This plan has been designed exclusively for physicians and surgeons and their employees, allowing them access to superior health and dental coverage with a choice of options. We charge no membership or administration fees to our members and coverage is available without any medical approval. All claims are adjudicated and paid by Blue Cross in the insured member’s province of residence (excluding Quebec).

COVERAGE

Extended Health Care -

There are two options available under this plan:

Option 1:

  • 100% reimbursement for all coverage (including prescription drugs and out-of-country medical expenses)
  • $25 annual deductible per person or family
  • $225 vision care benefit every two years
  • Physician Referral coverage for medical/hospital treatment not available in Canada
  • Semi-Private and Private hospital accommodation
  • Medical Practitioners reimbursement at $400 per person per calendar year
  • Worldwide emergency medical assistance coverage
  • Coverage available to age 70
  • Unlimited overall maximum

Option 2:

  • The same as Option 1 except coverage is at 80% reimbursement (except emergency out-of-country medical expenses which are reimbursed at 100%)

Additional Options:

Direct Pay Drug Card: This is a pay-direct feature which enables prescription drug claims to be paid at point of sale, eliminating the need to submit claims for reimbursement.

Eye Examinations: reimbursement of the cost of Eye Examinations to a maximum of $75 per person every two calendar years. Available in British Columbia only.

Dental Care

There are three options available under this plan, for all options:

  • There is no annual deductible
  • Coverage is available to age 70
  • There are no lifetime maximums (except for Orthodontics at $3,000 lifetime per person)
  • There are no annual maximums for Basic Services
  • There is a $1,500 annual maximum for Major Restorative Services

 

Option
Basic Services
Major Restorative
Orthodontics
1
100%
75%
75%
2
100%
60%
60%
3
100%
50%
n/a
Includes
oral examinations, cleaning, routine scaling and fluoride treatment,consultations, X-rays, extractions and fillings, endodontic and periodontic treatment
crowns, bridges, onlays and/or inlays, dentures
corrections for malocclusions (improper bites) with a maximum lifetime benefit of $3,000 per person (Options 1 & 2).

 

Dental reimbursement for all Plans is based on the Blue Cross fee guide in the insured person's province of residence.