Blue cross Ontario

• Health Benefits
• Health Benefits plus Hospital Coverage

If you're not covered by a company health plan, Blue Choice Balance is the cost-effective way to ensure you're protected. It provides coverage that compliments your provincial health plan, with a wide range of extended health care benefits like vision care, hearing aids, nursing care, dental, prescription drugs and optional hospital coverage at an affordable monthly premium.

Benefits are based on a yearly schedule commencing from the effective date of your policy. Coverage for residents of Ontario only. Limitations may apply, see contract for details. All Blue Choice Balance contracts with Health Benefits include the following:

Blue Cross Assistance Program

We are pleased to provide our clients with the Blue Cross Assistance Program. This program includes Health Consulting and Support services, Information and Prevention services, and Partner privileges and discounts.

When you enrol in a health plan from Ontario Blue Cross, you automatically have access to these services 24 hours a day, 7 days a week.

Our staff will provide you with:

• Access to a Registered Nurse to answer your questions and provide advice and guidance on your health related questions
• Home Support Services following a hospital stay
• Referrals to specialists and health organizations in your area and much more

Blue Cross Assistance offers exclusive benefits with our health care partners and as part of this essential program, you also have access to quality services at discounted rates through Ontario Blue Cross partnerships.

Upon enrolment, all customers will receive a booklet detailing the benefits of this program along with an Assistance Program card. Simply present your card, and enjoy quality products and services at a preferred rate.

Blue Cross Assistance. Another unique and valuable feature added to your health care plan.

Extended Health Care

(The following benefits are reimbursed at 80%, up to specified maximum. Amounts refer to each covered person.)

• Hearing Aids (3 months waiting period)-up to $300 every 5 calendar years
• Orthopaedic shoes up to $175 per calendar year
• Accidental Dental-up to $2,000 per calendar year
• Prostheses & Accessories-up to $2,500 per calendar year
• Nursing Services and Home Care-up to $2,500 per calendar year
• Ambulance Services-amount not covered by OHIP

(The following benefits are reimbursed at 100%, up to specified maximum. Amounts refer to each covered person.)

• Vision Care (3 month waiting period)-up to $100 every 2 calendar years
• Eye Exam by an opthalmologist or an optometrist (for insured under 65 years of age) up to $50 every two calendar years
• Emergency Out-of-Province Travel Coverage -up to $5 million
• 24-Hour Toll-Free Health Assistance Hotline

Registered Specialists and Therapists

Costs and number of appointments vary for visits to an Acupuncturist, Chiropodist, Chiropractor, Massage Therapist, Naturopath, Osteopath, Physiotherapist, and Speech therapist.

Benefits are payable only after the yearly maximum allowed under the Ontario Health Insurance Plan (OHIP) has been reached.

A written recommendation from a physician is required for Massage Therapy.

Travel Insurance-15 day medical coverage

Enjoy a 15-day annual travel plan with all Blue Choice Balance Health Benefit Plans

Our plan provides emergency medical coverage while travelling outside the province and includes:

• Benefits paid at 100%
• An unlimited number of trips per year (15-day maximum trip)
• Emergency hospital and medical expenses
• Worldwide Assistance Service
• No deductible
• Available Top-up coverage
• Emergency financial assistance
• Up to $5 million in coverage

Restrictions may apply. Please contact our Call Centre for further details.

Accidental Death and Loss of Use (available only to persons under 75 years of age)

Maximum payable amount:

• $25,000 per applicant
• $25,000 per spouse
• $5,000 per child

Prescription Drug Benefit*

• Available up to age 64
• Ontario Blue Cross pays 70%
• Pay Direct Drug Card
• $5,000 per person, per calendar year maximum

*Benefits are pro-rated in the first year.

Dental Benefit*

• Available up to age 74
• For individuals 75 years of age and older, please call to apply:1-866-732-2583
• Current ODA Fee Guide
• Up to 70% for Basic Dental Services per calendar year
• $500 per person, per calendar year maximum

*Benefits are pro-rated in the first year.

Blue Choice Balance with Optional Hospital Coverage includes all of the benefits listed above with the following Hospital Coverage:

• $200 per day
• 90 days per year
• Semi-private/private room

Benefits are not paid for hospitalization due to pregnancy or pregnancy-related conditions during the first eight months following the effective date of coverage.