What Does Fee For Service Mean When Choosing A Medi-cal Dental Plan

Private health and dental insurance for individual needs...

We all know medical and dental treatment tin be expensive. And while regime plans assist with the toll, they don't cover everything. If yous're one of the thousands of British Columbians without benefits through your employer, our Health and Dental program is an affordable way to protect you and your loved ones from those costs not covered by the regime plans.

Our Wellness and Dental provides supplementary coverage to regime programs by offering unique personal extended wellness, dental and travel options for people who are non covered by an employer group plan. Our plans give y'all the tools you need to plan ahead, so that if something unexpected occurs, yous are prepared and tin can focus on healing instead of worrying about your finances.

This programme is perfect for:

Retirees
Part-fourth dimension employees
Contract workers
Professionals
People who are self-employed
Students

Our Programme provides flexibility to fit your life and budget.

With our plan, you tin build your own plan and tailor your coverage to conform you and your family's specific needs. This provides you with maximum coverage at a toll you tin beget. Virtually chiefly, our plans give you peace of heed and protection for y'all and your family against unexpected health bug and emergencies.

The program covers 80% of eligible expenses up to a lifetime maximum of $250,000 per covered person.

Plan Highlights:

Our plan consists of a core health programme with prescription drug and dental coverage options so yous tin can choose the coverage y'all need. Certain cadre benefits provide a sliding scale for reimbursement. The longer yous have coverage, the more coverage y'all enjoy.

Every bit a plan member you can as well take advantage of Personal Health Insurance Bridge. It offers you the security of keeping your individual benefits 'on hold' should yous obtain full-time or temporary employment with group benefits.

Core Health Programme

Vision Intendance

Subsequently six months on the program, Pacific Blue Cantankerous covers the cost of prescription lenses, frames, contact lenses and laser eye surgery up to:

First 24 months	25-48 months	49 months +
$100 per person	$200 per person	$300 per person
$30 for optometrist	$50 for optometrist	$70 for optometrist

Registered Therapists and Health Practitioners

Benefits are paid for visits to: naturopaths, massage therapists*, physiotherapists, chiropractors, speech pathologists, registered counsellor, chiropodists/podiatrists, osteopaths, psychologists, audiologists, acupuncturists, and registered dieticians* upwards to:

First 24 months	25-48 months	49 months +
$300 per person per year	$400 per person per year	$500 per person per year
$25 per visit	$25 per visit	$25 per visit

* Services of a massage practitioner or registered dietician require referral past a md.

Infirmary Accommodation
Benefits cover costs for semi-private or private hospital rooms (no historic period restrictions).
Hospital Daily Greenbacks Benefit
If you are confined to a infirmary, nosotros will pay you $20 a 24-hour interval, for up to ninety days, from the 4th day of hospitalization, up to historic period 65.
Local Ambulance
Benefits encompass the price of ambulance fees in emergencies, including air ambulance and Treat No Ship.
Includes payment for Care for-No-Ship, charges for treatment when an ambulance is called to the scene of an accident or identify of illness and transportation to hospital is not required.

Private Duty Intendance Nursing

Benefits comprehend the price for individual duty care nursing in your home, provided the nurse is a Registered Nurse(RN) and care begins immediately following the discharge of an acutely ill bed patient from a infirmary up to:

Beginning 24 months	25-48 months	49 months +
$1,200 per person per year	$2,500 per person per yr	$5,000 per person per year

* Palliative care services and the services of an RN to assist with activities of daily living are non covered.

Out of Province, In-Canada Travel
Benefits encompass 100% of Out-of-Province and In-Canada medical emergency care.

Medical Services and Supplies

Benefits encompass supplies and services not covered by government plans up to:

First 24 months	25-48 months	49 months +
$1,200 per person per year	$two,500 per person per twelvemonth	$5,000 per person per year

Accidental Dental
Benefits comprehend upwards to $2,500 per person for adventitious damage to natural teeth.
Accidental Death and Dismemberment
Benefits embrace the principal sum up to $25,000 (under the age of 70).
Final Expense Benefit
Benefits encompass up to $3,000 for each person.
Survivor Benefit
Benefits begin 12 months following approving of application.

