Common use of Extended Health Benefit Clause in Contracts

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · injury or illness due to war or engaging in a riot or insurrection; · aesthetic surgery (cosmetic surgery for beautification purposes); · services required due to an intentional self-inflicted injury; · delivery charges; · hearing tests; · pregnancy tests; · injury or illness for which you or your dependents are covered under Worker’s Compensation or a similar program; · services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · expenses for contraceptives other than oral contraceptives; · expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s or treatment’s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is limited to a maximum of ninety (90) days per trip, for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence from the actual date of departure from Canada. Additional coverage is available from Atlantic Blue Cross Care on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Letters of Agreement

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Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-pre- approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · injury or illness due to war or engaging in a riot or insurrection; · aesthetic surgery (cosmetic surgery for beautification purposes); · services required due to an intentional self-inflicted injury; · delivery charges; · hearing tests; · pregnancy tests; · injury or illness for which you or your dependents are covered under Worker’s Worker‟s Compensation or a similar program; · services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · expenses for contraceptives other than oral contraceptives; · expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s product‟s or treatment’s treatment‟s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is limited to a maximum of ninety (90) days per trip, for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence from the actual date of departure from Canada. Additional coverage is available from Atlantic Blue Cross Care Xxxxxxxxxx Financial Security on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Maintenance and Operational Services

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · injury or illness due to war or engaging in a riot or insurrection; · aesthetic surgery (cosmetic surgery for beautification purposes); · services required due to an intentional self-inflicted injury; · delivery charges; · hearing tests; · pregnancy tests; · injury or illness for which you or your dependents are covered under Worker’s =s Compensation or a similar program; · services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · expenses for contraceptives other than oral contraceptives; · expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s =s or treatment’s =s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is now limited to a maximum of ninety (90) days per trip, trip for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence Coverages commences from the actual date of departure from Canadadeparture. The current 30 day period per trip for travel outside Canada will still apply. There will be no coverage for travel outside Canada under this program following the first 30 days of a trip outside the participants’ province of residence. Additional coverage is available from Atlantic Blue Cross Care Xxxxxxxxxx Financial Security on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Collective Agreement

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-pre- approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · $ injury or illness due to war or engaging in a riot or insurrection; · $ aesthetic surgery (cosmetic surgery for beautification purposes); · $ services required due to an intentional self-inflicted injury; · $ delivery charges; · $ hearing tests; · $ pregnancy tests; · $ injury or illness for which you or your dependents are covered under Worker’s =s Compensation or a similar program; · $ services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · $ services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · $ expenses for contraceptives other than oral contraceptives; · $ expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · $ expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · $ expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · This is not the official version. $ experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s =s or treatment’s =s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · $ expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is now limited to a maximum of ninety (90) days per trip, trip for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence Coverages commences from the actual date of departure from Canadadeparture. The current 30 day period per trip for travel outside Canada will still apply. There will be no coverage for travel outside Canada under this program following the first 30 days of a trip outside the participants’ province of residence. Additional coverage is available from Atlantic Blue Cross Care Xxxxxxxxxx Financial Security on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Marine Services Division Collective Agreement

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-Pre- authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · injury or illness due to war or engaging in a riot or insurrection; · aesthetic surgery (cosmetic surgery for beautification purposes); · services required due to an intentional self-inflicted injury; · delivery charges; · hearing tests; · pregnancy tests; · injury or illness for which you or your dependents are covered under Worker’s Compensation or a similar s program; · services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · expenses for contraceptives other than oral contraceptives; · expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s or treatment’s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximumsmaximum) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is now limited to a maximum of ninety (90) days per trip, trip for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence Coverages commences from the actual date of departure from Canadadeparture. The current day period per trip for travel outside Canada will still apply. There will be no coverage for travel outside Canada under this program following the first days of a trip outside the participants province of residence. Additional coverage is available from Atlantic Blue Cross Care on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Master Collective Agreement

