Eligible Benefits and Limitations. Out-of-Province Coverage – Supplementary coverage is provided to pay physicians, or to reimburse patients, for covered medical-surgical and hospital expenses incurred under certain circumstances outside the patient's province of residence. "Covered services" are those medical-surgical services for which a fee is scheduled under the fee schedule for the provincial medical-surgical plan and those hospital services for which a benefit is provided under the xxxx coverage of the provincial hospital. Benefits are provided under such coverage upon submission of proof satisfactory to the Insurer that a member received covered services out of the province of his/her residence because of:
Eligible Benefits and Limitations. (1) The services (excluding x-rays) of a Practitioner of Chiropracty are an eligible benefit. Chiropractic treatments will be reimbursed at a maximum rate of $25 per visit (except as indicated below) to an annual maximum of
(2) Treatments provided by a Practitioner of Chiropody, when prescribed by a physician, and a Practitioner of Podiatry are eligible. Podiatry treatments are eligible when they occur subsequent to the exhaustion of the applicable provincial benefit period maximum. These benefits will be reimbursed at a maximum rate of $11.45 per visit for either Podiatry or Chiropody, to an annual combined maximum of
(3) The services of a Doctor of Naturopathy (N.D.) are an eligible benefit and will be reimbursed at a maximum of
(4) The services of a Registered Massage Therapist are an eligible benefit, when prescribed by a physician and will be reimbursed at a maximum rate of $45 per visit, to an annual maximum of $200 per benefit year per covered person.
(5) Effective January 1, 2017, the services of a Physiotherapist are an eligible benefit, when prescribed by a physician and will be reimbursed at a maximum rate of $50 per visit to an annual maximum of $200 per benefit year per covered person.
Eligible Benefits and Limitations. The services (excluding x-rays) of a Practitioner of Chiropracty are an eligible benefit. Effective October 1, 2005, chiropractic treatments will be reimbursed at a maximum rate of $25.00 per visit, to an annual maximum of $450.00.
Eligible Benefits and Limitations. (A) The services (excluding x-rays) of a Practitioner of Chiropracty are an eligible benefit. Effective October 1, 2005, chiropractic treatments will be reimbursed at a maximum rate of $25.00 per visit, to an annual maximum of $450.00.
(B) Treatments provided by a Practitioner of Chiropody, when prescribed by a physician, and a Practitioner of Podiatry are eligible. Podiatry treatments are eligible when they occur subsequent to the exhaustion of the applicable provincial benefit period maximum. These benefits will be reimbursed at a maximum rate of $11.45 per visit for either Podiatry or Chiropody. Effective October 1, 2005, the annual combined maximum is
(C) The services of a Doctor of Naturopathy (N.D.) are an eligible benefit and will be reimbursed at a maximum of $25.00 per visit. Effective October 1, 2005, the annual maximum is $325.00 per benefit year per covered person.
(D) The services of a Registered Massage Therapist are an eligible benefit, when prescribed by a physician and will be reimbursed at a maximum of $45.00 per visit, to an annual maximum of $200.00 per benefit year per covered person.
Eligible Benefits and Limitations. (A) Out-of-Province Coverage – Supplementary coverage is provided to pay physicians, or to reimburse patients, for covered medical-surgical and hospital expenses incurred under certain circumstances outside the patient's province of residence. "Covered services" are those medical-surgical services for which a fee is scheduled under the fee schedule for the provincial medical-surgical plan and those hospital services for which a benefit is provided under the xxxx coverage of the provincial hospital. Benefits are provided under such coverage upon submission of proof satisfactory to the Insurer that a member received covered services out of the province of his/her residence because of:
(i) accidental injury or emergency medical-surgical services, or
(ii) referral for medical-surgical care by the member's attending
Eligible Benefits and Limitations. (A) The services (excluding x-rays) of a Practitioner of Chiropracty are an eligible benefit. Effective October 1, 2008, chiropractic treatments will be reimbursed at a maximum rate of $25.00 per visit, to an annual maximum of $465.00. Effective October 1, 2008, in provinces where chiropractic treatments are covered by a provincial benefit plan, reimbursement shall be at a maximum rate of $15.00 per visit until the applicable provincial benefit plan is exhausted and at a maximum rate of $25.00 per visit thereafter, to an annual maximum of $465.00.
(B) Treatments provided by a Practitioner of Chiropody, when prescribed by a physician, and a Practitioner of Podiatry are eligible. Podiatry treatments are eligible when they occur subsequent to the exhaustion of the applicable provincial benefit period maximum. These benefits will be reimbursed at a maximum rate of $11.45 per visit for either Podiatry or Chiropody. Effective October 1, 2005, the annual combined maximum is $325.00 per benefit year per covered person.
(C) The services of a Doctor of Naturopathy (N.D.) are an eligible benefit and will be reimbursed at a maximum of $25.00 per visit. Effective October 1, 2005, the annual maximum is $325.00 per benefit year per covered person.
Eligible Benefits and Limitations. (A) Out-of-Province Coverage – Supplementary coverage is provided to pay physicians, or to reimburse patients, for covered medical-surgical and hospital expenses incurred under certain circumstances outside the patient's province of residence. "Covered services" are those medical-surgical services for which a fee is scheduled under the fee schedule for the provincial medical- surgical plan and those hospital services for which a benefit is provided under the xxxx coverage of the provincial hospital. Benefits are provided under such coverage upon submission of proof satisfactory to the Insurer that a member received covered services out of the province of his/her residence because of:
(i) accidental injury or emergency medical-surgical services, or
(ii) referral for medical-surgical care by the member's attending physician. The benefit payment for covered medical-surgical expenses incurred equals the fee charged for such services less the fee scheduled under the provincial medical-surgical plan for the covered services received, but only to the extent that the fee charged is reasonable and customary in the area where covered services are received. The benefit payment for covered hospital expenses incurred equals the hospital's charge for covered services in semi-private accommodations, less the sum of the payments made by the provincial and supplementary hospital plans.
(B) Special Assistance for Out-of-Province Claims – World Access Canada, an international medical service organization, is retained by the carrier to provide special assistance regarding facilitating claims payment and funds transfers to a provider (i.e. physician, hospital or clinic) for hospital, surgical, medical services covered under the patient's out–of-province hospital, surgical, medical expense benefits plan and provincial health insurance plan. Such assistance will provide that the payment for such covered medical services to the provider will be guaranteed by the carrier when the provider or covered patient calls a pre-arranged toll-free number. In cases where a provider will not agree to xxxx the patient's out-of-province hospital, surgical, medical expense benefit plan or the applicable provincial health insurance plan for covered services as provided above, the carrier will arrange for a direct payment of the eligible hospital, surgical, medical expenses to the provider or directly to the patient if such patient incurred eligible hospital-surgical-medical expenses resulting in ...
