Paramedical Practitioners Sample Clauses

Paramedical Practitioners. The following expenses are reimbursed one-hundred percent (100%) subject to the specified per visit maximums. Referral to these services by a licensed physician is not required for reimbursement. Professional services of the following licensed, certified or registered paramedical practitioners (when operating within their recognized fields of expertise) up to $275 for each covered person per benefit plan year for each practitioner: Chiropractor*, Massage Therapy, Naturopath, Chiropodist, Osteopath*, Physiotherapist, Podiatrist, Psychologist, Speech Therapist, Audiologist, Social Worker, Dietician and Occupational Therapist. * includes a maximum of $15 for one x-ray examination ordered by a licensed chiropractor or osteopath. ** an additional $100 per benefit plan year may be paid per covered person for the surgical removal of toenails or the excision of plantar warts. Note: Under some circumstances, benefits may not be payable until the government plan, where applicable, has paid its yearly maximum. Where a practitioner is charging over and above the government fee schedule, the difference between the government fee and the practitioner charge may be claimed. Professional services of a Registered Nurse (RN), only while the patient is not confined to a hospital, up to a maximum of $15,000 during any period of three (3) consecutive benefit plan years. The Registered Nurse (RN) or practitioners noted above may not be someone normally residing in the patient’s home. Hearing Aids up to a maximum benefit of $500 for each covered person, every five (5) benefit years.
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Paramedical Practitioners. Charges for professional paramedical practitioners subject to an annual maximum payment of $750 for the combined services of all the following specified paramedical practitioners: Charges for diagnostic x-rays and laboratory tests ordered by a chiropractor, osteopath, podiatrist or chiropodist will be covered under the services of such practitioners subject to a maximum of one
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Paramedical Practitioners. Maximum: $500 per practitioner in a calendar year $35 for X-rays in a calendar year per practitioner Overall maximum: $1,500 in a calendar year for all practitioners Charges for treatment, except when performed in a hospital, by a licensed speech therapist, massage therapist, clinical psychologist, chiropractor, osteopath, physiotherapist, acupuncturist, chiropodist/podiatrist or naturopath. PROSTHETIC APPLIANCES Charges for the following remedial appliances or supplies, when authorized by the attending physician: - artificial limbs (limited to one prosthetic appliance to each limb in a lifetime); - breasts (limited to a left and a right prosthesis every two consecutive calendar years); - eyes (limited to one left and one right prosthesis in a lifetime); - canes or crutches (limited to two in a lifetime); - splints; - casts; - trusses (limited to one truss every five consecutive calendar years); and - braces (limited to one cervical collar in a calendar year and all other braces are limited to one in a lifetime). Replacement must be due to pathological or physiological change. Repairs and/or adjustments are provided to a maximum eligible expense of $300 in a calendar year. Hair prosthetics (wigs), when hair loss is due to an underlying pathology or its treatment, to a maximum eligible expense of $300 in a lifetime. Hair prosthetics, replacement therapy and other procedures for physiological hair loss are excluded (i.e., male pattern baldness).
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Paramedical Practitioners. 5 Prescription Drugs ...................................... 6
Sample 1
Paramedical Practitioners. Managed Drug Formulary 80% If purchased Xxxx Group Limited corporate stores. $2.00 Minimum payment per prescription Yes Mandatory generic substitution, drug must be covered under managed formulary $400 per lifetime Excluded Excluded 100% semi-private 100% maximum of $10,000 for 12 months per condition 70% reimbursement to a maximum of $300 per practitioner per calendar year for Chiropractor, Podiatrist, Naturopath, Osteopath, Physiotherapist, Masseuse, Acupuncturist, Psychologist/Social Worker (combined) and Speech Therapist. Managed Drug Formulary 100% If purchased at Xxxx Group Limited corporate stores. $2.00 Minimum payment per prescription Yes Mandatory generic substitution, drug must be covered under managed formulary $400 per lifetime Excluded Excluded 100% private or semi-private 100% maximum of $10,000 for 12 months per condition 90% reimbursement to a maximum of $500 per practitioner per calendar year for Chiropractor, Podiatrist, Naturopath, Osteopath, Physiotherapist, Masseuse, Acupuncturist, Psychologist/Social