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · injury or illness due to war or engaging in a riot or insurrection; · aesthetic surgery (cosmetic surgery for beautification purposes); · services required due to an intentional self-inflicted injury; · delivery charges; · hearing tests; · pregnancy tests; · injury or illness for which you or your dependents are covered under Worker’s Worker‟s Compensation or a similar program; · services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · expenses for contraceptives other than oral contraceptives; · expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s product‟s or treatment’s treatment‟s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is limited to a maximum of ninety (90) days per trip, for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence from the actual date of departure from Canada. Additional coverage is available from Atlantic Blue Cross Care Desjardin Financial Security on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Collective Agreement

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · - injury or illness due to war or engaging in a riot or insurrection; · - aesthetic surgery (cosmetic surgery for beautification purposes); · - services required due to an intentional self-inflicted injury; · - delivery charges; · - hearing tests; · - pregnancy tests; · - injury or illness for which you or your dependents are covered under Worker’s Compensation or a similar program; · - services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · - services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · - expenses for contraceptives other than oral contraceptives; · - expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · - expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · - expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · - experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s or treatment’s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · - expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is limited to a maximum of ninety (90) days per trip, for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence from the actual date of departure from Canada. Additional coverage is available from Atlantic Blue Cross Care Xxxxxxxxx Financial Security on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Master Collective Agreement

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · - injury or illness due to war or engaging in a riot or insurrection; · - aesthetic surgery (cosmetic surgery for beautification purposes); · - services required due to an intentional self-inflicted injury; · - delivery charges; · - hearing tests; · - pregnancy tests; · - injury or illness for which you or your dependents are covered under Worker’s Compensation or a similar program; · - services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · - services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · - expenses for contraceptives other than oral contraceptives; · - expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · - expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · - expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · - experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s or treatment’s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · - expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is limited to a maximum of ninety (90) days per trip, for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence from the actual date of departure from Canada. Additional coverage is available from Atlantic Blue Cross Care Desjardin Financial Security on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Master Collective Agreement

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · injury or illness due to war or engaging in a riot or insurrection; · aesthetic surgery (cosmetic surgery for beautification purposes); · services required due to an intentional self-inflicted injury; · delivery charges; · hearing tests; · pregnancy tests; · injury or illness for which you or your dependents are covered under Worker’s 's Compensation or a similar program; · services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · expenses for contraceptives other than oral contraceptives; · This is not the official version. • expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s 's or treatment’s 's safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling traveling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is now limited to a maximum of ninety (90) days per trip, trip for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence Coverages commences from the actual date of departure from Canadadeparture. The current 30 day period per trip for travel outside Canada will still apply. There will be no coverage for travel outside Canada under this program following the first 30 days of a trip outside the participants’ province of residence. Additional coverage is available from Atlantic Blue Cross Care Xxxxxxxxxx Financial Security on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: General Service Collective Agreement

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-pre- approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · - injury or illness due to war or engaging in a riot or insurrection; · - aesthetic surgery (cosmetic surgery for beautification purposes); · - services required due to an intentional self-inflicted injury; · - delivery charges; · - hearing tests; · - pregnancy tests; · - injury or illness for which you or your dependents are covered under Worker’s =s Compensation or a similar program; · - services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · - services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · - expenses for contraceptives other than oral contraceptives; · This is not the official version. - expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · - expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · - expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · - experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s products or treatment’s treatments safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · - expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is now limited to a maximum of ninety (90) days per trip, trip for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence Coverages commences from the actual date of departure from Canadadeparture. The current 30 day period per trip for travel outside Canada will still apply. There will be no coverage for travel outside Canada under this program following the first 30 days of a trip outside the participants province of residence. Additional coverage is available from Atlantic Blue Cross Care Desjardin Financial Security on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Ferry Service

