- Search
- Search
-
New business and underwriting
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 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 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 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 Quebec residents, medically necessary MRI, Ultrasound, CAT and CT scan. |
100% reimbursement No deductible Paramedical practitioners 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 |
Enhanced |
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 |