Healthcare in Canada is a source of pride for many Canadians. And around the world, it’s recognized as a far better health care system compared to the US. But that doesn’t mean it’s not without its difficulties or flaws.
If you’re Canadian and you’re looking for supplemental insurance, it’s easy to get overwhelmed by the information and statistics available. Do you really have to do your own in-depth research?
Nope! Keep reading this guide on the Zone 6 health plan, part of Green Shield health insurance’s comprehensive coverage.
What is Green Shield Health Insurance?
First, what makes GSC so different? A few things! GSC has been Canada’s only non-profit health and dental benefits provider. And they’ve been doing that since 1957.
And this great distinction doesn’t stop there. They’ve been involved with giving organizations such as the Community Giving Program. They also spearhead the Frontline Care Partnerships that aim to assist vulnerable citizens.
But what about the actual health insurance coverage?
GSC offers benefits they would want their own families to receive. You’re dealing with real humans who care about your well-being, not how to make a quick dollar. And with affordable rates that bring excellent services, GSC will stand out in your search.
Other ways that GSC stands out is they also provide insurance for people about to lose their Group coverage, or for freelancers.
There are two SureHealth insurance types within Green Shield to choose from: Zone and Link.
What Are the Differences Between Plans?
The most basic plans, at the lowest cost, still offer great coverage for prescription drugs, dental, and specialist care. Of course, paying more for a plan will offer even more coverage. But no matter what level of plan you choose, you’ll still get awesome benefits.
Let’s look at Zone 6 coverage, one of the most comprehensive plans that GSC offers.
Zone 6 Coverage: What are the Benefits?
ZONE 6 is the plan with the most benefits and perks. It’s touted for its generous prescription drug coverage and awesome dental care. Vision, specialist care and emergency medical coverage are all top-notch. This means you’ll have fewer out-of-pocket expenses.
It’s important to note that unlike many of GSC’s other plans, ZONE 6 requires its applicants to complete a questionnaire. If you have a pre-existing condition, you might receive an offer for coverage that won’t include your Rx drugs. But you can rest easy knowing it will still be a simple process.
Your prescription drug plan offers coverage for Rx generic meds that are approved for use in Canada, and have all the appropriate regulatory and licensed authorization. Your brand name meds might be covered if no generic equivalent exists.
However, drugs that treat infertility, ED, obesity or smoking cessation are not covered.
Residents of Quebec must be covered by the RAMQ, and Rx drug claims must be submitted to the RAMQ prior to reimbursement. If the RAMQ reimburses part of the drug cost, unpaid balances will be coordinated and you may be fully reimbursed.
Drug coverage maximums are at $10,000 per person, each year. This is paid at 90%. Dental care is covered to increasing maximums for the first three years. The first year, coverage is at $800, the second year, $1,000. At year three, $1,300 is covered, per person and every year beyond.
Basic dental services are covered with teeth cleanings, routine exams, and x-rays, fillings, and extractions, as well as fluoride treatments for kids. Basic dental is paid at 80%.
Comprehensive basic services include root canals, scaling and root planing, occlusal adjustments, and denture repairs. This is paid at 80% as well. Major Services cover crowns, inlays, dentures, and bridgework. In the third year, these services are paid at 50%.
Eye care is covered with your glasses, contact lenses eye surgery at $200 per person, every 2 years in your first two years. Years 3 and 4, you’ve covered at $250 per person, and at year 5 and beyond, $300 per person is covered. Eye exams are covered up to $80 per person, every 2 years.
Specialist care with acupuncturists, chiropractic care, naturopaths and physical therapists is covered to $25 per visit or $600 per each practitioner. Psychological and social work care is covered to $600 per person, per year.
Accidental dental is covered up to $10,000 per year. Ambulance transport, both land, and air, are covered. Hearing aids are covered to $500 per person, every 4 years.
Diagnostic testing and imaging, like x-rays and dialysis, is covered at $2,000 per year. Medical supplies which include catheters, diabetic supplies, custom orthotics or compression stockings, wheelchairs, and prosthetics, are covered to $2,000 per year in the first year. At year 2, you’re covered to $4,000 and at year 3, you’re covered to $6,000 per benefit category, every year.
Your emergency medical travel coverage is covered for 30 days per trip, at $5,000,000 per person, each year. Your hospital accommodation is covered for 30 days per year, and the difference in cost between standard ward charges and both semi-private and private rooms is covered.
Recap your Awesome Benefits:
So, let’s recap all you’ve read thus far. Your coverage for dental care will increase each year for the first three years, vision care will increase for the first five years, and your emergency medical travel coverage keeps you covered for 30 days, each trip.
You can add an optional preferred hospital accommodation if you want to increase your protection. There’s no waiting period for coverage. Once your application is approved, your benefits will begin on the first of the following month.
You can get instant access to your coverage with the GSC pay-direct card, and you can file a claim or locate a nearby practitioner from anywhere with GSC on the GO.
Ready to Buy Insurance?
By now you’ve figured out that Zone 6 is loaded with benefits, and might be the right choice for you and your family.
Although this guide has given you a great overview of what to expect from Green Shield health insurance, you might still have questions. Like, should you talk to an insurance broker? Or you could just check out all of our service offerings.