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HEALTH & DENTAL PLAN OPTIONS
	Base	Bronze	Silver	Gold
Your premiums
Spouse premiums
Child premiums
Require medical questionnaire when applying? If no medical questionnaire is required when applying, acceptance is guaranteed if eligibility is met, and is subject to receipt of first premium payment. Otherwise, underwriting questionnaire is required.close	NO	YES	YES	YES
DENTAL SERVICES^‡ Covers basic services, paid at a percentage of the current Dental Fee Guide or the reasonable and customary charge in your province of residence. Expandable section - click to expand
Basic: Reimbursement on exams, cleanings, fillings, scaling, polishing, root planing, diagnostics and other basics.	70%	70%	80%	80%
Supplementary: Reimbursement on endodontics, periodontics and denture services.	70%	70%	80%	80%
Major Restorative: Reimbursement on crowns, bridges, dentures and orthodontics.	Not covered	Not covered	Not covered	Year 1 & 2: 0% Year 3 & beyond: 60% ($800 maximum every 2 consecutive years)
Combined anniversary year maximums	$400 per year	$500 per year	Year 1: $600 Year 2 & beyond: $900	Year 1: $750 Year 2: $1,000 Year 3: $1,200 Year 4: $1,200 Year 5 & beyond: $1,500
Recall visits	9 months	9 months	9 months	6 months
PRESCRIPTION DRUGS^† Expandable section - click to expand
Generic^* vs. brand-name coverage	Generic	Generic	Generic	Brand-name
Shared dispensing fee (none for Quebec)	$6.50 maximum	$6.50 maximum	$7.50 maximum	Covered
Birth control and fertility drugs	Not covered	Not covered	Covered	Covered
Reimbursement per anniversary year^††	70% of first $750	70% of first $500	70% of first $500	90% of first $2,222
Reimbursement on next amount per anniversary year^††	None	80% of next $2,500	100% of next $4,650	100% of next $8,000
Maximum per anniversary year^††	$525	$2,350	$5,000	$10,000
HEALTH BENEFITS (Including Registered Therapists, Vision Care, Travel and more) Expandable section - click to expand
Vision Care - See new discounts from Preferred Vision and Hearing Services (PVS) below.^�	$100 per 2 benefit years plus $50 for optometrist visits per 2 benefit years	$100 per 2 benefit years plus $50 for optometrist visits per 2 benefit years	$150 per 2 benefit years plus $50 for optometrist visits per 2 benefit years	$250 per 2 benefit years plus $50 for optometrist visits per 2 benefit years
Hospital Benefits
Type of accommodation	n/a	n/a	Semi-private only	Semi-private and private
Maximum charge per day	n/a	n/a	$150	$200
Reimbursement per anniversary year	n/a	n/a	100% of first 30 days; 50% of next 100 days	100% for complete year
Cash benefit in lieu of accommodation Note : not available in Quebec	n/a	n/a	$25 payable per day starting on the 4th day (maximum of $750)	$50 payable per day starting on the 1st day (maximum of $3,000)
Accidental Death and Dismemberment	$10,000 per adult under 65 $4,000 per child or per adult 65 and older	$12,500 per adult under 65 $5,000 per child or per adult 65 and older	$25,000 per adult under 65 $10,000 per child or per adult 65 and older	$50,000 per adult under 65 $20,000 per child or per adult 65 and older
Travel Coverage (to age 65) - Emergency hospital/medical expenses covered while outside your province or territory of residence.	Up to a maximum of $5,000,000 per trip 24-hour worldwide medical assistance centre	Up to a maximum of $5,000,000 per trip 24-hour worldwide medical assistance centre	Up to a maximum of $5,000,000 per trip 24-hour worldwide medical assistance centre	Up to a maximum of $5,000,000 per trip 24-hour worldwide medical assistance centre
Number of trips per year	Unlimited	Unlimited	Unlimited	Unlimited
Maximum trip length	5 days	9 days	17 days	30 days
Survivor Benefit - Provides continuous coverage for 1 year, following the death of an insured adult.	Available 1 year after policy effective date	Covered	Covered	Covered
Registered Specialists & Therapists** Includes visits to acupuncturists, chiropractors, osteopaths, podiatrists, naturopaths, chiropodists, registered massage therapists, physiotherapists, psychologists, psychotherapists, social workers and speech therapists.
