Your Group Benefits. On settlement or judgement of your legal action, you will be required to reimburse Manulife Financial those amounts you recover which, when added to the disability benefits that Manulife Financial paid to you, exceed 100% of your lost income.
Your Group Benefits. The expenses specified are covered to the extent that they are reasonable and Care customary, provided they are: Covered medically necessary for the treatment of sickness and recommended by a physician, and incurred for the care of a person insured under this Group Benefit Program. Payment of any Covered Expenses under this benefit which may be purchased in large quantities will be limited to the purchase of up to a months’ supply at any one time. Hospital Care charges, in excess of the hospital’s public xxxx charge, for semi-private accommodation confinement in a convalescent care facility which starts within days of discharge from a hospital, up to a of days per disability Direct Drugs Plan A Your Prescription Drug coverage is administered by Plus. Details on the coverage are contained in your Plus brochure. If you have not received your brochure, please contact your Plan Administrator. Charges for the followingexpenses are not covered: the administration of serums, vaccines, or injectable drugs Vision Care eye exams, once per calendar year purchase and fitting of prescription glasses or elective contact lenses, as well as repairs, to a maximum of per calendar year for dependent children under age and during any calendar years for all other Insured persons if contact lenses are required to treat a severe condition, or if vision in the better eye can be improved to a level with contact lenses but not with glasses, the maximum payable will be during any calendar years visual training, to a maximum of per lifetime Professional Services Services provided by the following Chiropractor per calendar year Osteopath per calendar year Podiatrist per calendar year Masseur or Masseuse per calendar year Care Care
Your Group Benefits a assistance in contacting local authorities for replacement of lost or stolen passports, visas, tickets, or other travel documents referral to a local advisor, and if necessary, arrangements for cash advances from credit cards, family or friends Transportation, Meals and Accommodation Expenses return of dependent children to Canada if left unattended due to hospitalization of an insured person. If necessary, a qualified escort will accompany the children. costs to upgrade a return ticket to economy airfare for an insured person or travelling companion, if a return flight is missed due to the illness or injury of an insured person. Expenses incurred for meals and accommodation after the scheduled departure date are payable. A travelling companion is someone whose transportation and accommodation were at the same time as the insured person’s. if an insured person is unable to travel for medical reasons following hospital discharge, expenses incurred for and accommodationafter the scheduled date of departure are payable. round trip economy transportation for an immediate family member to visit an insured person who is travelling alone and has been hospitalized for longer than days. Meals and accommodationfor the family member are payable. The overall maximum for transportation, meals and accommodationexpenses is per medical emergency.
Your Group Benefits services or supplies which would have been payable by the Provincial Health Care Plan if proper application had been made a medical treatment which is not usual or customary, or is experimental or investigational in nature Dental Care you or your dependents require any of the dental specified under Covered Expenses, your Dental Care benefit can provide financial assistance. The Benefit Deductible Nil Dental Fee Guide Current Fee Guide for General Practitioners for your Province of Residence Benefit Percentage (Co-insurance) for Plan A Basic Services for Plan B Major Restorative Services for Plan C Orthodontic Services Benefit Maximums Unlimited for Plan A Basic Services per calendar year for Plan B Major Restorative Services per lifetime for Plan C Orthodontic Termination Age you and your dependent’s coverage continues when you retire Waiting months for employees hired on or prior to the Group Policy Effective Date months for all other employees Covered The following are covered expenses when they-are incurred for the necessary dental care of an insured person. A Services complete oral exams Dental Care
Your Group Benefits your own occupation, during the Qualifying Period and the 2 years immediately following the Qualifying Period • any occupation for which you are qualified, or may reasonably become qualified by training, education or experience, after the 2 years specified above The availability of work will not be considered by Manulife Financial in assessing your disability. If you must hold a government permit or licence to perform the duties of your job, you will not be considered Totally Disabled solely because your permit or licence has been withdrawn or not renewed. Entitlement Criteria Employee Life Insurance - Entitlement Criteria To be entitled to Waiver of Premium, you must meet the following criteria: • you must be continuously Totally Disabled throughout the Qualifying Period. If you cease to be Totally Disabled during this period and then become disabled again within 3 weeks due to the same or related illness or injury, your Qualifying Period will be extended by the number of days during which you ceased to be Totally Disabled. • Manulife Financial must receive medical evidence documenting how your illness or injury causes restrictions or lack of ability, such that you are prevented from performing the essential duties of: - your own occupation, during the Qualifying Period and the following 2 years, and - any occupation for which you are qualified, or may reasonably become qualified by training, education or experience, after the 2 years specified above. • you must be receiving from a physician, regular, ongoing care and treatment appropriate for your disabling condition, as determined by Manulife Financial. At any time, Manulife Financial may require you to submit to a medical, psychiatric, psychological, functional, educational and/or vocational examination or evaluation by an examiner selected by Manulife Financial.