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Extended Health Benefit. Reimbursement is provided for reasonable and customary charges for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It Reimbursement is important to note that reimbursement under provided at for the first per calendar year of eligible extended health and vision care benefit is made at 80% of covered claims per calendar year; for eligible expenses up to $5,000; expenses over $5,000 between and less than $10,000 are per calendar year, of the eligible amount will be reimbursed at 90%per calendar year, and expenses over $10,000 are reimbursed at 100% for any amount exceeding per calendar year the program will reimburse in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · injury or illness due to war or engaging in a riot or insurrection; · aesthetic surgery (cosmetic surgery for beautification purposes); · services required due to an intentional self-inflicted injury; · delivery charges; · hearing tests; · pregnancy tests; · injury or illness for which you or your dependents are covered under Worker’s Workers’ Compensation or a similar program; · services or supplies received from a dental or medical department maintained by your employersemployer, a mutual benefit association, labour union, trustee or similar type group; · services or supplies which are covered under a government hospital plan, a government health plan or any other government plan.; · expenses for contraceptives other than oral contraceptives; · expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s or treatment’s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · ; expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is now limited to a maximum of ninety (90) thirty days per trip, for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence Coverage commences from the actual date of departure from Canadadeparture. Additional coverage is available from Atlantic Blue Cross Care of Atlantic Canada on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Benefits Agreement

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · injury or illness due to war or engaging in a riot or insurrection; · aesthetic surgery (cosmetic surgery for beautification purposes); · services required due to an intentional self-inflicted injury; · delivery charges; · hearing tests; · pregnancy tests; · injury or illness for which you or your dependents are covered under Worker’s Worker‟s Compensation or a similar program; · services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · expenses for contraceptives other than oral contraceptives; · expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s product‟s or treatment’s treatment‟s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is limited to a maximum of ninety (90) days per trip, for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence from the actual date of departure from Canada. Additional coverage is available from Atlantic Blue Cross Care Xxxxxxxxx Financial Security on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Collective Agreement

Extended Health Benefit. Reimbursement is provided for reasonable and customary charges for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It Reimbursement is important to note that reimbursement under provided at for the first per calendar year of eligible extended health and vision care benefit is made at 80% of covered claims per calendar year; for eligible expenses up to $5,000; expenses over $5,000 between and less than $10,000 are per calendar year, of the eligible amount will be reimbursed at 90%per calendar year, and expenses over $10,000 are reimbursed at 100% for any amount exceeding per calendar year the program will reimburse in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · injury or illness due to war or engaging in a riot or insurrection; · aesthetic surgery (cosmetic surgery for beautification purposes); · services required due to an intentional self-inflicted injury; · delivery charges; · hearing tests; · pregnancy tests; · injury or illness for which you or your dependents are covered under Worker’s Workers’ Compensation or a similar program; · services or supplies received from a dental or medical department maintained by your employersemployer, a mutual benefit association, labour union, trustee or similar type group; · services or supplies which are covered under a government hospital plan, a government health plan or any other government plan.; · expenses for contraceptives other than oral contraceptives; · expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s or treatment’s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is now limited to a maximum of ninety thirty (9030) days per trip, for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence Coverage commences from the actual date of departure from Canadadeparture. Additional coverage is available from Atlantic Blue Cross Care of Atlantic Canada on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Collective Agreement

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · injury or illness due to war or engaging in a riot or insurrection; · aesthetic surgery (cosmetic surgery for beautification purposes); · services required due to an intentional self-inflicted injury; · delivery charges; · hearing tests; · pregnancy tests; · injury or illness for which you or your dependents are covered under Worker’s Worker‟s Compensation or a similar program; · services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · expenses for contraceptives other than oral contraceptives; · expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s product‟s or treatment’s treatment‟s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is limited to a maximum of ninety (90) days per trip, for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence from the actual date of departure from Canada. Additional coverage is available from Atlantic Blue Cross Care Xxxxxxxxxx Financial Security on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Agreement