Maximum claims paid	$300 per specialist/therapist	80% to a maximum of $450 per specialist/therapist	90% to a maximum of $600 per specialist/therapist	$1,500 combined
Per visit maximum	$20	n/a	n/a	n/a
Chiropractic X-rays	$35 per year	$35 per year	$35 per year	$35 per year
Psychologist/ Psychotherapist/ Social Worker
Maximum per first visit	$80	$80	$80	$80
Maximum per subsequent visit	$65	$65	$65	$65
Maximum visits per year	10	10	12	15
Speech Therapist**
Maximum per first visit	$65	$65	$65	$65
Maximum per subsequent visit	$45	$45	$45	$45
Maximum visits per year	10	10	12	15
Lifeline^� Personal Response Service - Provides 24-hour monitoring service for people coping with medical problems at home.^¥	3 months per lifetime	3 months per lifetime	6 months per lifetime	6 months per 3-year period
Homecare and Nursing, Prosthetic Appliances, and Durable Medical Equipment Covers the services of registered health professionals including a registered nurse, registered practical nurse or personal support worker; includes surgical bandages and dressings and the purchase or rental of medically necessary equipment such as crutches, non-electric wheelchairs and hospital beds, oxygen and other equipment recommended by your physician and approved by Manulife. Also includes prosthetic appliances such as artificial limbs, eyes, splints, casts and breast prostheses following mastectomies. Payment will be coordinated where benefits are available through the Assistive Devices Program.	For each of Homecare and Nursing, Prosthetic Appliances, and Durable Medical Equipment: Year 1: $1,000 Year 2: $1,300 Year 3: $1,500 Year 4: $2,000 Year 5+: $2,500	Homecare and Nursing: $2,500 per year Prosthetic Appliances: $2,500 per year Durable Medical Equipment: $2,500 per year	Homecare and Nursing: $3,500 per year Prosthetic Appliances: $3,500 per year Durable Medical Equipment: $3,500 per year	Combined maximum for Homecare and Nursing, Prosthetic Appliances, and Durable Medical Equipment $8,500 per year
Orthotics	Custom-made orthotics: $225 per year	Custom-made orthotics: $225 per year	Custom-made orthotics: $225 per year	Custom-made orthotics: $225 per year
Hearing Aids	$300 per 4-year period	$300 per 4-year period	$400 per 4-year period	$500 per 4-year period
Ambulance Services**	Unlimited ground and air transport	Unlimited ground and air transport	Unlimited ground and air transport	Unlimited ground and air transport
Accidental Dental	$2,000 per year	$2,000 per year	$2,500 per year	$3,000 per year
Health Service Navigator^� - Offers evaluation of medical records upon diagnosis of serious illness or injury; medical coordination; second opinions; and web/toll-free health care information.^�	All covered family members can quickly and easily get answers to questions and access to support services.	All covered family members can quickly and easily get answers to questions and access to support services.	All covered family members can quickly and easily get answers to questions and access to support services.	All covered family members can quickly and easily get answers to questions and access to support services.
