Your EHC benefits include coverage for health expenses not covered by government MSP. This includes 80% coverage for items such as medical supplies and equipment, hospitalization, and at higher levels massage therapy and vision care.
Your prescription drug coverage includes a pay-direct drug card to make life easy. Reimbursement is for drugs that fall under a Pacific Blue Cross managed list of drugs (Pacific Blue Cross Rx formulary). Certain drug claims will require prior authorization from Pacific Blue Cross or special authorization from BC PharmaCare. Lifestyle drugs for fertility, smoking cessation, anti-obesity and erectile dysfunction are not covered.
Customize your plan by selecting one of the below Health options.
- Oral contraceptives require a prescription and are included as part of the drug benefit. Therefore, they are not specifically mentioned.
- As per our standard Pacific Blue Cross contract terms, chiropractic x-rays are included. Also, out-of-country referral ($25,000 lifetime maximum) is included but terminates at age 65.
- All plans include a lifetime maximum coverage of $5 million. There are no deductibles.
Maximum amounts shown below are per person, per year, unless otherwise noted.
- Basic work max.Combined Basic & Major $1500
- Major work max.Combined Basic & Major $1500
- Recall Frequency6 months
- Endodontic & periodontal services are included under major restorative.
- Scaling, root planning and gingival curettage will be combined and limited to a dollar maximum equivalent to 6 units.
- Fluoride is covered for dependents 18 and under.
- Oral hygiene instructions excluded.
- Major work attached to implants are not included, however certain dentures and crowns may be eligible.
- Eligible services under PBC standard dental fee schedule 3.
- Waiting period for Basic is 3 months and 12 months for Major.
This benefit provides a lump sum, tax-free cash payment. The payment can help with everyday living expenses or additional expenses associated with recovering from a critical condition:
- Mortgages or Rent
- Additional Child care costs
- Loss or reduction in income
- Alternative treatments and experimental drugs
- Bank or Car loans
- Home health care services
- Adaptive equipment or modifications
- Travel and accommodations for treatments
Any sickness, injury or symptoms existing in the 24 months before coverage are not covered within the first 24 months.
HSA credits are deposited annually and must be spent in the year they are allocated.