Extended Health Benefits

Reimbursement is subject to a deductible of $250 per contract per calendar year for prescription drugs only. The amount will be subtracted from your first claim(s). Once the deductible has been satisfied, you will be reimbursed 80% of eligible expenses for Prescription Drugs. You will be reimbursed 100% of all other eligible expenses.

Summary of Benefits

Accidental Dental Treatment

Charges for dental treatment resulting from accidental injury to jaw or natural teeth. Treatment must commence within 90 days of the accident.

Athletic Therapy

Charges for the services of an athletic therapist when prescribed by a physician to a maximum of $100 per person per calendar year.

Audiologist

Charges for the services of an audiologist to a maximum of $350 per person per calendar year.

Cardiac Rehabilitation

A lifetime maximum of $300 for patients with diagnosed cardiac disease requiring the services of a recognized cardiac rehabilitation program when prescribed by the attending physician.

Chiropractor

Charges for the services of a chiropractor to a maximum of $350 per person per calendar year.

Clinical Psychology

Charges for the services of a clinical psychologist when prescribed by a physician to a maximum of $350 per person per calendar year.

Drugs

Formulary Drugs

For Manitoba Residents

Charges for drugs or medicines that are eligible with Manitoba Pharmacare, prescribed by a physician and dispensed by a pharmacist. The annual maximum amount payable will be governed by the amount of the deductible of Pharmacare or any other government sponsored program.

For Non-Manitoba Residents

Charges for drugs or medicines which are prescribed by a physician and dispensed by a pharmacist. To be considered eligible, these drugs or medicines must be listed in the most current edition of the applicable Provincial Drug Plan Benefits List, or where there is no Provincial Drug Plan Benefits List, in a Drug Plan Benefits List developed by Manitoba Blue Cross. Benefits payable will be integrated with those available from any government Provincial Drug Plan.

Eye Examinations

Charges for the cost of one eye examination to a maximum of $45 per person every 2 calendar years when rendered by a physician, ophthalmologist, or optometrist, provided that no portion of the cost of the examination is eligible for payment under any legislative plan.

Foot Care

Charges for diagnosis and treatment by a podiatrist (foot doctor) and charges for services by a certified foot care nurse to a combined maximum of $350 per person per calendar year. This benefit is subject to per visit maximums.

Licensed Massage Therapist

Charges for the services of a licensed massage therapist to a maximum of $350 per person per calendar year.

Medical Appliances

When prescribed by a physician charges for rental, purchase or repair of:

• an iron lung, wheelchair, hospital bed, oxygen equipment or respirator to a lifetime maximum of $1,000 per item per person.
• walkers.
• other medical equipment to a lifetime maximum of $250 per person.

Naturopath

Charges for the services of a naturopath to a maximum of $350 per person per calendar year.

Nutritional Counselling

Charges for the services of a registered dietitian when prescribed by a physician to a maximum of $350 per person per calendar year.

Orthopedic Shoes and Modification to Orthopedic Shoes

Charges for orthopedic shoes custom made from a mould, or stock shoes which are modified (excluding orthotics or insoles, removable or permanently affixed) to accommodate, relieve or remedy a mechanical foot defect or abnormality. Payment is limited to one pair per person per calendar year.

Charges for orthopedic shoe modifications (excluding orthotics or insoles, removable or permanently affixed) to accommodate, relieve or remedy a mechanical foot defect or abnormality.

A copy of a prescription from the attending physician is required which includes a medical diagnosis and detailed description of the orthopedic shoes and modification(s).

Boots, sandals or sport specific footwear are not eligible.

Orthotics

Charges for the cost of foot orthotics when prescribed by the attending physician, physiotherapist or podiatrist to a maximum of $200 per person per calendar year.

Osteopath

Charges for the services of an osteopath to a lifetime maximum of $1,000 per person.

Physiotherapy

Charges for the services of a physiotherapist for diagnosis and treatment to a maximum of $350 per person per calendar year. This benefit is subject to per visit maximums.

Private Duty Nursing

Charges for private duty nursing or home visits by a professional registered nurse (not a relative) either in the hospital or home when prescribed by the attending physician, to a maximum of $3,000 per person per calendar year. Visits to the home must be within 12 months following discharge from the hospital and the service must be consistent with the treatment for the condition for which the patient was hospitalized.

Prosthetic and Remedial Equipment

When prescribed by a physician charges for rental, purchase or repair of:

• artificial limbs and eyes, compression garments, splints, casts, canes, crutches, trusses, braces, lumbarsacro supports, corsets, traction equipment and cervical collars.
• breast prostheses and surgical bras to a maximum of $100 per single mastectomy and $200 per double mastectomy per person per calendar year.
• wigs or hairpieces to a lifetime maximum of $1,000 per person.

Speech Therapist

Charges for the services of a speech therapist to a maximum of $350 per person per calendar year.

Travel Health Care

If you are age 70 or over, you and your eligible dependents are entitled to reimbursement for charges for medical, surgical and hospital services resulting from accident or illness while travelling out of the province to a maximum of $2,500 per person per calendar year. Additional coverage for U.S. or international travel is recommended. If you are under age 70, you and your eligible dependents also have UNLIMITED Travel Health coverage, see the Travel Health Plan in this booklet.

Exclusions and Limitations

Manitoba Blue Cross shall not pay for the following:

• Orthodontic services.
• Any drugs or medicines in excess of a 100-day supply.