Scotia Health & Dental Insurance

Prescription drugs

Maximum: Lifetime maximum of $1 million per person (not including Emergency Medical and Travel Assistance).

Deductible: None

• Covers 75% of drugs that legally require a written prescription by a doctor or dentist up to an annual maximum of $10,000. Unless a specific drug is prescribed, the plan covers 75% of the cost of the generic drug equivalent
• Covers a maximum dispensing fee of $5.00 per prescription (not applicable in Quebec), $250 lifetime maximum of $10,000smoking cessation drugs and $250 annual maximum for oral contraceptives
• Fertility drugs are not covered
• Convenient drug card provided (not available in Quebec)

Emergency medical & travel assistance

100% coverage is available during the first 30 days of a trip (out of province or out of country) up to a lifetime maximum of $1 million. Coverage is not available for pre-existing conditions within the past 9 months. Coverage terminates at age 80.

Paramedical services

• 75% coverage up to a maximum of $25 per visit and 12 visits per practitioner per year
• $800 per year maximum combined for all practitioners
• Includes: Chiropractor, Osteopath, Podiatrist, Chiropodist, Registered Massage Therapist, Naturopath, Speech Language Pathologist, Psychologist, Physiotherapist and Acupuncturist

Vision care

• 1 year waiting period from effective date of coverage
• $150 maximum every 2 years, including a maximum of $50 per biannual eye exam (1 exam per year for a person under age 18)
• Coverage includes: prescription glasses, contact lenses, prescription sun glasses, and laser eye surgery

Medical services & equipment expenses

• Private Duty Nursing - Up to an annual maximum of $2,500
• Accidental Dental - Up to an annual maximum of $2,000
• Hearing Aids - $400 maximum every 5 years
• Orthotics - Orthotics, including custom orthopedic shoes - $300 annual maximum
• Ambulance - 75% coverage for ground ambulance
• Emergency air ambulance - $10,000 maximum per incident
• Durable Equipment - $2,500 annual maximum. Includes: artificial limbs or other prosthetic appliances, splints and crutches, casts, walkers, braces (not solely for athletic use), traction kits, wheelchairs (lifetime maximum of $4,000), and hospital beds (lifetime maximum of $1,500).
• Other - Includes: wigs following chemotherapy ($350 annual maximum), surgical stockings (2 pairs per year), stump socks (5 pairs per year), oxygen, diagnostic laboratory and x-ray examinations, and blood glucose monitors ($150 maximum every 5 years).

Overview

• The plan covers 75% of costs up to a maximum of $500 in the first year of coverage
• Subsequent years' annual maximum is $750
• 3 month waiting period from effective date of coverage
• No coverage for orthodontia or major dental services, such as root canals, bridges or crowns

Oral Exams

• 1 recall exam every 9 months
• 1 complete exam every 3 years
• Emergency or specific examinations

X-Rays

• 1 set of bitewing x-rays every 18 months
• 1 complete series of x-rays every 5 years

Other

• Polishing - 1 unit every 9 months
• Topical fluoride - 1 unit every 9 months
• Scaling and root planing - 4 units every year
• Fillings - amalgam, composite, acrylic or equivalent
• Diagnostic tests and laboratory examinations
• Emergency or palliative services
• Uncomplicated removal of teeth