Coverage for emergency ambulance services provided by a participating ambulance company anywhere in Manitoba, and payment of up to $500 per trip for services provided elsewhere. Non-emergency trips are also covered on the prior recommendation of an attending physician if the patient is non-ambulatory (can't walk) and cannot be transported by any means other than ambulance.
Treat No Transport (Treat and Release)
Coverage for medical treatment received by an ambulance paramedic when a participating ambulance operator is called to the scene of an accident or place of illness and transportation to a hospital is not provided. Payment is limited to allowable charges set by the applicable Regional Health Authority.
Coverage for air ambulance to a maximum of $5,000 per trip. Maximum $10,000 per person, per calendar year.
Stretcher Service (Medical Van)
Coverage for "non-emergency" transport by stretcher by a participating stretcher service to a lifetime maximum of $400 per person.
Semi-Private Hospital Room
Combined maximum of 60 days in any one hospital per person, per calendar year for:
- Coverage for a semi-private hospital room in Manitoba, or comparable payment toward the cost of a semi-private room in a hospital elsewhere.
- Payment of $20 per person for each day hospitalized when semi-private room accommodations are requested but not available.
Payment of the per diem charge for hostel accommodation if diagnostic testing or treatment is required at a Manitoba hospital located more than 60 kilometres from your home and you are placed in a recognized medical hostel associated with the hospital.
Extended Health Benefits
Coverage for drugs or medicines listed in the most current edition of the Manitoba Drug Benefits and Interchangeability Formulary as issued by the Government of Manitoba. Maximum $130 per contract per calendar year. Drug benefits payable will be integrated with those provided by Pharmacare or any other government sponsored program. For Pharmacare information please visit the Province of Manitoba Health website.
The following benefits will be reimbursed at 80% of eligible expenses up to the maximum payments indicated.
Coverage for dental treatment resulting from accidental injury to jaw or natural teeth to a maximum of $1,000 per accident.
Athletic Therapy/Occupational Therapy
Coverage for the services of an occupational therapist when prescribed by a Physician and coverage for the services of a certified athletic therapist to a combined maximum of $250 per person, per calendar year.
Coverage for the cost of one eye examination during any consecutive 24-month period. Benefit is subject to per visit fee guide maximum.
Coverage for the services of a physiotherapist. Maximum $450 per person, per calendar year. This benefit is subject to per visit maximum.
Prosthetic And Remedial Equipment
Coverage for purchase or repair of:
- cast, canes and crutches
- artificial limbs and eyes when prescribed by the attending physician
- compression garments when prescribed by the attending physician
- splints, trusses, braces, lumbar-sacro supports, corsets, traction equipment and cervical collars, when prescribed by the attending physician, occupational therapist, physiotherapist or athletic therapist
Charges for tutorial services to a maximum of $15 per hour. Maximum $1,500 per accident or injury.
Extended Health Benefit Maximum
Lifetime maximum $40,000 per person.
Accidental Death & Dismemberment
Maximum $10,000 per person. Payments vary depending on nature of loss.
Payment for the loss of, or loss of use of, limb or sight to the covered person who suffers the loss shall be paid at the amount of insurance specified for the loss. Payment for accidental death of the applicant will be made to the designated beneficiary or to the estate when no beneficiary is designated.
The GenX Plan covers 80% of basic or major dental work with allowable charges set by the Manitoba Dental Association fee guide. Maximum $300 per person, per calendar year.
Basic Services Covered
- Diagnostic: procedures necessary to assist the dentist in evaluating existing conditions to determine required treatment.
- Preventive: procedures including the removal of deposits and stains and the application of fluoride.
- Extractions: uncomplicated procedures for the removal of teeth that are beyond restoration.
- Restorative: procedures to restore natural teeth by fillings or with steel pins or crowns. Repairing, relining, or adding to existing dentures.
Major Services Covered
- Dentures, crowns, and bridge work.
- Inlays and onlays.
- Pulpal therapy and root canal filling.
- Treatment of diseases of the tissues and bones supporting the teeth.
- General anesthesia.
- Nitrous oxide analgesia.
- Complicated surgical procedures and post-operative care.
Coverage for orthodontic services provided by a licensed dentist. Treatment must commence prior to the child's 17th birthday.