Health Protection Plus

Wednesday, October 09, 2013
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Insurance Basics, Insurance made easy

Health Protection Plus provides you greater protection with flexibility

If your employer provided you with Health Protection Plus, you are protected against high cost medical expenses with the flexibility of a Health Spending Account.

In the event you experience an unexpected serious illness or medical issues, you can be assured you are protected from larger medical expenses that arise through an Extended Health Care plan.

Your Health Spending Account works like a special savings account. Every year, a fixed dollar amount is placed in your account. You use this money to cover medical and dental expenses. To be eligible for reimbursement, all care must be medically necessary and eligible for income tax credits as per the Canada Revenue Agency rules.

Understanding Health Protection Plus

How does the Health Protection Plus plan work?

Eligible expenses under the Extended Health Care plan are considered for reimbursement first and these claims count toward the plan’s deductible. If the extended health plan’s deductible has not been reached, these expenses may be paid by the Health Spending Account.

When the Extended Health Care plan’s deductible has been satisfied, eligible claims are paid by this plan.

Expenses not eligible under the Extended Health Care benefit category, but are eligible under Canada Revenue Agency guidelines, are automatically considered for reimbursement under the Health Spending Account plan.

What’s covered by the Health Spending Account?

The Health Spending Account pays 100% of eligible expenses. Claimable items under your Health Spending Account must be recognized as medical expenses under the Canada Revenue Agency (CRA) Income Tax guidelines. This means any medical expense you can claim on your tax return is an eligible expense under your Health Spending Account plan.

Please note some medical expenses or services require a doctor’s note to be eligible for reimbursement.

To find information related to claimable medical expenses, go to the CRA website or phone them, toll-free 1 800 959-8281.

See Understanding Health Spending Accounts to learn more.

What’s covered by the Extended Health Care plan?

The Extended Health Care plan has an annual deductible of $3,000 per family.

The plan also has an overall lifetime maximum of $100,000 per person and an annual maximum of $50,000 per person.

Once the plan’s deductible has been satisfied, 100% of eligible expenses are paid up to the annual and lifetime maximums.

  • Prescription Drugs
  • Hospital
  • Private Duty Nursing
  • Ambulance
  • Dental Accident
  • Standard durable medical equipment and medical aids and supplies
  • Out-of-country emergency travel

(See pdf document for details)

How to submit a claim under your Health Protection Plus Plan

Health Protection Plus has two claiming deadlines:

  • Claims to be paid by the Health Spending Account must be received in our office by March 31 of the following year in which the expense was incurred.
  • Claims to be paid by the extended health plan must be received by December 31 of the following year in which the expense was incurred.

Use a Health Spending Account Claim form to submit your expenses. To get claim forms, visit CARESNet

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