Your Group Benefits the date you do not supply Manulife Financial with appropriate medical evidence documenting how your illness or injury causes restrictions or lack of ability, such that you are prevented from performing the essential duties of: - your own occupation, during the Qualifying Period and the following 2 years, and - any occupation for which you are qualified, or may reasonably become qualified by training, education or experience, after the 2 years specified above. • the date you are no longer receiving from a physician, regular, ongoing care and treatment appropriate for the disabling condition, as determined by Manulife Financial. • the date you do not attend an examination by an examiner selected by Manulife Financial. • the date of your 65th birthday. • the date of your death.
Your Group Benefits incurred for the care of a person while insured under this Group Benefit Program • reasonable taking all factors into account • not covered under the Provincial Plan or any other government-sponsored program • legally insurable Advance Supply Limitation Payment of any Covered Expenses under this benefit which may be purchased in large quantities will be limited to the purchase of up to a 3 months’ supply at any one time, except for covered drug expenses. - Drug Expenses The maximum quantity of drugs or medicines that will be payable for each prescription will be limited to the lesser of:
Your Group Benefits drugs or medicines for the treatment of a sickness or injury, which by law or convention require the written prescription of a physician or dentist (charges for anti-smoking drugs and anti-obesity drugs are not covered) • oral contraceptives • injectable medications (charges made by a practitioner or physician to administer injectable medications are not covered) • life-sustaining drugs • standard syringes, needles and diagnostic aids, required for the treatment of diabetes (charges for cotton swabs, rubbing alcohol, automatic jet injectors and similar equipment are not covered) Charges for preventive vaccines and medicines (oral or injected) are not covered. Charges for drugs, biologicals and related preparations which are intended to be administered in hospital on an in-patient or out-patient basis and are not intended for a patient’s use at home are not covered. Charges for drugs used in the treatment of a sexual dysfunction are not covered. - Drug Maximums - Payment of Covered Expenses - No Substitution Prescriptions - Drug Maximums Fertility Drugs - $1,500 per lifetime All other covered drug expenses - Unlimited - Payment of Covered Expenses Payment of your covered drug expenses will be subject to any Drug Deductible, any Drug Dispensing Fee Maximum and the Co-insurance of 100%. Covered expenses for any prescribed drug or medicine will not exceed the price of the lowest cost generic equivalent product that can legally be used to fill the prescription, as listed in the Provincial Drug Benefit Formulary. If there is no generic equivalent product for the prescribed drug or medicine, the amount covered is the cost of the prescribed product.
Your Group Benefits. Payment of Drug Claims Your Pay Direct Drug Card provides your pharmacist with immediate confirmation of covered drug expenses. This means that when you present your Pay Direct Drug Card to your pharmacist at the time of purchase, you and your eligible dependents will not incur out-of-pocket expenses for the full cost of the prescription. The Pay Direct Drug Card is honoured by participating pharmacists displaying the appropriate Pay Direct Drug decal. To fill a prescription for covered drug expenses:
Your Group Benefits charges for the treatment of accidental injuries to natural teeth or jaw, provided the treatment is rendered within 12 months of the accident, excluding injuries due to biting or chewing Extended Health Care - Submitting a Claim Submitting a Claim To submit an Extended Health Care claim, you must complete an Extended Health Care Claim form which is available from your Plan Administrator. All applicable receipts must be attached to the completed claim form when submitting it to Manulife Financial. All claims must be submitted within 12 months after the date the expense was incurred. However, upon termination of your insurance, all claims must be submitted no later than 90 days from the termination date. Subrogation (Third