But Pacific Blueish Cross Personal Health Insurance gives you 24/vii access to on-demand doctors and a care director for referrals to specialists forth with prescriptions from our Preferred Pharmacy Network delivered directly to your door.

Prescription Drug Options

Drug coverage can be purchased as an option to your Extended Health Care programme: Both the Essential and Enhanced options provide a sliding scale for reimbursement. The longer you take coverage, the more coverage you savor.

First 24 months	25 - 48 months	49+ months
$ane,000 per person per year	$ii,000 per person per year	$5,000 per person per year

Coverage is for drugs that legally require a prescription. Sure high-price drugs will require special authorization from BC PharmaCare

Essential Prescription Drug Pick

The Essential drug pick covers 80% of the cost of PharmaCare-eligible prescription drugs. This is an increasing do good coverage up to a predetermined maximum.
Enhanced Prescription Drug Option
The Enhanced drug option covers 80% of the cost of PharmaCare-eligible prescription drugs, plus prescriptions that are not eligible under the authorities PharmaCare program. Drugs used for birth control are eligible under this choice only. This is an increasing benefit coverage selection up to a predetermined maximum.

The Enhanced drug option can include a Straight Pay Drug bill of fare provided no pre-existing medical conditions be at the time of application. With a Direct Pay Drug card, your chemist submits your claim electronically. PBC pays the chemist's 80% of your prescription cost, and you pay the chemist the remaining xx%. There is no need to submit a newspaper claim.

Dental Options

Dental coverage can be purchased as an option to your plan: Both the Essential and Enhanced options provide a sliding scale for reimbursement. Like the prescription drug options on the extended health plan, the longer you accept coverage, the more than coverage you enjoy.

	First 12 months	13-24 months	25 months +
Reimbursement percentage	lxx% Basic	fourscore% Basic *l% Major, Dentures	80% Basic *50% Major, Dentures & Orthodontics
Annual combined maximum	$600 per person	$900 per person	$1200 per person

*applicable to Enhanced Dental Option only

Essential Dental Plan Pick
The Essential dental programme covers eligible expenses after a 3-month no-claims waiting period, up to a predetermined maximum. Eligible expenses include:
- Diagnostic expenses (oral examinations, ten-rays)
- Preventive treatments (polishing, fluoride treatments)
- Restorative treatments (fillings)
- Periodontal cleaning (scaling and root planing)
- Prosthodontic services (repairs & pocket-size services but)
- Oral surgery (routine extractions)
In addition, the programme covers emergency treatment of the above services while temporarily outside of BC or the Yukon. There is no fiscal limit on the corporeality that volition be paid for the services covered over the lifetime of the plan.
Enhanced Dental Plan Selection
The Enhanced dental plan covers all of the Essential dental benefits with the addition of major restorative services, up to a combined predetermined maximum.

The plan covers 50% of eligible expenses incurred afterwards 12 sequent months on the plan. The maximum amount payable for major restorative, orthodontic and denture services is limited to $500 for each covered person per twelvemonth.

Boosted eligible expenses include:
- Major Restorative services (crowns, bridges, inlays and onlays)
- Endodontics (root canals)
- Orthodontic coverage.(children just, do good begins after 24 months)
- Consummate or partial dentures

Healthy Blue Living

Staying healthy is worth jubilant

Only Pacific Blue Cross offers British Columbians a discount on wellness insurance for maintaining a healthy lifestyle. With Good for you Blueish Living you receive a ten% discount off your monthly Personal Health and Prescription Drug benefit plan rate.

To qualify, you and your spouse must come across our good for you profile:

Are a non-smoker
Fall within the normal Body Mass Index (BMI) range for your historic period.
Maintain a healthy blood pressure.
Have healthy cholesterol and blood saccharide levels.

Do yous and your spouse fit the above profile? We'll reward you with a discount when we review your application. Children will automatically become the discount if their parents qualify.

Questions? Speak with 1 of our private plan representatives