What's Covered?

Print Email

For a detailed description of what is covered by the Chambers Plan, look through the list of products and services, or type in a keyword you wish to search for. If you already have coverage, your employee booklet details the benefits available under your firm’s coverage as well as any deductibles or limits that may apply. If we don't mention the item you're looking for, then email us, or contact our Service Line at 1-800-665-3365.

_WC_HEALTH
A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z |
A

Accidental Tooth Damage

If you receive a blow to the mouth, the Plan will pay dental expenses to repair or replace sound natural teeth injured by the blow. Coverage does not include damage from anything you place in your mouth, intentionally or unintentionally.

Acupuncturist

The Plan covers many paramedical services, including acupuncture, at the usual and customary rate of charges, to a maximum of $300, $400 or $500 per person per type of service each calendar year.

Aerochamber Inhaler

The Plan will cover the purchase of an aerochamber inhaler for a child less than 7 years of age.

Ambulance

The Plan covers emergency transport by licensed ground or air ambulance to the nearest hospital. Ground transfers between hospitals and, where medically necessary, ground transport to your residence are also covered.

Artificial Eye

If the loss of an eye occurs while you are insured under the Plan, the Plan will cover the initial purchase of such an item and replacements if they are required because of physiological changes.

Artificial Limb

If the loss of a limb occurs while you are insured under the Plan, the Plan will cover the initial purchase.

Athletic Therapist

The Plan covers $10 per visit to a certified athletic therapist for a sports related injury, when recommended by a physician, to a calendar year maximum of $100 per person.

Audiologist

The plan covers many paramedical services, including audiologists, at the usual and customary level of charges, to a maximum of $300, $400 or $500 per person per type of service each calendar year.

back to top ↑

B

Birth Control

The Plan covers oral contraceptives which require a prescription.

Blood and Substitutes

The Plan covers such supplies and any cost of administering them to you.

Brace

If an injury occurs while you are insured under the Plan, approval will be given for the purchase or rental (at the discretion of the insurer) of a limb truss or crutch. Repairs and replacements are not covered.

Brassieres

An insured patient may purchase two surgical brassieres per year under the Plan, when they are required as a result of a total or radical mastectomy.

Breast Prosthesis

After a total or radical mastectomy while insured under this plan, patients are eligible for up to $200 per calendar year for a breast prosthesis.

back to top ↑

C

Cardiac Rehabilitation

When prescribed by an attending physician, recognized cardiac rehabilitation programs are covered following a patient's heart attack, bypass surgery or valve replacement, and during treatment for angina pectoris. This benefit has a lifetime per person maximum of $300.

Chiropodist / Podiatrist

The Plan covers many paramedical services, at the usual and customary level of charges, to a maximum of $300, $400 or $500 per person per type of service each calendar year.

Chiropractor

The Plan covers many paramedical services, at the usual and customary level of charges, to a maximum of $300 or $500 per person per type of service each calendar year.

Christian Science

The Plan covers many paramedical services, at the usual and customary level of charges, to a maximum of $300, $400 or $500 per person per type of service each calendar year.

Colostomy

The Plan covers the purchase of supplies.

Continuous Positive Airway Pressure (CPAP machine)

Continuous Positive Airway Pressure Machine (commonly referred to as CPAP machine) is covered and combined with the oxygen maximum of $1,000.

Convalescent Hospital

Most plans will pay up to $30 room & board per day for 180 days per confinement in an approved convalescent hospital, if the insured patient is admitted within 14 days of discharge as an in-patient at a hospital. Stays in nursing homes, rest homes and substance abuse treatment centres are not covered.

Cosmetic Surgery

The Plan does not cover expenses from any cosmetic procedures except for those performed as a result of an accidental injury.

back to top ↑

D

Dependent Benefits

If an employee dies, any dependent health and dental benefits in effect will be extended to the insured dependents for 24 months. No premiums are payable during the benefit extension.

Diabetic Supplies

The Plan covers the purchase of reagent strips and other eligible diabetic supplies. (Insulin is covered as a prescription medication.)

