AFFORDABLE HEALTH BENEFITS FOR ALL

For individuals who don’t have access to Group Benefits through their employer, we’re proud to offer our Georgian Bay Plan, an affordable health benefits plan that provides medical and dental coverage for individuals and families.

EHC/Dental - single: $140.08

EHC/Dental - family: $357.9

EHC/Dental - single: $170.67

EHC/Dental - family: $417.67

*upon medical approval, all members medically required questionaire

Over 65

Under 65

DRUG

A co-payment of 20% plus the rendered dispensing fee applies to each prescription
Ontario residents only: The Ontario Drug Benefit co-pay/deductible for seniors is not a benefit
Generic equivalent drug substitution applies
Quebec residents only: Legislation states that Green Shield Canada is obligated to follow RAMQ reimbursement guidelines for all residents of Quebec. For those 65 years of age and under, Green Shield Canada is primary payor
Benefits include drugs legally requiring a prescription by law, diabetic needles and syringes.
Benefits do not include smoking cessation products and medication for the treatment of obesity, erectile
dysfunction and infertility.

MEDICAL ITEMS

Prosthetic Appliances and Durable Medical Equipment as well as replacements, repairs, fittings and adjustments of such devices. Contact the Customer Service Centre to verify eligibility of a particular benefit.

PRIVATE DUTY NURSING IN THE HOME TRANSPORTATION

Private duty nursing benefits carry a maximum of $5,000.00 per calendar year for the services of a Registered Nurse (R.N.) in the home on a full or part shift basis

PROFESSIONAL SERVICES

Physiotherapist, Psychologist, Chiropractor*, Osteopath, Podiatrist/Chiropodist, Naturopath, Registered Massage Therapist (medical referral required) or Speech Therapist: up to a maximum of $400.00 per practitioner per calendar year. Chiropractor X-rays are eligible up to a maximum of $50.00 per calendar year
Chiropractor (Ontario residents only): Your deductible is $375 (Single) per calendar year. Reimbursement is based on the usual and customary per visit amount
Professional Services are only eligible when the practitioner rendering the service is a member in good standing with their provincial regulatory agency or an active member of a professional association, either of which must be recognized by Green Shield Canada. Please contact the Green Shield Customer Service Centre to confirm eligibility when in doubt

HEALTH SERVICES

Your overall Health deductible is nil
Our co-insurance for Health Services is 100%

EMERGENCY TRANSPORTATION

Ambulance Transportation, for land or air ambulance to the nearest hospital equipped to provide the required treatment.

ACCIDENTAL DENTAL BENEFIT

Accidental Dental benefits for treatment by a dentist. A dental accident report form must be submitted immediately following the accident.

AUDIO

Reimbursement will be made for standard hearing aids, repairs or replacement parts up to a maximum of $500.00 every 3 years. Batteries are not eligible.

VISION

Our Vision Benefit carries a maximum of $100.00 every 24 months for prescription eye glasses or contact lenses, or $100.00 every 24 months for medically necessary contact lenses provided they are dispensed by an Optometrist, an Optician or an Ophthalmologist
Eye examinations performed by a registered, licensed Optometrist or Physician limited to one exam every 24 months, up to a maximum of $80.00 (available only where eye examinations are not covered by the Provincial Health Insurance Plan).
Commencement of your benefit period is based on the initial date you receive vision benefits. This service date is the actual pick-up date of the eyewear.

PREFERRED PROVIDER VISION NETWORK ARRANGEMENT

As a Green Shield plan member, you have access to our national preferred provider vision network arrangement where all Green Shield plan members are eligible to receive a discount on eyewear and laser eye surgery.
Features of this great value-added service for either eyewear or laser eye surgery include:
Offer applies to any Green Shield plan member, regardless of whether you have Green Shield vision benefits or not
The vision provider may bill Green Shield directly; the plan member just pays any portion of the expense not covered under their vision benefit
Trustworthy retail chains with convenient locations
Discount offer applies to everything such as all extra coatings, upgrades and accessories
Hundreds of the latest frame styles to choose from plus the latest lens and coating technology
Professional opticians to assist in selecting products
For some vendors, this offer applies to non-disposable contact lenses only (excludes disposable contact lenses)
Visit our web site at greenshield.ca or call our Customer Service Centre at 1.888.711.1119 for information on the vision providers.

How to Submit Your Vision Claim
Present your Green Shield Identification Card as proof of being a Green Shield plan member.
The vision provider will apply the appropriate discount(s) to your claim and may submit the claim directly to Green Shield for payment. You pay your vision provider any balance not covered under your vision benefit.
If no vision benefit exists, you pay your provider the full balance owing after the applicable discounts have been applied.

DENTAL

Your deductible is nil
Your overall Dental maximum is $1,000.00 per calendar year
Stated maximums are based on paid dollars
Your co-insurance which is applied to the eligible allowed amount is 80% for Basic and Comprehensive basic services
Basic services cover: recalls twice every 12 months, other exams and full mouth x-rays every 3 years
Comprehensive basic services cover denture relines once every 3 years
Applicable lab, drug and other expenses are eligible to a maximum of 40% of the allowable professional fee. Any applicable co-payment is then applied
Your eligible claims are reimbursed at the level stated above and in accordance with the current Ontario Dental Association Fee Guide for General Practitioners

BASIC SERVICES

Recalls include exams, bitewing X-rays, preventive cleanings and fluoride treatments
Complete, general or comprehensive oral exams, full mouth X-rays and panoramic X-rays
Basic restorations, fillings and inlay
Extractions and surgical services. General anaesthesia and intravenous sedation only when done in conjunction with eligible oral surgery

COMPREHENSIVE BASIC SERVICES

Endodontic treatment including standard root canal therapy, excluding retreatments
Periodontal treatment including scaling and/or root planing
Standard denture services including relining and rebasing of dentures plus denture adjustments after 3 months from installation