Medical Plan Overview 2025
You can choose Comprehensive or Basic coverage or you can opt out of Medical and/or Dental.
The Comprehensive options provide the highest level of coverage, plus annual Health Spending Account credits.
The Basic options offer lower coverage designed to top up coverage under a partner’s plan or to provide a basic level of coverage for those with lower benefit needs. If you select this option, you’ll receive a larger Health Spending Account than what’s provided with Comprehensive coverage.
Opting out is also an option if you do not require coverage. However, if you opt out of both Medical and Dental, you will not receive any Health Spending Account credits.
*If your out-of-pocket prescription drug expenses reach $1,000 in any year, coverage under both the Comprehensive and Basic options will increase to 100% for the balance of that year.
| Types of services | Comprehensive Option | Basic Option | |
| Prescription Drugs* | Pay-direct drug card | 80% reimbursement, subject to an $8 dispensing fee cap | 20% reimbursement, subject to an $8 dispensing fee cap |
| Semi-private hospital accommodation | 80% reimbursement, up to $200 per day | 20% reimbursement, up to $200 per day | |
| Paramedical Services | Includes physiotherapist, chiropractor, naturopath, osteopath, podiatrist/chiropodist, masseur, acupuncturist, occupational therapist | 100% reimbursement and $1,000 per year for all practitioners combined | 20% reimbursement and $1,000 per year for all practitioners combined |
| Psychologist | Includes licensed registered counsellors; social workers, psychiatrists, psychotherapists, psychoanalysts and clinical counsellors | 100% reimbursement and $2,000 per year maximum | 20% reimbursement and $2,000 per year maximum |
| Fertility Treatments | $5,000 combined lifetime maximum for fertility drugs and fertility treatments | $5,000 combined lifetime maximum for fertility drugs and fertility treatments | |
| Speech Therapy | 100% reimbursement and $1000 per year maximum combined with Paramedical services | 20% reimbursement and $1000 per year maximum combined with Paramedical Services | |
| Transgender Core Services | Coverage for a selection of basic surgical procedures, available in some provinces, but not covered under the individual’s provincial health care plan | $10,000 annual maximum and $50,000 life time maximum | $10,000 annual maximum and $50,000 life time maximum |
| Private Duty Nursing | 100% reimbursement up to $25,000 lifetime | 20% reimbursement up to $25,000 lifetime | |
| Vision Care | 100% reimbursement up to $200 for glasses/contacts and $75 for eye exams every 24 months | 20% reimbursement up to $200 for glasses/contacts and $75 for eye exams every 24 months | |
| Hearing Aids | 80% reimbursement up to $1,000 every 36 months | 20% reimbursement up to $1,000 every 36 months | |
| Orthopedic shoes and orthotics | 50% reimbursement up to a combined maximum up to $250 per year | 20% reimbursement up to a combined maximum up to $250 per year | |
| Out of province/country emergencies | 100% reimbursement for up to 60 days per trip | 100% reimbursement for up to 60 days per trip | |
| Medical equipment and supplies | 80% reimbursement up to any specified limits | 20% reimbursement up to any specified limits |