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Under 65

EHC/Dental - single: $140.08

EHC/Dental - family: $357.96

Over 70

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 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 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.

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
 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 
been applied.

 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

 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 
Referral Services
 Hospital and medical services are eligible only if your provincial government health plan provides payment 
toward the cost of the services received

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