Worker (combined) and Speech Therapist. EMPLOYEE FLEX BENEFIT PLAN CORE PLAN ENHANCED PLAN EXTENDED HEALTHCARE (CONT’D) Vision Care No coverage 100% to a maximum of $300 per 24 months (frames, lenses, contact lenses, laser eye surgery) Eye Examination 100% to a maximum of $50 per 24 months 100% to a maximum of $50 per 24 months Out of Province Emergency 100% 100% Out of Province Referral 100% to a maximum of $10,000 for life (for services not available in province of residence (limited to Canada and U.S.)) 100% to a maximum of $10,000 for life (for services not available in province of residence (limited to Canada and U.S.)) Travel Assist Yes Yes Hearing Aids 70% to a maximum of $500 every 4 years 90% to a maximum of $500 every 4 years Custom fitted Orthopedic Shoes & Custom-made foot Orthotics 70% to a maximum of $300 every 2 calendar years (must be prescribed by doctor, podiatrist or chiropodist) 90% to a maximum of $300 every 2 calendar years (must be prescribed by doctor, podiatrist or chiropodist) Ambulance 100% 100% Other Health 70% 90% Survivor Benefit 24 months 24 months Termination Clause Coverage terminated at termination or retirement Coverage terminated at termination or retirement EMPLOYEE CONTRIBUTION (PER PAY) Single Nil $17.01 – Biweekly(plus appl. Taxes) Family Nil $44.33 – Biweekly(plus appl. Taxes) *plus provincial sales tax where applicable EMPLOYEE DISCOUNT CARD Discount applies to all merchandise in Corporate stores...
Sample 1
Paramedical Practitioners. The following expenses are reimbursed one-hundred percent (100%) subject to the specified per visit maximums. Referral to these services by a licensed physician is not required for reimbursement. Professional services of the following licensed, certified or registered paramedical practitioners (when operating within their recognized fields of expertise) up to for each covered person per benefit plan year for each practitioner: Chiropractor*, Massage Therapy, Naturopath, Chiropodist, Osteopath*, Physiotherapist,Podiatrist**, Psychologist, Speech Therapist, Audiologist, Social Worker, Dietician and Occupational Therapist. includes a maximum of for one x-ray examination ordered by a licensed chiropractor or osteopath an additional per benefit plan year may be paid per covered person for the surgical removal of toenails or the excision of plantar warts. Note: Under some circumstances,benefits may not be payable until the government plan, where applicable, has paid its yearly maximum. Where a practitioner is charging over and above the government fee schedule, the difference between the government fee and the practitioner charge may be claimed. Professional services of a Registered Nurse only while the patient is not confined to a hospital, up to a maximum of during any period of three (3) consecutive benefit plan years. The Registered Nurse or practitioners noted above may not be someone normally residing in the patient’s home. Hearing Aids up to a maximum benefit of for each covered person, every five (5) benefit years. SCHEDULE MEDICARE SUPPLEMENT BENEFIT PROVISION FOR ALL DIVISIONS ELIGIBLE EXPENSES Eligible Expenses are charges for the following services or supplies which are medically necessary in relation to the nature and severity of the Illness. Prescription Drug Benefit Drugs or supplies must be prescribed by a Doctor or Dentist and dispensed by a licensed pharmacist. Certain Drugs prescribed by other qualified health professionals will be covered the same way as if the drugs were prescribed by a Doctor or a Dentist if the applicable provincial legislationpermits them to prescribe those drugs. For Public Health Subject to Ineligible Expenses, charges for medication listed in the Federal or Provincial Drug Schedules which bears a Drug Identification Number (DIN) and which requires a prescription. Injectable drugs, injectable vitamins, and allergy extracts bearing a DIN. Extemporaneouspreparations and compounds, of which at least one ingredient is an el...
Sample 1

Related to Paramedical Practitioners

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  • Medical Exams 18.1: The Sheriff's Department may require a physical and/or psychological exam by a doctor, at the Employer's expense, to determine the employee's ability to perform his/her regular duties, if deemed appropriate. The employee may obtain a second opinion, at the employee's expense, and in the event there is a dispute between the Employer's doctor and the employee's doctor, both of these doctors shall select a third doctor, whose decision shall be final and binding on the parties. The expense for the third doctor's opinion shall be split 50-50 by the Employer and the employee if not covered by the employee's insurance.

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