List of health insurance plans

List of health insurance plans
AMI - for people aged 60 years and over
Hospitalization and Diagnostic Services

Hospitalization

100% reimbursement (no deductible) of expenses for semi-private room accommodation:

  • In a hospital for short-term medical care, unlimited number of days
  • In a public or private convalescent home, or in a rehabilitation centre, combined maximum of 90 days per year
  • Compensation of $25 per day of hospitalization from the 4th to 18th day inclusive, if you have to stay in a ward due to the unavailability of a private or semi-private room.

Diagnostic Services

80% reimbursement, after the annual deductible of $50, of the following eligible expenses :

  • laboratory tests : blood and urine tests, throat culture and cytology
  • Scanner (CT scans), up to $250 per calendar year
  • magnetic resonance imaging (MRI), up to $675 per calendar year
  • ultrasound, up to $100 per calendar year
  • polysomnography, up to $500 per period of 24 months
  • home nursing care by a registered nurse, up to 20 8-hour periods, maximum 160 hours per calendar year
  • purchase or rental of non-motorized wheelchair or manual hospital bed
  • emergency ambulance transportation (for people under the age of 65)
Hospitalization and Extended Health Care

Hospitalization

100% reimbursement (no deductible) of expenses for semi-private room accommodation:

  • In a hospital for short-term medical care, unlimited number of days
  • In a public or private convalescent home, or in a rehabilitation centre, combined maximum of 90 days per year
  • Compensation of $25 per day of hospitalization from the 4th to 18th day inclusive, if you have to stay in a ward due to the unavailability of a private or semi-private room.

Extended Health Care

Covers eligible expenses, subject to a lifetime maximum of $15,000 per insured person.

100% reimbursement (no deductible) of the following expenses due to illness or injury:

Professional health services
Medical recommendation not required for the following professional services:

  • Acupuncturist, audiologist or audioprosthetist, naturopath, occupational therapist, osteopath, physiotherapist or rehabilitation therapist,
    $25 per visit, maximum 20 visits per calendar year, per specialist
  • Chiropractor or podiatrist, $25 per visit, combined maximum of 20 visits per calendar year,
    • chiropractor’s X-rays, up to $25 per calendar year

Eye care

  • Glasses or contact lenses or soft intraocular lenses following a cataract surgery,
    maximum $200 per period of 36 consecutive months

80% reimbursement (annual deductible of $50) of the following eligible medical and paramedical expenses:

Private clinic exams

  • Scanner (CT scans), up to $250 per calendar year
  • Magnetic resonance imaging (MRI), up to $675 per calendar year
  • Ultrasound, up to $100 per calendar year.
  • Polysomnography, up to $500 per period of 24 months.

Private accommodation in a hospital, for short-term medical care

Laboratory tests

  • Blood and urine tests, throat culture and cytology.

Registered nurse for in-home nursing care

  • Maximum 20 8-hour periods, maximum 160 hours per calendar year

Various medical devices and accessories

  • Devices and accessories for ostomy patients
  • Syringes, needles, and reagent strips for diabetics
  • Purchase or rental of a manual hospital bed, non-motorized wheelchair, and respiration therapy equipment
  • Accessories such as walkers, canes, crutches, hernia straps, and oxygen supply, etc.
  • Elastic stockings, up to $100 per calendar year

Prostheses and accessories

  • Purchase and repair of auditory prostheses, up to $500 per period of 36 consecutive months
  • Purchase of a mammary prosthesis, up to $150 per calendar year
  • Purchase of a first capillary prosthesis following chemotherapy, up to $300 of eligible expenses
  • Purchase and adjustment of orthopaedic shoes or podiatric ortheses, up to $200 per calendar year

Dental care following an accident, up to $1,000 per accident, per insured.

