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Payment of Covered Expenses | No Substitution Prescriptions | Payment of Drug Claims | Professional Services | Dental Care This Benefit Summary provides information about the specific benefits supplied by Manulife Financial that are This version of the Benefit Summary produced: June 26, 2007 Benefit Amount - 1 times your annual earnings, to a maximum of $500,000 Termination Age - your benefit amount reduces by 50% at age 65 and further reduces to $5,000 if applicable 2. Accidental Death and Dismemberment Benefit Amount - 1 times your annual earnings, to a maximum of $500,000 Termination Age - your benefit amount reduces by 50% at age 65 and terminates at age 70 or retirement, whichever is earlier The Benefit Overall Benefit Maximum - Unlimited Deductible - Nil Drug Deductible - 20% of the total cost of each prescription Drug Deductible - the Drug Dispensing Fee portion of the cost of each prescription Benefit Percentage (Co-insurance) - Note: The Benefit Percentage for Out-of-Canada Emergency Medical Treatment is 100% 4. Termination Age - employee's age 85 or retirement, whichever is earlier 5. ManuScript Generic Drug Plan 2 - Prescription Drugs Charges incurred for the following expenses are payable when prescribed in writing by a physician or dentist 6. Payment of Covered Expenses Payment of your covered drug expenses will be subject to any Drug Deductible, any Drug Dispensing Fee Maximum Covered expenses for any prescribed drug or medicine will not exceed the price of the lowest cost generic If there is no generic equivalent product for the prescribed drug or medicine, the amount covered is the cost of the
7. No Substitution Prescriptions If your prescription contains a written direction from your physician or dentist that the prescribed drug or medicine is
not Payment of your covered drug expenses will be subject to any Drug Deductible, any Drug Dispensing Fee Maximum
Your Pay Direct Drug Card provides your pharmacist with immediate confirmation of covered drug expenses. This means that when you present your Pay Direct Drug Card to your pharmacist at the time of purchase, you and your eligible dependents will not incur out-of-pocket expenses for the full cost of the prescription. The Pay Direct Drug Card is honoured by participating pharmacists displaying the appropriate Pay Direct Drug decal. To fill a prescription for covered drug expenses: You will be required to pay the full cost of the prescription at the time of purchase if: For details on how to receive reimbursement after paying the full cost of the prescription, please see your Plan Administrator. Services provided by the following licensed practitioners: The maximum for each specialty includes one x-ray ($25 maximum) per calendar year. The Benefit Deductible - Nil Dental Fee Guide- Current Fee Guide for General Practitioners for your Province of Residence If you reside in Alberta, the current Fee Guide is considered to be the 1997 Alberta Dental Association Fee Guide Benefit Percentage (Co-insurance) 80% for Level l- Basic Services 80% for Level ll - Supplementary Basic Services Benefit Maximums $1,500 per calendar year combined for Level l and Level ll Termination Age - employee's age 85 or retirement, whichever is earlier
Employee Life Insurance |
Accidental Death |
Extended Health Care |
Termination Age |
Drug Plan |
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