Health and Health Plus
The plan year for Health and Health Plus is Jan. 1 to Dec. 31. Your plan will automatically renew each year. You have 180 days after the end of the benefit year (Dec. 31) to submit your claim expenses that were incurred during that benefit year.
Co-insurance for Health Insurance refers to the portion that is paid by the insurance company. For example, a 90 per cent co-insurance means the insurer pays 90 per cent and you pay 10 per cent.
Benefit |
Health
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Health Plus
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Plan maximum (lifetime reimbursement) |
Lifetime limits on expenses per insured person:
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Co-insurance |
This applies to prescription drugs, in-province hospital and convalescent hospital expenses, ambulance, nursing, medical equipment and services, paramedical services and hearing aids. |
This applies to prescription drugs, ambulance, nursing and paramedical services. |
Accidental Dental |
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Ambulance |
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Emergency out-of-province / country travel medical |
Learn more about Emergency Travel Assistance. Need more coverage to protect your entire trip? You can use the Emergency Medical Top-Up Plan. Learn more about the Top-Up Plan. |
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Hearing aids |
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Hospital |
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Convalescent hospital |
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Rehabilitative facility |
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Medical equipment |
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Paramedical services |
$350 per plan year per practitioner type, per insured person.
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$500 per plan year per practitioner, per insured person.
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Pharmacogenomic testing |
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Pregnancy and family support benefits |
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Prescription drugs |
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Prescription drugs (dispensing fee) |
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Private duty nursing |
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Medical services |
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Vision care |
Not included |
For any insured person, in two plan years, this can include:
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Your coverage information is always close at hand
By visiting mysunlife.ca or using the Sun Life mobile app, you can:
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Find out what your health plans cover
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Submit claims for instant processing
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Submit a copy of a receipt
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Easily check the status of your claims
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Get help faster by calling us from within the app — we’ll have your plan details ready to go
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Have your coverage cards handy wherever you go, view them on the app or save them to Apple Wallet
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Use the drug look-up tool to find out how much of your prescription drug costs are covered and more
If you don’t have the my Sun Life mobile app, you can still file a claim by visiting mysunlife.ca or completing an Extended Health Care Claim Form (for health claims only).
For details on changing between Health and Health Plus, see your benefits booklet or contact one of our OMA Insurance service representatives, who will be happy to help you.
OMA Health and Health Plus is underwritten by Sun Life Assurance Company of Canada. Sun Life Assurance Company of Canada is the insurer of this product and is a member of the Sun Life group of companies. For inquiries, please call Sun Life’s Client Care Centre at 1-800-758-1641, Monday to Friday, 8 a.m. to 8 p.m. ET. or visit www.sunlife.ca.
For complete details regarding coverage, please see the terms and conditions of Policy 17884. If there is any conflict between this document and the wording of the policies (or the certificate), the wording of the policies will govern. A copy of the policy may be requested.
Exclusions and limitations may apply.
Important Notice: Effective February 1, 2023, Canadian Premier Life Insurance Company (“Canadian Premier”), acquired the Association and Affinity business of Sun Life Assurance Company of Canada (“Sun Life”). Any reference you see to “Sun Life” on this website or on insurance documents you may receive, should be considered referring to “Canadian Premier”.