Step 1: Health |
BRONZE | SILVER* | GOLD* |
---|---|---|---|
Lifetime maximum | $375,000 | $500,000 | Unlimited |
Prescription drugs | $5,000 Limit 70 or 80%** $5 dispensing fee |
$10,000 Limit 70 or 90%** $10 dispensing fee |
Unlimited 80 or 90%** $10 dispensing fee |
Practitioner services | $30/session max $400/pract/year |
$40/session max $600/pract/year |
$50/session max $800/pract/year |
Mental wellness services | $750 combined/year | $750 combined/year | $1,500 combined/year |
Vision care 6 month waiting period |
$250 $60 eye exam Every 2 years |
$300 $80 eye exam Every 2 years |
$400 $80 eye exam Every 2 years |
Hearing aids 3 month waiting period |
$300 Every 4 years |
$400 Every 4 years |
$600 Every 4 years |
Family planning benefit 1 year waiting period |
$5,000/family/year*** - fertility drugs $5,000/family/year*** - fertility treatment & adoption |
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* A dental option must be chosen with the Silver or Gold Health Options ** Maximum coverage limits apply at Preferred Pharamacy Network (PPN) providers only. For a list of PPN providers, visit pac.bluecross.ca/PPN. *** If per your agreement infertility is a deemed to be a pre-existing condition then this benefit will reduce to a combined lifetime maximum of $2,000. |
Step 2: Dental |
BRONZE | SILVER | GOLD |
---|---|---|---|
Basic and routine services |
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Waiting period | 3 months | 3 months | No waiting period |
Recall frequency† | 9 months | 6 months | 6 months |
Year 1 | 70%, $500 | 70%, $800 | 80%, $1,0001 |
Year 2 | 80%, $700 | 80%, $1,1001 | 90%, $1,3001 |
Year 3+ | 80%, $900 | 80%, $1,4001 | 90%, $1,6001 |
Major services, dentures and orthodontics |
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Waiting period | 12 months | 6 months | |
Year 1 | 60% Major only1 | ||
Year 2 | 50% Major only1 | 60% incl. Dentures, Orthodontics1,2 | |
Year 3+ | 50% incl. Dentures, Child orthodontics1,2 |
60% incl. Dentures, Orthodontics1,2 | |
† The minimum frequency between select preventative and diagnostic services (e.g. exams, polishing, fluoride) 1 Combined annual maximum for all dental services. 2 $2,000 orthodontic lifetime maximum/person. Gold orthodontic coverage is for children and adults. |