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The Canadian’s Guide to Green Shield Health Insurance Zone 1

on 2 Oct, 2018

Canadians must pay 30% of their medical costs out of pocket.

While the government does provide necessary health insurance for most things in Canada, it does not provide everything necessary to live a balanced life.

That’s where Green Shield Health Insurance steps in.

They cover what Medicare doesn’t in an effort to keep all Canadians as healthy as possible.

Green Shield Health Insurance provides graded health insurance that is available to all residents.

The health insurance Green Shield Health Insurance provides is measured in zones, with Zone 1 being our most basic coverage plan.

In this article, we’ll discuss what you’ll get with your Zone 1 coverage and who is eligible.

Who is Eligible for Zone 1 Coverage?

Everyone under the age of 75 is eligible for Zone 1 coverage. Yes, everyone.

All you need is a valid provincial health insurance plan (you must have RAMQ as well if you live in Quebec) and to be a Canadian resident.

There are no extra medical questions, underwriting or requirements. You will be accepted, regardless of any pre-existing conditions.

The only way you can become no longer eligible to use the service is after non-payment.

Are My Prescriptions Covered in Zone 1?

As you know, Medicare does not cover prescription drugs. This leaves most Canadians having to purchase them out of pocket or rely on supplemental health insurance.

As Zone 1 is our most basic health care plan, they are not covered under this insurance plan.

Does Green Shield Health Insurance Cover Dental Under Zone 1?

Dental care is another aspect of Canadian well-being not covered by Medicare. However, as Zone 1 is our most basic plan, it also does not offer any dental care. You will need to upgrade to at least a Zone 2 plan in order to receive dental care.

Does Zone 1 Cover Vision Expenses?

Yes! Although Medicare neglects to cover vision expenses, Zone 1 does offer basic coverage. You will get $65 toward eye exams and $150 toward eyeglasses and vision correction every two years you remain on the plan.

Physical Therapy and Musculoskeletal Care

You may use physical therapists under Zone 1 coverage. This includes acupuncture, a chiropractor, massage therapist, osteopath, physical therapist, a podiatrist and naturopaths. With Zone 1, you’ll receive $300 per year toward these services for each practitioner you visit. You have a cap of $20 per visit.

Mental Health and Speech Therapy Services

Mental health and speech therapy services are covered under Zone 1. You’ll receive $300 per year per person to use with one practitioner.

Accident and Trauma Services

Although Zone 1 does not cover basic dental services, it does cover dental accidents. You are covered up to $5,000 a year for any dental trauma that you accidentally sustain.

Your ambulance transportation, both by land and air, will also be covered with Zone 1. This allows you to rest comfortably knowing that if something happens to you or a loved one, they will receive quality emergency services.

Hearing Aids

If you do need hearing aids, Zone 1 will provide $300 for the first four years you’re with the plan. After 5 years, Zone 1 provides $400 every four years.

Diagnostics

If you need diagnostic screening quickly and don’t want to use Medicare, you can have up to $2,000 of work done with Zone 1 each year. This can also include laboratory work and any dialysis equipment you might need.

Medical Items and Support Services

For those who need in-home care, this can be especially important. During the first year, you will receive $2,000 for these services. The amount will increase each year, up to your fourth year. After four years on Zone 1, you will receive $5,000 per year worth of benefits.

Travel Insurance

When travelling abroad, many people neglect to purchase travel insurance. This means being treated at state-run hospitals for a fee. With private health insurance, you can either receive state-run treatment free or can instead go to a private clinic.

Zone 1 covers you up to 15 days per trip at a time, making it a great service for those who travel for business. It works well for individuals who leave the country for short periods of time, but live in Canada for most of the year.

You will receive a $5,000,000 per person per year for travel insurance. For some, this makes Zone 1 worth it on its own.

Private and Semi-Private Hospital Rooms

You may pay a higher fee to have a semi-private or private hospital room in Canada. The benefit of Zone 1 can pay the difference between public and private accommodation in a public hospital.

This service, however, requires medical underwriting. This means that it is not guaranteed for every person who signs up for Zone 1, and you must undergo extra screening.

If you qualify, you will get up to 30 days in a private or semi-private room if you happen to be hospitalized that year. You can also have the difference paid to you if you’re in a hospital that does not have a private room for you.

Why Choose Zone 1?

Zone 1 is a great basic plan to help you get your feet wet in the world of supplemental health insurance. It is a great option for younger individuals or those in good health. If you don’t require too much time at the doctor, this is an excellent choice for you.

This plan also offers out-of-province care, so you’ll always be covered, even if you’re just visiting a friend or family member a few towns over.

You can even write Green Shield Health Insurance off as a tax-deductible item if you’re self-employed, which further sweetens the deal.

To read more about our Zone plans, click here.

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