Medical questionnaire filled by your physician to obtain Blue Cross travel insurance, up to $75 per calendar year

For people under 65

  • eye exam, up to $50 per period of 24 consecutive months,
  • emergency ambulance transportation
Home Health Care (optional)

This optional coverage reimburses eligible expenses incurred following hospitalization in an active care hospital, a day surgery or a medical consultation. There is no limit to the number of hospitalization or day surgery, but as for medical consultation the eligible expenses are limited to one consultation per calendar year.

The number of days covered varies according to the number of days of hospitalization. In the case of a fracture or cancer, prior hospitalization is not required.

You may choose our Regular Option or our Extended Option

  Regular Option Extended Option
Eligible expenses covered at 100%, no deductible
  • Registered nursing assistant or home health aide, to help the insured person who is temporarily unable to perform unassisted 2 of the 5 daily activities. *
    Daily maximum $50 **
  • Friend or relative who does not reside with the insured,
    Daily maximum $25 **
  • Registered nursing assistant or home health aide , to help the insured person who is temporarily unable to perform unassisted 2 of the 5 daily activities. *
    Daily maximum $70 **
  • Friend or relative who does not reside with the insured,
    Daily maximum $35 **

Daily compensation

  • payment of a daily hospitalization compensation of $25, also payable if hospitalized in a long-term care home.

Child care expenses

  • for dependent children of the insured aged 64 years and less, $25 per day

The combined lifetime maximum for the daily compensation and child care expenses is $9,125.

Palliative care

  • Fees of a registered nurse or nursing assistant for palliative care provided at the insured’s home, if his life expectancy is limited to 3 months, up to a lifetime maximum of $3000.

Eligible expenses covered at 80%, no deductible

Transportation expenses

  • Transportation in order to receive medical care or for a follow-up.
    • $0.25 per kilometre for the use of private automobile or the cost of a taxi ride, up to an eligible amount of $50 per day (including parking expenses, if applicable) and up to $500 per calendar year.
    • For insureds suffering from cancer, transportation expenses for a maximum period of 3 months, up to a maximum of $1500.

Medical supplies

  • Medical supplies required when the insured receives registered nursing care at home for the treatment of an illness or injury, up to $150 of eligible expenses per calendar year.

Transportation expenses

  • Transportation in order to receive medical care or for a follow-up.
    • $0.25 per kilometre for the use of private automobile or the cost of a taxi ride, up to an eligible amount of $50 per day (including parking expenses, if applicable) and up to $500 per calendar year.
    • For insureds suffering from cancer, transportation expenses for a maximum period of 3 months, up to a maximum of $1500.

Medical supplies

  • medical supplies required when the insured receives registered nursing care at home for the treatment of an illness or injury, up to $150 of eligible expenses per calendar year.

Home conversion

  • Expenses for home conversion if the insured is permanently disabled due to an accident or an illness, and unable to perform without assistance at least 2 daily activities of daily living* for a lifetime maximum amount of $5000.

    These expenses must be incurred within 6 months following discharge from the hospital.

Meals and accommodation

  • Expenses for meals and accommodation in a specialized facility affiliated to a hospital, if the insured must receive treatments for cancer or following a transplant, in a different city than his city of residence, up to a maximum of $500 per calendar year

 

Monthly benefit

  • When the insured person is unable to perform unassisted 2 of the 5 daily activities*, due to an accident or an illness, $200 for up to 3 months

The monthly benefit is subject to a 30-day waiting period.

Monthly benefit

  • When the insured person is unable to perform unassisted 2 of the 5 daily activities*, due to an accident or an illness, $500 for up to 6 months




The monthly benefit is subject to a 30-day waiting period.

* The daily activities are the following: eating, dressing, using the toilet, transferring from bed to chair and bathing/showering.


* * The number of days covered is determined according to the duration of hospital stay and expenses must be incurred within a maximum period following discharge from the hospital.

Hospitalization duration Number of days covered Maximum period to incur eligible expenses
0 to 3 days 5 7 days
4 to 7 days 7 14 days
8 to 14 days 14 28 days
15 days and over 21 35 days