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-pre- approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · injury or illness due to war or engaging in a riot or insurrection; · aesthetic surgery (cosmetic surgery for beautification purposes); · services required due to an intentional self-inflicted injury; · delivery charges; · hearing tests; · pregnancy tests; · injury or illness for which you or your dependents are covered under Worker’s Worker‟s Compensation or a similar program; · services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · expenses for contraceptives other than oral contraceptives; · expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s product‟s or treatment’s treatment‟s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is limited to a maximum of ninety (90) days per trip, for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence from the actual date of departure from Canada. Additional coverage is available from Atlantic Blue Cross Care Xxxxxxxxxx Financial Security on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Maintenance and Operational Services

Extended Health Benefit. Reimbursement is provided for many types of services, such as registered nurse, physiotherapist, wheelchair rental, braces, crutches, deep x-rays, ambulance service, chiropractors, to name a few. Pre-authorization is now required for the rental and/or purchase of all durable equipment and all Nursing Care/Home Care benefits. Effective April 1, 1997, insured employees/retirees and/or their dependents are required to obtain pre-approval for these services by calling the insurance carrier. Certain dollar amounts or time period maximums apply. It is important to note that reimbursement under the extended health care benefit is made at 80% of covered eligible expenses up to $5,000; expenses over $5,000 and less than $10,000 are reimbursed at 90%, and expenses over $10,000 are reimbursed at 100% in any calendar year. Where no maximum eligible expense is noted, reasonable and customary rates will apply. Please consult your employee benefit booklet for details. Services not Covered Under the Supplementary Health Insurance Program You and/or your dependents are not covered for medical expenses incurred as a result of any of the following: · injury or illness due to war or engaging in a riot or insurrection; · aesthetic surgery (cosmetic surgery for beautification purposes); · services required due to an intentional self-inflicted injury; · delivery charges; · hearing tests; · pregnancy tests; · injury or illness for which you or your dependents are covered under Worker’s Compensation or a similar program; · services or supplies received from a dental or medical department maintained by your employers, a mutual benefit association, labour union, trustee or similar type group; · services or supplies which are covered under a government hospital plan, a government health plan or any other government plan; · expenses for contraceptives other than oral contraceptives; · expenses for vitamins (except injectables), minerals, and protein supplements (other than expenses that would qualify for reimbursement under Eligible Expenses under the Drug Benefit); · expenses for diets and dietary supplements, infant foods and sugar or salt substitutes; · expenses for drugs which are used for a condition or conditions not recommended by the manufacturer of the drugs; · experimental products or treatments for which substantial evidence, provided through objective clinical testing of the product’s or treatment’s safety and effectiveness for the purpose and under the conditions of the use recommended does not exist to the satisfaction of the insurer/administrator. · expenses for lozenges, mouth washes, non-medicated shampoos, contact lens care products and skin cleaners, protectives, or emollients. Group Travel Insurance The group travel plan covers a wide range of benefits which may be required as a result of an accident or unexpected illness incurred outside the province while travelling on business or vacation. The insurer will pay 100% of the reasonable and customary charges (subject to any benefit maximums) for expenses, such as hospital, physician, return home and other expenses as outlined in the employee booklet. Coverage under the Group Travel Insurance is now limited to a maximum of ninety (90) days per trip, trip for travel within Canada. The maximum of 30 days is afforded for travel outside Canada and will commence Coverages commences from the actual date of departure from Canadadeparture. The current day period per trip for travel outside Canada will still apply. There will be no coverage for travel outside Canada under this program following the first days of a trip outside the participants province of residence. Additional coverage is available from Atlantic Blue Cross Care on an optional pay all basis. It is important to note that coverage is provided for emergencies only related to accidents or unexpected illness while traveling outside your province of residence. If you have an existing medical condition, the condition must be stable before traveling to have coverage for that condition. Stable means that in the last 3 months before leaving, there has been no hospitalization, no increase or modification in treatment or prescribed medication dosage or no symptom for which a reasonably prudent person would consult a physician. Stable dosage does not apply if you are a diabetic.

Appears in 1 contract

Samples: Collective Agreement

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