All benefits are subject to the terms of the insurance policies and the Official Plan Documents. This is a summary for your convenience.
| Benefit Amount | $30,000 (Member only) |
| Principal Amount | $5,000 (Member only) |
| Deductible | Nil. |
| Reimbursement | 100% for Basic and Major expenses. |
| Fee Guide | Current. |
| Annual Maximum | $2,500 per person each calendar year for Basic and Major expenses. |
| Coverage Notes | Dental implant coverage will be reimbursed at the equivalent cost of a bridge or partial denture. No orthodontic coverage. |
| Lifetime Maximum | $50,000 per covered person. |
| Annual Reinstatement Maximum | Commencing on the January 1st, following the year in which the balance of the lifetime maximum reduces below $5,000, the lifetime maximum becomes a $5,000 annual maximum. At that time, annual reinstatement also commences each January 1st to restore up to $5,000 each benefit year. |
| Reimbursement | 100% of most eligible expenses subject to maximums and limits; prescription drugs are reimbursed at the lower of the brand name or generic drug ingredient cost; If no generic drug is available, the Plan will pay 100% of the brand name drug ingredient cost. Automatic biologic/biosimilar switching program. |
| Paramedical Practitioners |
Acupuncture, Chiropractor, Homeopath, Massage Therapy, Naturopath, Osteopath, Speech Therapy - Expenses are reimbursed at 50%, up to an annual maximum of $500 per practitioner. Chiropodist or Podiatrist - Expenses are reimbursed at 100%, up to an annual maximum of $400. Physiotherapist or Certified Athletic Therapist - Expenses are reimbursed at 100%, up to a maximum of $100 per treatment and an annual maximum of $250. Psychologist and Psychotherapist - Expenses are reimbursed up to a maximum of $10,000 annually per person, and up to a maximum of $200 per hour. Please consider using the Plan's member assistance program for free private counselling. |
| Vision Care |
Lenses - $300 per 24 months; Frames - $150 per 24 months. Contact Lenses - $250 per 24 months. Basic or Retina Eye Exam - One exam per calendar year (when not covered by the provincial government plan). |
| Prescription Drugs | Prescription drugs, oral contraceptives, diabetic supplies, smoking cessation (1st treatment maximum of $400 at 100%, 2nd treatment maximum of $400 at 50%; lifetime maximum of $600), erectile dysfunction ($400 per calendar year maximum), anaesthetics, vaccinations and immunizations (subject to individual maximums). Over the counter drugs, vitamins or minerals are not covered. Medical cannabis including derivates is not covered. Automatic biologic/biosimilar switching program. |
| Deductible | Nil. Maximum dispensing fee of $9.50 per prescription. |
| Ambulance | Land/air/rail maximum; $200 per calendar year. |
| Accidental Dental | $5,000 per dental accident. |
| Annual Medical Exam | $50 reimbursement to physicians for providing the Plan's "Physician's Confirmation of Annual Medical Exam. |
| Hospital | $5,000 semi-private hospital per calendar year. |
| Medical Services and Supplies, Durable Medical Equipment | Oxygen services and supplies, Prostate-Specific Antigen (PSA) tests, anaesthesia, surgical and compression stockings (2 pairs per calendar year, maximum annual benefit of $200), radiation treatment (subject to a maximum annual benefit of $200), CPAP machine, wigs, surgical brassieres, rental or purchase (at the Plan's discretion) of an iron lung, oxygen tent, hospital bed, wheelchair, electronic heart pacemaker or other durable medical or surgical equipment required for therapeutic purposes (subject to a combined $2,000 maximum annual benefit). |
| Private Duty Nursing | $10,000 per calendar year. |
| Hearing Aids | $1,500 per 48 months. |
| Foot Orthotics & Orthopaedic Shoes | 50% reimbursement subject to a combined $400 maximum benefit each 36 months. |
| Mobility Assistance Equipment Benefit | Reimbursement of 75% of the expenses associated with specific mobility equipment and its installation, subject to a Lifetime Maximum benefit of $5,000. (Member only) |
| Over Age 65 Provincial Health Care Plan Fee | $200 annual maximum benefit to reimburse the actual cost incurred to enroll in the individual's provincially sponsored health care plan. Covers premium, deductibles and co-payments. |
| Travel Costs related to Medical Treatment | Reasonable expenses associated with travelling at least 100km to receive medically necessary treatment otherwise unavailable. 80% of such expenses are reimbursed for members or eligible dependants, subject to a lifetime family maximum benefit of $1,000. Includes accommodation, meal and gas/travel expenses. |
| Coverage | Unlimited Trips. 30 Day Trip Duration Maximum per trip. $5,000,000 Maximum per covered person, per trip. Must be in “Stable” Medical Condition prior to departure. "stable" definition: 180 Day “Pre-Existing Medical Condition Stability Period” exclusion applies. Please consult Manulife Policy documents on the Plan's ETA page |
| Coverage | Confidential counselling services by telephone, face-to-face, or online. Tel# 1.866.990.1113, TTY: 1.888.234.0414, Website: myfseap.com. Please visit this page for the group name and password. |
| Coverage | Available to all Plan members - offers discounted premiums for members coast to coast. Please visit here for more information. |
| Coverage | Live interactive health care services that allows members and their dependants to connect directly with a doctor or nurse practitioner 24/7/365, for consultation or other services such as; healthcare advise, prescription renewal, diagnostic and specialist referrals, lab requisitions, help to navigate the health care system, and more. Click here to learn more. |
| Contribution Amount | Depends on the number of Health hours paid into the Plan before retirement. Based on these hours, a percentage of the cost is paid by the Plan and the remainder is paid by the member. |
* Medical expenses must be necessary, reasonable and customary (R&C) in the circumstances.
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Markham, Ontario
Edmonton, Alberta