Lifetime Maximum	$100,000	$250,000	$350,000	$350,000
Diagnostic Services
CAT Scans	$200 per anniversary year	$200 per anniversary year	$200 per anniversary year	$200 per anniversary year
CA 125 Test	$75 per anniversary year	$75 per anniversary year	$75 per anniversary year	$75 per anniversary year
PSA Test	$75 per anniversary year	$75 per anniversary year	$75 per anniversary year	$75 per anniversary year
Ultrasound Scans	$50 per anniversary year	$50 per anniversary year	$50 per anniversary year	$50 per anniversary year
Magnetic Resonance Imaging	$500 per anniversary year	$500 per anniversary year	$500 per anniversary year	$500 per anniversary year
Audiologist	$500 per anniversary year	$500 per anniversary year	$500 per anniversary year	$500 per anniversary year
Laboratory Tests	$100 per category, per anniversary year	$100 per category, per anniversary year	$100 per category, per anniversary year	$100 per category, per anniversary year

DENTAL PLAN OPTIONS (with basic health)
	Base	Bronze	Silver	Gold
Your premiums
Spouse premiums
Child premiums
Require medical questionnaire when applying? If no medical questionnaire is required when applying, acceptance is guaranteed if eligibility is met, and is subject to receipt of first premium payment.close	NO	NO	NO	NO
DENTAL SERVICES^‡ Covers basic services, paid at a percentage of the current Dental Fee Guide or the reasonable and customary charge in your province of residence. Expandable section - click to expand
Basic Services: Reimbursement on exams, cleanings, fillings, scaling, polishing, root planing, diagnostics and other basics.	Year 1: 50% Year 2 & beyond: 70%	Year 1: 50% Year 2 & beyond: 70%	Year 1: 60% Year 2 & beyond: 80%	Year 1: 60% Year 2 & beyond: 80%
Supplementary Services: Reimbursement on endodontics, periodontics and denture services.	Year 1: 50% Year 2 & beyond: 70%	Year 1: 50% Year 2 & beyond: 70%	Year 1: 60% Year 2 & beyond: 80%	Year 1: 60% Year 2 & beyond: 80%
Major Restorative: Reimbursement on crowns, bridges, dentures and orthodontics.	Not covered	Not covered	Not covered	Year 1 & 2: not covered Year 3 & beyond: 60% $800 maximum every 2 consecutive years
Combined anniversary year maximums	$400 per year	$500 per year	Year 1: $500 Year 2 & beyond: $900	Year 1: $750 Year 2: $1,000 Year 3: $1,200 Year 4: $1,200 Year 5 & beyond: $1,500
Recall visits	9 months	9 months	9 months	6 months
PRESCRIPTION DRUGS^† Expandable section - click to expand
Generic^* vs. brand-name coverage	n/a	n/a	n/a	n/a
Shared dispensing fee (none for Quebec)	n/a	n/a	n/a	n/a
Birth control and fertility drugs	n/a	n/a	n/a	n/a
Reimbursement per anniversary year^††	n/a	n/a	n/a	n/a
Reimbursement on next amount per anniversary year^††	n/a	n/a	n/a	n/a
Maximum per anniversary year^††	n/a	n/a	n/a	n/a
CORE BENEFITS Expandable section - click to expand
Vision Care - See new discounts from Preferred Vision and Hearing Services (PVS) below.^�	$100 per 2 benefit years plus $50 for optometrist visits per 2 benefit years	$100 per 2 benefit years plus $50 for optometrist visits per 2 benefit years	$100 per 2 benefit years plus $50 for optometrist visits per 2 benefit years	$100 per 2 benefit years plus $50 for optometrist visits per 2 benefit years
Hospital Benefits - Accommodation in excess of the standard ward room rate.
