health insurance Personal health Health Coverage Choice PRODUCT FEATURE SHEET Health Coverage Choice (HCC) provides affordable coverage for health-related expenses that aren t covered by your provincial health plan. This includes your day-to-day expenses such as prescription drugs and visits to a chiropractor or physiotherapist, as well as unexpected medical emergencies when they happen. Giving you greater control over how you take care of your health and well-being, Health Coverage Choice puts coverage within reach for you and your family. For Quebec residents only.
Leaving an employer no longer means leaving your group health and dental benefits behind! Health Coverage Choice (HCC) gives you the opportunity to continue receiving similar coverage to what you ve become accustomed to with previous group benefit plans. You don t even need to provide medical information to apply! This personal health insurance plan provides you with the best options for getting the health services you and your family need at the level of care you deserve. All three types of HCC plans are available if we receive your application within 60 days from the date that your group benefits end. PLAN DETAILS Coverage Available to individuals for single person coverage Available to couples or families for multi-person coverage Available to age 74 Once issued, the plan is renewable each year for life The options provided are similar, not necessarily identical, to the coverage you may have received through your group benefit plan. If you are applying for supplemental health care and dental coverage, you must have had these same features covered through your group benefits plan. Be sure to check your policy for complete details of the terms and conditions of HCC coverage. Plan types Prescription drugs There are three types of plans to choose from: Health and dental choice A Health choice B Health choice C Health and dental choice A $400 annual maximum Health choice B $600 annual maximum Health choice C $1,200 annual maximum No deductible Up to $5.00 paid towards dispensing fee on prescriptions Smoking cessation medication ($250 lifetime maximum) Reimbursement refers to the percentage of a purchase cost that will be covered by your plan. Tip A dispensing fee is the amount charged by a pharmacy to fill a prescription. Self-employed individuals and business owners may be able to deduct a portion of the premiums paid for Health Coverage Choice as a business expense. Other individuals may be able to include premiums as part of their medical expenses when calculating tax credits. You should talk to your tax or legal advisor for tax guidance.
PLAN DETAILS continued Supplemental health care to the stated maximums Hearing aids ($300 maximum every 5 years) Accidental dental ($2,000 per fracture or injury) Ground ambulance service The following items have a combined $2,500 annual maximum and a combined $20,000 lifetime maximum: In-home nursing* Orthopedic shoes ($150 annual maximum) Blood glucose monitor ($150 every 5 years) Medically necessary wigs and hair pieces ($100 annual maximum) Prosthetic appliances (eg. artificial limbs) Wheelchairs ($1,000 lifetime maximum), walkers, traction kit Hospital bed, oxygen Casts, crutches or braces Paramedical practitioners are covered as follows: $25 maximum per visit, up to $250 annually per practitioner, except psychologists ($50 per visit maximum up to $250 annually) This applies to: Physiotherapists Speech language pathologists Chiropractors, including one x-ray examination per calendar year Osteopaths, including one x-ray examination per calendar year Naturopaths and acupuncturists Podiatrists or chiropodists, including one x-ray examination per calendar year Massage therapists *In-home nursing includes RNs, RPNs or RNAs. Did you know You must be a Canadian resident and have health and drug insurance coverage through Régie de l assurance maladie du Québec (RAMQ) to be eligible for HCC. If you are under the age of 65, you are not automatically enrolled in Régie de l assurance maladie du Québec (RAMQ). You must enrol to receive coverage from RAMQ who will help to cover your medical and health-related expenses.
PLAN DETAILS continued Eligible expenses are the specific costs that will be paid for by Sun Life Financial as part of your coverage. Your policy will include the complete details of the terms and conditions of coverage. Preventive dental Health and dental choice A $700 annual maximum Coverage automatically included Eligible expenses: Examinations and diagnosis Tests, x-rays and lab exams White fillings Scaling and extractions Space maintainers for children under 12 years of age Pit and fissure sealant for children under 19 years of age Health choices B & C Optional dental benefit available (see back cover for details) Recall visits every 9 months Minor emergency treatments Vision care 100% reimbursement $150 maximum every 2 years, including $50 maximum per eye exam Coverage of prescription eyewear, contact lenses, prescription sunglasses and laser eye surgery A pre-existing condition is a medical condition where symptoms have appeared or required medical attention, hospitalization or treatment (this includes changes in medication or dosage), before you began travelling. Emergency travel medical Health and dental choice A No coverage Health choices B & C 100% reimbursement $1 million lifetime maximum Coverage provided for the first 60 days of a trip Covers travel outside of your province and outside of Canada Available until the age of 80 In a semi-private hospital room, you ll share a room with one other person. In other words, there are two patient beds per semi-private room. Semi-private hospital room 50% reimbursement $5,000 annual maximum If you have a pre-existing medical condition that existed during the nine months prior to your trip, expenses related to this condition are not included Rates may change from year to year. If they are going to change, you ll receive written notice 45 days prior to the change.
Did you know Health Coverage Choice from Sun Life Financial automatically includes access to Best Doctors - an international medical referral network that helps you make informed decisions about your health care. By connecting you and your physician with world-renowned specialists, Best Doctors confirms the right diagnosis and the right treatment options. Once insured, you can use this service if you: suspect you have a medical condition that you would like more information and services for, or have a spouse or dependant child who can benefit from their services. Please note: Best Doctors is a service we currently make available to you but it s not part of your plan and may be altered or withdrawn at any time. things to remember Annual or lifetime maximums Family coverage RAMQ coverage All annual or lifetime maximums are per person. Annual maximums are based on a calendar year. You can t carry forward any unused amounts into future years. Your spouse or dependants who were included on your group plan can be added to your new HCC plan. If you have a baby after coverage is in place, he/she may be added to your existing plan within 30 days of birth. HCC is an individual plan and does not take the place of a group plan. Therefore you cannot opt out of coverage through Régie de l assurance maladie du Québec (RAMQ) because you have personal health insurance.
Optional benefit The waiting period is the amount of time that needs to pass before your dental coverage is available. This period starts from the day that your HCC coverage begins. Consider including the following optional benefit at the time you purchase your plan, based on your needs. Q: Can I get additional dental coverage? A: Preventive and major restorative dental coverage is an optional benefit you may add to Health choice B or C. The optional coverage includes the same features for both plans, as follows: on preventive services 50% reimbursement on major restorative services after a 1-year waiting period $700 combined annual maximum for preventive and major restorative combined Preventive services include: Examinations and diagnosis Tests, x-rays and lab exams White fillings Scaling and extractions Space maintainers for children under 12 years of age Pit and fissure sealant for children under 19 years of age Recall visits every 9 months Minor emergency treatments Major restorative services include: Endodontics Periodontics Oral surgery Crowns Onlays Bridges Dentures (and repairs) Questions? We re here to help. Talk to an advisor about Sun Life Financial today! For more information and resources: Visit www.sunlife.ca Call 1 877 SUN-LIFE (1 877 786-5433) We re dedicated to helping you achieve lifetime financial security. Sun Life Assurance Company of Canada, 2008. 810-3489-08-08