EHC/Dental - single: $140.08
EHC/Dental - family: $357.96
EHC/Dental - single: $170.67
EHC/Dental - family: $417.67
*upon medical approval, all members medically required questionaire
A co-payment of 20% plus the rendered dispensing fee applies to each prescription
Ontario residents only: The Ontario Drug Benefit co-pay/deductible for seniors is not a benefit
Generic equivalent drug substitution applies
Quebec residents only: Legislation states that Green Shield Canada is obligated to follow RAMQ
reimbursement guidelines for all residents of Quebec. For those 65 years of age and under, Green Shield
Canada is primary payor
Benefits include drugs legally requiring a prescription by law, diabetic needles and syringes.
Benefits do not include smoking cessation products and medication for the treatment of obesity, erectile
dysfunction and infertility.
Your overall Health deductible is nil
Your co-insurance for Health Services is 100%
Ambulance Transportation, for land or air ambulance to the nearest hospital equipped to provide the required
ACCIDENTAL DENTAL BENEFITS
Accidental Dental benefits for treatment by a dentist. A dental accident report form must be submitted immediately
following the accident.
Reimbursement will be made for standard hearing aids, repairs or replacement parts up to a maximum of $500.00
every 3 years. Batteries are not eligible.
Prosthetic Appliances and Durable Medical Equipment as well as replacements, repairs, fittings and adjustments
of such devices. Contact the Customer Service Centre to verify eligibility of a particular benefit.
PRIVATE DUTY NURSING IN THE HOME
Private duty nursing benefits carry a maximum of $5,000.00 per calendar year for the services of a Registered
Nurse (R.N.) in the home on a full or part shift basis
Physiotherapist, Psychologist, Chiropractor*, Osteopath, Podiatrist/Chiropodist, Naturopath, Registered
Massage Therapist (medical referral required) or Speech Therapist: up to a maximum of $400.00 per
practitioner per calendar year. Chiropractor X-rays are eligible up to a maximum of $50.00 per calendar year
*Chiropractor (Ontario residents only): Your deductible is $375 (Single) per calendar year.
Reimbursement is based on the usual and customary per visit amount
Professional Services are only eligible when the practitioner rendering the service is a member in good
standing with their provincial regulatory agency or an active member of a professional association, either of
which must be recognized by Green Shield Canada. Please contact the Green Shield Customer Service
Centre to confirm eligibility when in doubt
Your Vision Benefit carries a maximum of $100.00 every 24 months for prescription eye glasses or contact
lenses, or $100.00 every 24 months for medically necessary contact lenses provided they are dispensed by an
Optometrist, an Optician or an Ophthalmologist
Eye examinations performed by a registered, licensed Optometrist or Physician limited to one exam every 24
months, up to a maximum of $80.00 (available only where eye examinations are not covered by the Provincial
Health Insurance Plan).
Commencement of your benefit period is based on the initial date you receive vision benefits. This service
date is the actual pick-up date of the eyewear.
PREFERRED PROVIDER VISION NETWORK ARRANGEMENT
As a Green Shield plan member, you have access to our national preferred provider vision network
arrangement where all Green Shield plan members are eligible to receive a discount on eyewear and laser eye
Features of this great value-added service for either eyewear or laser eye surgery include:
1. offer applies to any Green Shield plan member, regardless of whether you have Green Shield vision
benefits or not;
2. the vision provider may bill Green Shield directly; the plan member just pays any portion of the expense not
covered under their vision benefit;
3. trustworthy retail chains with convenient locations;
4. discount offer applies to everything such as all extra coatings, upgrades and accessories;
5. hundreds of the latest frame styles to choose from plus the latest lens and coating technology;
6. professional opticians to assist in selecting products;
7. for some vendors, this offer applies to non-disposable contact lenses only (excludes disposable contact
Visit our web site at greenshield.ca
or call our Customer Service Centre at 1.888.711.1119 for information on
the vision providers.
How to Submit Your Vision Claim
1. Present your Green Shield Identification Card as proof of being a Green Shield plan member.
2. The vision provider will apply the appropriate discount(s) to your claim and may submit the claim directly to
Green Shield for payment. You pay your vision provider any balance not covered under your vision benefit.
3. If no vision benefit exists, you pay your provider the full balance owing after the applicable discounts have
Your deductible is nil
Your overall Dental maximum is $1,000.00 per calendar year
Stated maximums are based on paid dollars
Your co-insurance which is applied to the eligible allowed amount is 80% for Basic and Comprehensive basic
Basic services cover: recalls twice every 12 months, other exams and full mouth x-rays every 3 years
Comprehensive basic services cover denture relines once every 3 years
Applicable lab, drug and other expenses are eligible to a maximum of 40% of the allowable professional fee.
Any applicable co-payment is then applied
Your eligible claims are reimbursed at the level stated above and in accordance with the current Ontario
Dental Association Fee Guide for General Practitioners
Recalls include exams, bitewing X-rays, preventive cleanings and fluoride treatments
Complete, general or comprehensive oral exams, full mouth X-rays and panoramic X-rays
Basic restorations, fillings and inlays
Extractions and surgical services. General anaesthesia and intravenous sedation only when done in
conjunction with eligible oral surgery
COMPREHENSIVE BASIC SERVICES
Endodontic treatment including standard root canal therapy, excluding retreatments
Periodontal treatment including scaling and/or root planing
Standard denture services including relining and rebasing of dentures plus denture adjustments after 3
months from installation
Travel Benefits are eligible within the first 60 days per trip
Your maximum is $1,000,000 per calendar year for Emergency Services; and $50,000 per calendar year for
Hospital and medical services are eligible only if your provincial government health plan provides payment
toward the cost of the services received