Benefits Included | Menuflex™ BASIC | Menuflex™ PLUS |
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EHC BENEFITS
Echelon General Insurance Company | 100% Reimbursement except Drugs | 100%
Reimbursement except Drugs |
Prescription Drugs | - 70% Reimbursment of 1st $500/year,
- 100% of next $3,000 per
policy year;
- Generic Drugs;
- Dispensing fee cap of $7.50 per prescription;
- ESI Pay Direct Card.
| - 80%
Reimbursement of first $500,
- 100% of next $4,000 per policy year (except Quebec where it is based on calendar year);
- Brand name drugs;
- ESI Pay Direct Card
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Accidental Dental | $2,500 per policy year | $3,000 per policy year |
Ambulance | Ground $10,000; $4,000 air ambulance per policy year | Ground $10,000; $4,000 air ambulance per policy year |
Home Support | $3,000 per policy year | Combined policy year maximum of $7,500 for Home Support & Durable Medical Equipment, and Prosthetic appliances and Orthotics |
Durable Medical Equipment | $3,000 per policy year
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Prosthetics | $3,000 per policy year |
Medical Supplies | Included | Included |
Orthopedic footwear | Custom
Orthotics to $225 per policy year | Custom Orthotics to $225 per policy year as part of Durable Medical Equipment maximum |
Private Duty Nurse | Included in Home Support & Durable Equipment maximum of $7,500 | Included in Home Support & Durable Equipment maximum of $7,500 |
| $450 maximum per practitioner per policy year ($50 maximum per visit): - Acupuncturist;
- Chiropractor;
- Chiropodist;
- Naturopath;
- Osteopath;
- Physiotherapist;
- Podiatrist;
- Registered Massage Therapist.
- $35 for Chiropractic X-rays per policy year.
- Psychologist limited to 15 visits per year, maximum of $75 first visit and $60 subsequent;
- Speech Therapist $60 and $40.
| $500 maximum per practitioner per policy year ($50 maximum per visit): - Acupuncturist;
- Chiropractor;
- Chiropodist;
- Naturopath;
- Osteopath;
- Physiotherapist;
- Podiatrist;
- Registered
Massage Therapist.
- $35 for Chiropractic X-rays per policy year.
- Psychologist limited to 15 visits per year, maximum of $75 first visit and $60 subsequent;
- Speech Therapist $60 and $40.
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Hearing Aids | $400/4 years. | $500/4 years |
Vision | Eye glasses: $150/2 years; Eye Examinations: $100/24 months | Eye glasses: $250/2 years; Eye Examinations: $100/24 months |
Hospital | Semi-private $150/day to a maximum of $4,500 per policy year | Semi-private or Private up to $200/day; maximum $25,000 per policy year |
Maximum per person | Benefit maximums | Benefit maximums |
Lifetime Maximum | $250,000 | $250,000 |
Out-of-Country
Royal & Sun Alliance | $1M –30 days, unlimited trips with $100 deductible per claim | $1M –30 days, unlimited trips with $100 deductible per claim |
DENTAL | Menuflex™ BASIC |
Menuflex™ PLUS |
Preventive Services
Echelon General
Insurance Company | - 80% reimbursement;
- no waiting period
- 8 units scaling;
- 9 month recall;
- Oral Surgery,
- Endodontics,
- Periodontics.
| - 80% reimbursement;
- no waiting period;
- Exams, cleaning, scaling every 6 months;
- fillings, x-rays, fluoride, space maintainers,
- extractions,
- anesthesia,
- endodontics,
- periodontics,
- denture repairs.
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Major Restorative Services | Not Included | - Available Year 3+ at 60% reimbursement;
- Crowns, bridges,
dentures & orthodontics;
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Orthodontia | Not Included | See above |
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Maximums | - 80% to $500 year 1;
- 80% to $750 year 2+
| - 80% to $500 year 1;
- 80% to $750 year 2;
- 80% to $1,000 year 3 & 4; and
- $1,250 year 5, including combined Periodontics / Endodontics maximum of $500/year;
- 50%
Periodontics reimbursement.
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