Extended Health Care Benefit
for
W.A.N.T.E. members - Winnipeg School Division
Effective Date February 1, 1999
Extended Health Care Rates Effective April 2009
The 12 month premiums have been averaged over 10 months for all members in the plan.
The premiums are:
Single ......... $30.14
Family ......... $67.21
Benefit Summary - Policy 98240
- $50 annual deductible - single or family
- 100% reimbursement for ambulance expenses
- 80% reimbursement for all other expenses
- *Definition of Dependent includes coverage for same sex spouse
Ambulance:
- Reimbursement of reasonable and customary charges within Manitoba
- Reimbursement of up to $250 per trip outside of Manitoba
- Non-emergency medical transfer service: $250 lifetime maximum
Prescription Drugs:
- Reimbursement of eligible drugs listed on the Manitoba Provincial formulary to a maximum of $800 per person per calendar year
Professional Services:
$350 maximum per calendar year / per insured / per practitioner for:
- Chiropodist, Psychologist, Physiotherapist, Dietician
- $100 maximum per calendar year / per insured / per practitioner for:
- Athletic Therapist
Medical Services and Supplies:
- Private Duty Nursing - $3,000 per calendar year
- Cardiac Rehabilitation treatment - $300 per lifetime per insured
- Breast Prosthesis and Surgical Bras - $100 per single prostheses or bra per calendar year
- Artificial limbs and eyes, surgical stockings, braces (other than foot brace), trusses, collars, casts and splints
- Orthopedic Shoes - 1 pair per calendar year when part of a brace, if not part of a brace 50% of the cost of 1 pair per calendar year
- Orthotics $400 per calendar year
- Charges for the treatment of accidental injuries to natural teeth or jaw, provided the treatment is rendered with 90 days of the accident, excluding injuries due to biting or chewing
- Wigs or hairpieces due to illness or accidental injury to a lifetime maximum of $1000
Medical Equipment:
- Iron lung, Wheelchair, Hospital Bed, Respirator and Oxygen Equipment - $1000 lifetime maximum
- other rental equipment - $250 lifetime maximum
The following benefits are applicable to employees under age 65:
Out-of-Province/Out-of-Canada Travel
- Emergency medical treatment of a sickness or injury which occurs while temporarily outside the province of residence, provided that treatment is also covered by Provincial Plan during the absence from province of residence.
- Physician's services, hospital room and board, cost of special hospital services, hospital charges for out-patient services
- unlimited maximum
- referral outside of Canada for treatment which is available in Canada - 50% reimbursement, to a maximum of $3000 every 3 calendar years
ManuAssist Benefit (Out-of-Province/Country)
Assistance is provided for both Medical and Non-Medical travel emergencies.
- Medical Emergency Assistance:
- Interruption/Delay, After Hospital Convalescence, Visit of Family Member, Vehicle Return, Identification of Deceased
- Return of Deceased to Province of Residence, Lost Document and Ticket Replacement, Legal Referral, Interpretation Service, Message Service, Pre-trip Assistance Service
The following benefit is applicable to employees age 65 and over:
Out-of-Province/Out-of-Canada Travel
- Emergency medical treatment of a sickness or injury which occurs while temporarily outside the province of residence, provided that treatment is also covered by Provincial Plan during the absence from province of residence.
- Physician's services, hospital room and board, cost of special hospital services, hospital charges for out-patient services
- $2500 maximum per per, per calendar year
This information is only a brief summary of the provisions of Group Policy 98240. In the event of a discrepancy between this and the Policy, the terms of the Group Policy will apply. Detailed Employee Benefit booklets may be obtained by contacting Human Resources Department at the Winnipeg School Division.
To view the complete manual issued January 29, 2004 click here