Dietitian

The Plan pays up to $300, $400 or $500 per person per calendar year for registered dietitian services. Fees for weight loss programs are not covered.

back to top ↑

E

Eye Exams

The Plan pays up to $50 or $75 per person for eye exams conducted by a qualified ophthalmologist or licensed optometrist. Adults are covered for one such exam in any 24 month period. Children are covered once in any 12 month period.

back to top ↑

F

Fertility Drugs

Such products are not covered under the Plan.

back to top ↑

G

Glucometer

The Plan will cover the purchase of one glucometer per insured, on the written recommendation of the insured patient’s physician. This is a ‘lifetime’ maximum.

back to top ↑

H

Hearing Aids

On the written recommendation of a physician, the Plan pays for the purchase and installation of hearing aids. The maximum benefit is $500 or $700 per person in any 4 or 5 year period and does not include batteries or repairs.

Hospital Bed

On written recommendation of a physician, the Plan covers the rental or purchase of a hospital bed up to a lifetime maximum of $5,000. The insurance company will approve the rental or purchase of the appropriate item.

Hostel

The Plan pays reasonable and customary charges for up to 180 days in a hostel that is in your province of residence and located more than 60 kilometers from the insured’s home. Your physician must recommend a hostel associated with the hospital performing diagnostic tests or treatment on you.

back to top ↑

I

Ileostomy

The Plan covers purchase of supplies.

back to top ↑

M

Massage Therapist

The Plan covers many paramedical services, at the usual and customary level of charges, to a maximum of $300 or $500 per person per type of service each calendar year.

Mastectomy

After a total or radical mastectomy while insured under this plan, patients are eligible for up to $200 per calendar year for a breast prosthesis. An insured patient may also purchase two surgical brassieres per year under the Plan.

Medical Travel

The benefit will provide up to $750 per person each 24 months to transport an insured from their normal place of residence to a medical facility for medically necessary treatment. Certain restrictions may apply.

back to top ↑

N

Naturopath

The Plan covers many paramedical services, including naturopaths, at the usual and customary level of charges, to a maximum of $300, $400 or $500 per person per type of service each calendar year.

Nursing

The Plan will cover charges for nursing visits in an insured's home, on the written recommendation of the insured's physician and consistent with the individual's condition. Custodial care is not included. The maximum payment is $25,000 per person in any period of 24 consecutive months.

back to top ↑

O

Obus Form

The Plan does not cover Obus forms or similar items.

Oral Contraceptives

Oral contraceptive prescriptions are covered.

Orthopaedic Supplies

For each insured, the Plan covers the purchase of one pair of custom designed orthopaedic shoes from a recognized orthopaedic supplier per year. Custom-made foot orthotics or arch supports are also covered, to a maximum of $200 per person per calendar year. Please click on the link for more information Orthotics 05-10.pdf

Orthotics

For each insured, the Plan covers the purchase of one pair of custom designed orthopaedic shoes from a recognized orthopaedic supplier per year. Custom-made foot orthotics or arch supports are also covered, to a maximum of $200 per person per calendar year.  Please click on the link for more information Orthotics 05-10.pdf

Osteopath

The Plan covers many paramedical services, including osteopaths, at the usual and customary level of charges, to a maximum of $300, $400 or $500 per person per type of service each calendar year.

Oxygen

On the written recommendation of a physician, respirators and oxygen are covered to a lifetime maximum of $1,000 each. The insurance company will approve the rental or purchase of the appropriate item.

back to top ↑

P

Paramedical Services

The Plan covers the following paramedical services, at the usual and customary level of charges, to a maximum of $300, $400 or $500 per person per type of service each calendar year.

  • naturopaths, excluding food supplements or vitamins;
  • licensed clinical psychologists;
  • licensed physiotherapists;
  • chiropractors, including one diagnostic x-ray per year;
  • practitioners registered in the Christian Science Journal;
  • osteopaths;
  • podiatrists or chiropodists;
  • licensed speech therapists;
  • qualified acupuncturists;
  • registered massage therapists

Physiotherapist

The Plan covers many paramedical services, including physiotherapists, at the usual and customary level of charges, to a maximum of $300 or $500 per person per type of service each calendar year.

