About Saint Mary's

Extended Health Care Benefit

Coverage under the program includes reimbursement of 100% of the following health care expenses, not normally covered by the provincial medical care program:

Expense Individual Limits
Private nursing care by a Registered Nurse, Licensed Practical Nurse or Personal Care Worker, other than a relative or an employee of the hospital, and with the prior approval of the employee's physician who must sign a special authorization form certifying approval of the services $5,000 per participant in any 12 consecutive months
Accidental dental treatment if natural teeth are damaged due to accidental blow to the mouth or jaw. Services must be rendered or approved for payment within 180 days of accident. No Limit
Diagnostic and x-ray services in a hospital when not provided by a government program No Limit
Oxygen No Limit
Ambulance or air transportation, if necessary for a stretcher patient  
Special ambulance attendant including travel expenses of a registered nurse where medically necessary and having prior authorization $300 in any 12 consecutive months
Ostomy supplies No Limit
Physiotherapy treatment, including the services of an athletic therapist  Annual Maximum $1,000
Treatment by a licensed Chiropractor, Naturopath, Acupuncturist, Homeopath, Dietician, Osteopath, Chiropodist/Podiatrist, Audiologist, Speech Therapist, Occupational Therapist, Massage Therapist* (licensed masseur as authorized by the attending physician osteopath or chiropodist/podiatrist Annual Maximum $500 per practitioner every 12 months. Combined annual maximum $1,500 every 12 consecutive months.
Remedial prosthetic appliances/supplies--breasts, artificial eyes, or limbs, crutches, splints (including carpel tunnel splint @ $85 maximum), casts, trusses, braces, and hair.

Replacements due to pathological change are also covered
No Limit, except Hair - which has a $300 lifetime limit

$50 in any 12 consecutive months for repairs

Rental (or purchase if approved in advance by Medavie Blue Cross) of wheelchair, hospital bed, equipment for administration of oxygen No Limit
Orthopaedic shoes, including repairs and adjustments, as prescribed by a physician specializing in orthopaedics (include doctor's referral & diagnosis with submission of paid in full receipt) $200 in a calendar year
Molded arch supports including prescribed replacements where due to pathological change $300 per calendar year
TENS machine $200 per calendar year
Hearing aids (excluding batteries) prescribed by an otologist or audiologist (include report from audiologist/otologist with submission of receipt) $700 in any 3 consecutive calendar years
Chronic Disease Management Maximum $500 every 12 consecutive months
Clinical Psychologist/Social Worker $1,000 every 12 consecutive months combined.

All services/supplies must be through Medavie Blue Cross approved providers.