Individual Health
& Dental Benefits

Health & Dental Insurance by finance wyse in Canada

Health & Dental Insurance

If you’re in search of a health plan that covers prescription drugs, dental care, extended health care, or a combination of all three, Finance Wyse offers a range of plans with varying levels of protection. This ensures you only pay for the coverage that truly suits your needs. Are you 65 or older?

Understanding that your health priorities may be unique, Finance Wyse customizes coverage in specific areas to better address your individual healthcare requirements.

Our individual health insurance plans provide simple, affordable coverage for you and your family, reducing the burden of paying routine and unexpected health-related expenses out of your own pocket. Gain confidence in your healthcare coverage with Us

Health & Dental Insurance

Here’s a summary of the key benefits and coverage details:

  • Lifetime Maximum: Up to $250,000 per person.
  • Health Service Navigator®: Access a dedicated toll-free line or web service for information, medical coordination, and support in navigating the Canadian healthcare system. Second opinions from world-class hospitals are also facilitated.

Specific Healthcare Services:

  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist: $20 maximum per visit, 20 visits maximum per person per discipline per anniversary year.
  • Chiropractic X-ray: $35 maximum per person per anniversary year.
  • Psychologist: $80 maximum for the first visit, $65 maximum for subsequent visits, 15 visit maximum per person per anniversary year.
  • Physiotherapist: $250 maximum per person per anniversary year.
  • Home care and Nursing, Prosthetic Appliances, Durable Medical Equipment: $3,500 maximum per person per anniversary year for each of these 3 categories of benefits separately.
  • Custom-made Orthotics: $225 maximum per person per anniversary year.
  • Speech Pathologist/Therapist: $65 maximum for the first visit, $45 maximum for subsequent visits, 10 visit maximum per person per anniversary year.
  • Lifeline® Personal Response Service: Maximum of 6 months of service per person per 3 anniversary years.

Dental and Hearing Benefits:

  • Accidental Dental: $2,000 maximum per person per anniversary year.
  • Ambulance: Unlimited ground transportation to the hospital and $4,000 maximum for air ambulance transportation per person per anniversary year.
  • Hearing Aid: $400 maximum per person per 4 consecutive benefit years.
  • Preferred Vision Services (PVS) Discounts: Offers a 10% deduction depending on the province of residence and hearing practitioner participation in the PVS network.

Extended Health Care benefits are payable after Government Health Insurance Plan maximums have been reached.

Travel Coverage:

  • $5,000,000 emergency health coverage per person for trips lasting a maximum of 9 days. (A $100 deductible applies per claim.) Additional coverage for either 8 or 21 days can be purchased as an Add-On.
  • Note: Coverage may be limited or excluded for any illness or condition that first manifested itself within the 9-month period immediately preceding each departure date. Not available to persons age 65 and over.

Accidental Death & Dismemberment (Basic):

  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult 65 and over, or a child. Additional coverage can be purchased as an Add-On.

Survivor Benefit: Coverage continues for 1 year following the death of an adult policyholder.

Definitions:

  • Anniversary Year: The consecutive 12 months following the Effective Date of the Agreement, and each 12-month period thereafter.
  • Benefit Year: The 12-month period following the date a claim for a specific benefit is first incurred, and each 12-month period thereafter.
  • Calendar Year: The 12 consecutive month period commencing January 1 and ending December 31.
Prescription Drugs CoveragePercentage PaidMaximum Benefit per Anniversary Year
Name brand or generic drugs, including birth control and fertility drugsUp to 90% on your first $2,222 of eligible prescription costs$2,000
Name brand or generic drugs, including birth control and fertility drugs100% on your next $8,000 of eligible prescription costs$8,000
Total benefits payable per person per anniversary year $10,000
Exclusions: Smoking cessation drugs, erectile dysfunction drugs, over-the-counter drugs, and drugs not requiring a prescription 

Certainly, here’s the information in a table format:

Dental CoveragePercentage PaidMaximum (per anniversary year)
First $500 of eligible services100%$500
Next $700 of eligible services60%$420
Total benefits payable per person per anniversary year $920

The following dental services have combined maximums:

Dental ServicesAnniversary Year 1Anniversary Year 2Anniversary Year 3 & Beyond
Oral Surgery60%60%80%
Periodontics60%60%80%
Endodontics (Root Canal)60%60%80%
Orthodontics0%0%60%
Crowns, Bridges0%0%60%
Dentures0%0%60%

Please note that coverages are designed to coincide with your current provincial Dental Association Fee Guide for General Practitioners, and the Flexcare ComboPlus Dental coverage will be adjusted to match any increases in the fee guide.

Certainly, here’s the information:

Vision Coverage:

  • Prescription Lenses, Frames, Contact Lenses, and Laser Eye Surgery: Up to $250 maximum per person per 2 consecutive benefit years to cover the costs of these vision-related expenses.

  • Optometrist Fees: Up to $50 maximum per person per 2 consecutive benefit years for optometrist fees (payable only after Government Health Insurance Plan maximum has been reached, if applicable).

Preferred Vision Services (PVS):

  • PVS allows you to enjoy discounts available through a specific network of providers and retailers. You can save up to 20% on eyewear purchases made at participating optical retailers, which includes lenses, frames, and contact lenses, depending on where you shop.

  • PVS discounts are also available for laser eye surgery.

  • The complete listing of participating retailers and practitioners across Canada is easily accessible online or over the phone.