CONDITIONS AND ELIGIBILITY. This coverage provides for the reimbursement of reasonable, usual, and customary expenses contracted for the services, supplies, and medical care described in the “Eligible expenses” section, except for the applicable limitations and exceptions. This coverage is not intended to replace the health insurance plan of the province in which the insured person resides or any other government health insurance plan. An insured person is eligible for this coverage only if he or she is also eligible for the benefits available under government hospitalization plans and provincial health care programs. Only reasonable, usual, and customary fees in excess of the fees paid or reimbursed by any government program will be reimbursed under this coverage. Claims payments after your policy ends: We must receive your claim within 90 days of the date your coverage or policy ended. We will not pay for any claims received by us more than 90 days after the date your policy ended, regardless of when the eligible expense was incurred.
CONDITIONS AND ELIGIBILITY. The DES is available to all GP practices and cannot be withheld by the NHS Board should a GP practice wish to participate in the enhanced service. The DES will be available as a one year DES in the first instance. There are two elements to the DES: ▪ Part A which is the basic information element; and ▪ Part B which is a supplementary element. The supplementary information element (Part B) is optional but practices wishing to participate must also complete part A.
