Plus Plan Benefits

Ambulance/Hospital Benefits

Ambulance

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 coverage set by the applicable Regional Health Authority.

Air Ambulance

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 coverage 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.

Hostel Care

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

Prescription Drugs

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 $200 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.

What is BlueNet?

BlueNet is a point-of-sale claim processing system created by Manitoba Blue Cross.

How does BlueNet work?

The BlueNet system eliminates the need to file paper claims. When you purchase a prescription drug, present your BlueNet card to the participating pharmacy. The pharmacist will enter your contract information along with the details of the drug purchase. Within seconds the BlueNet system will process your claim. The BlueNet system will notify the pharmacist if you have reached your prescription drug maximum, or if the drug being purchased is not covered.

Hearing Aids

Coverage for the purchase or repair of hearing aids (excluding batteries) when prescribed by an otologist or clinical audiologist to a maximum of $500 per person every five calendar years.

Hospital In-Patient Allowance

An allowance of $10 for each day hospitalized as an in-patient. Maximum $100 per illness or injury.

Vision Care

Coverage for prescription eyeglasses or contact lenses as well as coverage for repairs to existing prescription eyeglasses. Maximum of $100 per person, every 24 consecutive months.

The following benefits will be reimbursed at 90% of eligible expenses up to the maximum payments indicated.

Accidental Dental

Coverage for dental treatment resulting from accidental injury to jaw or natural teeth to a maximum of $1,000 per accident.

Assisted Care

Coverage for assisted care services provided by a person regularly employed as a professional health care aid, home care worker, or homemaker (not a relative) when prescribed by the attending physician. Payment is limited to $40 per day, to a maximum of 14 days per illness or injury.

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.

Cardiac Rehabilitation

Coverage for a recognized cardiac rehabilitation program when prescribed by the attending physician for patients with diagnosed cardiac disease to a lifetime maximum of $500.

Foot Care

Coverage for diagnosis and treatment by a podiatrist and coverage for services by a certified foot care nurse to a combined maximum of $450 per person, per calendar year. This benefit is subject to per visit maximums.

Medical Appliances

Coverage for rental, purchase or repair of:

• a hospital bed, oxygen equipment or respirator, when prescribed by the attending physician or occupational therapist, to a lifetime maximum of $1,000 per item, per person.
• a wheelchair, when prescribed by the attending physician, occupational therapist or physiotherapist, to a lifetime maximum of $1,000 per person.
• walkers, when prescribed by the attending physician, occupational therapist or physiotherapist, to a lifetime maximum of $500 per person.
• other medical equipment, including medical devices used to aid daily living, when prescribed by the attending physician, occupational therapist, athletic therapist or physiotherapist, to a lifetime maximum of $250 per person.

Nutritional Counselling

Coverage for the services of a registered dietitian when prescribed by a physician. Maximum $450 per person, per calendar year.

Orthopedic Shoes or Modifications to Orthopedic Shoes

Coverage for othopedic shoes custom made from a mould, or stock shoes which are modified (excluding orthotics or insoles, removable or permanently-affixed) to accommodate, relieve or remedy a mechanical foot defect or abnormality.

Coverage for orthopedic shoe modifications (excluding orthotics or insoles, removable or permanently-affixed) to accommodate, relieve or remedy a mechanical foot defect or abnormality.

A copy of a prescription from the attending physician or podiatrist that includes a medical diagnosis and detailed description of the orthopedic shoe and modification(s) is required.

Boots, sandals or sport specific footwear are not eligible.

Payment is limited to a combined maximum of $200 per person, per calendar year.

Physiotherapy

Coverage for the services of a physiotherapist to a maximum $450 per person, per calendar year. This benefit is subject to per visit maximums.

Private Duty Nursing

Coverage for private duty nursing or home visits by a professional registered nurse (not a relative) either in the hospital or home when prescribed by the attending physician, to a maximum $3,000 per person, per calendar year.

Prosthetic & Remedial Equipment

Coverage for rental, purchase or repair of:

• casts, canes and crutches.
• artificial limbs and eyes, when prescribed by the attending physician.
• compression garments, when prescribed by the attending physician.
• breast prostheses and surgical bras, when prescribed by the attending physician, to a maximum of $400 per single mastectomy and $800 per double mastectomy per person, per calendar year.
• wigs or hairpieces, when prescribed by the attending physician, to a lifetime maximum of $1,000 per person.
• splints, trusses, braces, lumbar-sacro supports, corsets, traction equipment and cervical collars when prescribed by the attending physician, occupational therapist, physiotherapist or athletic therapist.

Psychological Counselling

Coverage for the services of a clinical psychologist to a maximum of $450 per person per calendar year.

Specialist Referral

Mileage allowance for residents of rural Manitoba who have been referred to a medical specialist practicing in a major urban centre in the province. Payments of $0.30 per kilometre for distance of more than 150 kilometres one way allowed. Maximum $200 per person, per calendar year.

Travel Health Care

Coverage for emergency medical, surgical and hospital services resulting from illness or injury while travelling outside of the province. Maximum $2,500 per person, per calendar year.

Additional coverage for U.S. or international travel is recommended.

Tutorial Allowance

Coverage 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.

(This benefit is underwritten by Blue Cross Life Insurance Company of Canada.)

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.

Dental Benefits

The Plus Plan covers 80% of basic or major dental services with allowable coverage set by the Manitoba Dental Association fee guide. Maximum $600 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.

Orthodontics

Coverage for orthodontic services provided by a licensed dentist. Treatment must commence prior to the child’s 17th birthday.