medical examinations, certificates or tests required for:
    • Driving a motor vehicle
    • Employment
    • Life Insurance
    • School or University
    • Recreational or Sporting activities
    • Immigration purposes

Supplemental healthcare and dental care can be purchased by individuals, couples and families. There are various tiers of coverage available and prices vary depending on client age and who (single person, a couple or a family with kids) is covered under the plan.

Aon provides supplemental coverage through its partnership with Greenshield, the recognized, industry leading health and dental benefit specialist and innovator. Greenshield are also Canada’s only national not-for-profit health and benefits carrier.

Who is eligible for this coverage?

  • Canadian residents
  • Between the ages of 18 – 79
  • Covered under the provincial healthcare plan

Greenshield has two plan options – Zone and Link

Zone:

  • Seven pre-packaged plans
  • 4 come with guaranteed acceptance; 3 require a medical questionnaire
  • Optional preferred hospital accommodation coverage
  • Applicant between the ages of 18 – 74
  • No termination age

Link:

  • Individuals and dependents who are leaving a group benefit plan
  • Guaranteed acceptance
  • Application form submitted within 60 days of losing group benefits
  • No questionnaire required
  • Applicant between the ages of 18 – 79
  • No termination age

So what’s covered by optional healthcare coverage?

Dental

  • Basic services – Preventative cleaning, routine examinations, x-rays, fillings and extractions, Flouride treatment for children, Endodontic treatment (root canal therapy), Periodontal treatment and Denture repairs, rebasing, and relining
  • Yearly maximums (limits apply to each person under the plan), if not used the first year, higher limits are available the second year, the third year and so on.
  • Major services (available after 3 years) – Crowns and onlays, dentures and bridgework

Extended Health

  • Accidental dental
  • Ambulance transportation
  • Hearing aids
  • Medical services – Diagnostic tests and x-rays, dialysis equipment, laboratory tests
  • Medical items and Home Support services – aids for daily living, braces, casts, catheters, and ostomy supplies, compression stockings, diabetic supplies, custom made footwear for orthotics, mobility aids, prosthetics and respiratory/cardiology items
  • Professional services and Registered Therapists – Acupuncturist, Chiropractor, Chiropodist/Podiatrist, Massage Therapist, Naturopath, Osteopath, Physiotherapist, Psychologist and Speech Therapist
  • Vision – Prescription eyeglasses, contact lenses and laser eye surgery
  • Eye examination
  • Emergency travel – $5 million coverage per year, either 15 or 30 days (depending on the plan) coverage a year

Prescription Drugs

  • Coverage is subject to the selected plan and can range from $550 to $10,000 a year.
  • Greenshield covers a percentage of the drug cost; the amount is subject to the selected plan and ranges from 70% to 90%.
  • Prescription drugs must be approved for use in Canada and requires a prescription by law and have been prescribed by an authorized medical practitioner.
  • Coverage does not include smoking cessation products or drugs for treatment of obesity, infertility, and erectile dysfunction.
  • Limits and coverage limits vary from one plan to the next.  E.g. Zone Plan 1 comes with Extended Health only, there is no dental or drug coverage. Take the time to review each plan to determine if it meets yours and your families needs.

Without coverage and interested in a quote? Click the link here!

 

 

 

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