Medical Services And Equipment. The plan will cover eighty percent (80%) of the costs after you pay the deductible for the medical services when ordered by a doctor (the services of a licensed optometrist, ophthalmologist or dentist do not require a doctor’s order).
Medical Services And Equipment. We will cover 100% of the costs after you pay the deductible for the medical services listed below when ordered by a doctor (the services of a dentist do not require a doctor’s order). ◼ out-of-hospital private duty nurse services when medically necessary. Services must be for nursing care, and not for custodial care. The private duty nurse must be a nurse, or nursing assistant who is licensed, certified or registered in the province where you live and who does not normally live with you. The services of a registered nurse are eligible only when someone with lesser qualifications can not perform the duties. ◼ transportation in a licensed ambulance, if medically necessary, that takes you to and from the nearest hospital that is able to provide the necessary medical services. ◼ laboratory tests performed by a commercial laboratory for the diagnosis of an illness. Tests performed in a doctor's office or pharmacy are not covered. ◼ dental services, including braces and splints, to repair damage to natural teeth caused by an accidental blow to the mouth that occurs while you are covered. These services must be received within 12 months of the accident. We will not cover more than the fee stated in the Dental Association Fee Guide for a general practitioner in the province where the employee lives. The guide must be the current guide at the time that treatment is received. ◼ services of a licensed physiotherapist. ◼ services of a licensed qualified speech therapist, for any disease or malformation other than congenital. The maximum amount eligible is $200 per family in a benefit year. ◼ equipment rented, or purchased at our request, that is for temporary therapeutic use, including an iron lung. ◼ casts, splints, trusses, braces, crutches or orthopaedic devices for the back, neck, arm or leg, including its replacements when medically necessary. ◼ breast prostheses required as a result of surgery. ◼ artificial limbs and eyes, including replacements when medically necessary, but excluding myoelectric appliances. ◼ treatment of an illness by the use of radiotherapy or coagulotherapy. ◼ oxygen, plasma and blood transfusions. ◼ glucometers prescribed by a diabetologist or a specialist in internal medicine. Contact lenses or eyeglasses We will cover the cost of contact lenses or eyeglasses as long as they are prescribed by an ophthalmologist or licensed optometrist and are obtained from an ophthalmologist, licensed optometrist or optician. We will cover 100% of these c...
