Plan Details
Health Questionnaire Required
The ZONE 5 Choice health insurance plan offers comprehensive coverage for prescription drugs and dental care, vision care, extended health care and emergency medical travel coverage. We’ll ask you to answer some health questions when you apply for this insurance plan, but we keep it as simple as possible.
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Health Questionnaire Required
Your application will be evaluated. If you are taking prescription medication on an ongoing basis when you apply, or if you have a pre-existing medical condition, you will receive an offer for coverage that excludes the medications you’re currently taking and those approved by Health Canada to prevent or treat the medical conditions.
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Prescription Drugs
SureHealth plans offer coverage for generic prescription medications that are approved for use in Canada, have a DIN, require a prescription by law and have been prescribed by an authorized medical practitioner. Brand name prescription medications may be covered if no generic equivalent exists. Smoking cessation products and drugs for the treatment of obesity, infertility and erectile dysfunction are not covered.
Quebec residents must be covered by the RAMQ (Régie de l’assurance maladie du Québec) plan. Prescription drug claims must be submitted to RAMQ first. When RAMQ reimburses a portion of the drug cost, unpaid balances (including co-payments and deductibles) will be co‑ordinated so that you may be reimbursed up to 100% of the eligible expense incurred. If the drug is not covered by RAMQ, the standard co-pay applies.
MaximumsPays 90% up to $5,000 per person per year
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Overall Maximums
Year 1: $700
Year 2: $900
Year 3+: $1,100 per person per year
Recall Frequency9 monthsBasic ServicesBasic Services include coverage towards:
- Preventive cleaning
- Routine examinations, x-rays
- Fillings and extractions
- Flouride treatment for children
Pays 80%, subject to annual maximum
Comprehensive Basic ServicesComprehensive Basic Services include coverage towards:
- Endodontic treatment – root canal therapy
- Periodontal treatment – scaling and root planing, occlusal adjustment, equilibration
- Denture repairs, rebasing, relining
Year 1: Pays 60%, subject to annual maximum
Year 2: Pays 70%, subject to annual maximum
Year 3+: Pays 80%, subject to annual maximum
Major ServicesMajor Services include coverage towards:
- Crowns and onlays
- Dentures
- Bridgework
Available in Year 3: Pays 50%, subject to annual maximumOrthodontic ServicesOrthodontic Services include coverage towards:
- Straightening teeth and correcting the bite
Not included -
Prescription eyeglasses, contact lenses, laser eye surgery
Maximums:
Year 1-2: $150
Year 3-4: $200
Year 5+: $250 per person every 2 years
Eye ExaminationMaximum:
$100 per person every 2 years
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Telemedicine
Maple Online Services:
4 virtual visits per family every year with a licensed general health care practitioner, available 7 days a week, 365 days a year (7 am – midnight, local time)
Professional Services / Registered TherapistsChiropractor, Massage Therapist, Physiotherapist, Acupuncturist, Chiropodist / Podiatrist, Dietitian, Naturopath, Osteopath
Maximums:
$25 per visit
$500 per person per practitioner, per year
Speech Therapist
Maximum:
$500 per person per year
Mental Health ServicesPsychologist / Psychotherapist / Registered Social Worker
Maximum:
$500 per person per year, combined
Inkblot™† Therapy:
4 hours of virtual counselling (2 hours for individual therapy, 2 hours for couples therapy) per person per year; additional therapy is eligible for coverage under the Psychology benefit
Accidental DentalMaximum:
$10,000 per person per year
Ambulance TransportationIncludes land and airHearing AidsMaximum:
$500 per person every 4 years
Medical ServicesDiagnostic tests and x-rays, dialysis equipment, laboratory tests
Maximum:
$2,000 per person per year
Medical Items and Home Support Services (in-home nursing)Medical Items include diabetic supplies (like blood glucose monitors and lancets), custom made boots or shoes, custom made foot orthotics, mobility aids (like canes, crutches, walkers, wheelchairs), prosthetics, aids for daily living (like hospital style beds, IV stands, a trapeze, a bedpan), braces, casts, catheters and ostomy supplies, compression stockings, respiratory/cardiology items like breathing and heart monitors for infants, compressors and oxygen.
Separate maximums for Medical Items and Home Support Services
Maximums:
Year 1: $2,000
Year 2: $4,000
Year 3+: $6,000 per person per benefit category, per year
CPAP, BIPAP, APAP and/or AMP machines and supplies are eligible for coverage.
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Multi-Trip Emergency Medical Travel Coverage out-of-province or country
Maximums:
30 days per trip
$5,000,000 per person per year
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Optional benefit pays for the difference in cost between standard ward charges and semi-private and/or private accommodation in a public general hospital in your province/territory of residence.
Maximum:
Up to 30 days per person per year
What's More
- Generous coverage for dental care that increases each year for the first three years and vision benefits that increase during the first five years
- Multi-trip emergency medical travel coverage (up to 30 days per trip)
- Add optional preferred hospital accommodation to increase your protection even more. It's your choice.
- No waiting period! Once your application is approved, your coverage will begin on the first day of the following month.
- Get instant access to your benefits with the GreenShield pay-direct benefit card.
- File a claim, review your coverage and locate a nearby health practitioner from anywhere, any time with GreenShield online services and the GreenShield mobile app.