Plasma

The Plan covers such supplies and any cost of administering them to you.

Podiatrist / Chiropodist

The Plan covers many paramedical services, including podiatrists, at the usual and customary level of charges, to a maximum of $300, $400 or $500 per person per type of service each calendar year.

Prescription Drugs

Health plans with drug benefits cover drugs approved in Canada, available only by prescription, and administered for medical necessity.

Private Duty Nursing

The Plan will cover charges for nursing visits in an insured's home, on the written recommendation of the insured's physician and consistent with the individual's condition. Custodial care is not included. The maximum payment is $25,000 per person in any consecutive 24 month period.

Psychologist

The Plan covers many paramedical services, including psychologists and social workers with combined maximum The plan pays the usual and customary level of charges, to a maximum of $300, $400 or $600 per person per type of service each calendar year.

back to top ↑

R

Reagent Strips

The Plan covers the purchase of reagent strips and other eligible diabetic supplies. (Insulin is covered as a prescription medication.)

Rehabilitation

The Plan pays up to $30 room & board per day for 180 days per confinement in an approved convalescent hospital, if you are admitted within 14 days of your discharge as an in-patient at a hospital. Stays in nursing homes, rest homes and substance abuse treatment centres are not covered.

Respirator

On the written recommendation of a physician, respirators and oxygen are covered to a lifetime maximum of $1,000 each. The insurance company will approve the rental or purchase of the appropriate item.

back to top ↑

S

Semi-Private Hospital Room

Most plans will pay the additional cost charged by a hospital for a semi-private room over a standard public ward.

Smoking Cessation Products

Such products are not covered under the Plan.

Social Workers

The Plan covers many paramedical services, including psychologists and social workers with combined maximum The plan pays the usual and customary level of charges, to a maximum of $300, $400 or $600 per person per type of service each calendar year.

Speech Therapist

The Plan covers many paramedical services, including speech therapists, at the usual and customary level of charges, to a maximum of $300, $400 or $600 per person per type of service each calendar year.

Spinal Brace

The plan will cover the initial purchase of such an item at the insurance company’s discretion.

Student Coverage

Students are covered as dependents up to age 25 (26 in Quebec) if they are attending school full time at an accredited college or university.

Surgical Elastic Stockings

On the written recommendation of a physician, the Plan will cover two pair of surgical elastic stockings per year.

Survivors Benefits

If an employee dies, any dependent health and dental benefits in effect will be extended to the surviving spouse and children who were insured, for up to 24 months. No premiums are payable during the benefit extension.

back to top ↑

T

Tens Nerve Stimulator

The Plan does not cover nerve stimulation machines. However, depending on medical need, TENS machines may be considered as a special equipment benefit, with a $250 lifetime maximum.

Travel Medical Insurance

Emergency medical treatment outside your province of residence is covered, if your provincial health plan is prepared to pay a portion of the claim. The coverage includes a Voyage Assistance program with a 24-hour global help line. There are limits on the length of the trip during which the emergency occurs.

Travel Vaccine

The Plan does not cover vaccines required for travel purposes.

back to top ↑

U

Uretherostomy

The Plan covers the purchase of such supplies.

back to top ↑

V

Vision Care (glasses, contacts, laser eye surgery)

The Plan offers vision care options under health care coverage. There are two levels of benefit: $100 and $200 per person. The benefit is available once in any 24 month period for adults and once in any 12 months for children. Claims can be made for eyeglass frames or lenses, contact lenses, or laser eye surgery. Repairs are not covered.

Vitamins

Over the counter products are not covered by this Plan.

back to top ↑

W

Weight Loss Programs

Fees for weight loss programs are not covered.

Wheelchair

On written recommendation of a physician, the Plan covers the rental or purchase, and the costs of repairs of a wheelchair up to a lifetime maximum of $5,000. The insurance company will approve the rental or purchase of the appropriate item.

Wigs

Where a wig is required because of chemotherapy or as a result of an accident, the Plan will pay up to a lifetime maximum of $1,000 per person.