Type of accommodation	n/a	n/a	n/a	n/a
Maximum charge per day	n/a	n/a	n/a	n/a
Reimbursement per anniversary year	n/a	n/a	n/a	n/a
Cash benefit in lieu of accommodation	n/a	n/a	n/a	n/a
Accidental Death and Dismemberment	$10,000 per adult under 65 $4,000 per child or per adult 65 and older	$10,000 per adult under 65 $4,000 per child or per adult 65 and older	$10,000 per adult under 65 $4,000 per child or per adult 65 and older	$10,000 per adult under 65 $4,000 per child or per adult 65 and older
Travel Coverage (to age 65) - Emergency hospital/medical expenses covered while outside your province or territory of residence.	n/a	n/a	n/a	n/a
Survivor Benefit - Provides continuous coverage for 1 year, following the death of an insured adult.	Available 1 year after policy effective date	Available 1 year after policy effective date	Available 1 year after policy effective date	Available 1 year after policy effective date
Registered Specialists & Therapists** Includes visits to acupuncturists, chiropractors, osteopaths, podiatrists, naturopaths, chiropodists, registered massage therapists, physiotherapists, psychologists, pyschotherapists, social workers and speech therapists.
Maximum claims paid	$300 per specialist/therapist	$300 per specialist/therapist	$300 per specialist/therapist	$300 per specialist/therapist
Per visit maximum	$20	$20	$20	$20
Chiropractic X-rays	$35 per year	$35 per year	$35 per year	$35 per year
Psychologist/ Pyschotherapist/ Social Worker
Maximum per first visit	$80	$80	$80	$80
Maximum per subsequent visit	$65	$65	$65	$65
Maximum visits per year	10	10	10	10
Speech Therapist**
Maximum per first visit	$65	$65	$65	$65
Maximum per subsequent visit	$45	$45	$45	$45
Maximum visits per year	10	10	10	10
Lifeline^� Personal Response Service - Provides 24-hour monitoring service for people coping with medical problems at home.^¥	3 months per lifetime	3 months per lifetime	3 months per lifetime	3 months per lifetime
Homecare and Nursing, Prosthetic Appliances, and Durable Medical Equipment Covers the services of registered health professionals including a registered nurse, registered practical nurse or personal support worker; includes surgical bandages and dressings and the purchase or rental of medically necessary equipment such as crutches, non-electric wheelchairs and hospital beds, oxygen and other equipment recommended by your physician and approved by Manulife. Also includes prosthetic appliances such as artificial limbs, eyes, splints, casts and breast prostheses following mastectomies. Payment will be coordinated where benefits are available through the Assistive Devices Program.	For each of Homecare and Nursing, Prosthetic Appliances, and Durable Medical Equipment: Year 1: $1,000 Year 2: $1,300 Year 3: $1,500 Year 4: $2,000 Year 5+: $2,500	For each of Homecare and Nursing, Prosthetic Appliances, and Durable Medical Equipment: Year 1: $1,000 Year 2: $1,300 Year 3: $1,500 Year 4: $2,000 Year 5+: $2,500	For each of Homecare and Nursing, Prosthetic Appliances, and Durable Medical Equipment: Year 1: $1,000 Year 2: $1,300 Year 3: $1,500 Year 4: $2,000 Year 5+: $2,500	For each of Homecare and Nursing, Prosthetic Appliances, and Durable Medical Equipment: Year 1: $1,000 Year 2: $1,300 Year 3: $1,500 Year 4: $2,000 Year 5+: $2,500
Orthotics	Custom-made orthotics: $225 per year	Custom-made orthotics: $225 per year	Custom-made orthotics: $225 per year	Custom-made orthotics: $225 per year
Hearing Aids	$300 per 4-year period	$300 per 4-year period	$300 per 4-year period	$300 per 4-year period
Ambulance Services**	Unlimited ground and air transport	Unlimited ground and air transport	Unlimited ground and air transport	Unlimited ground and air transport
Accidental Dental	$2,000 per year	$2,000 per year	$2,000 per year	$2,000 per year
Health Service Navigator^� - Offers evaluation of medical records upon diagnosis of serious illness or injury; medical coordination; second opinions; and web/toll-free health care information.^�	All covered family members can quickly and easily get answers to questions and access to support services.	All covered family members can quickly and easily get answers to questions and access to support services.	All covered family members can quickly and easily get answers to questions and access to support services.	All covered family members can quickly and easily get answers to questions and access to support services.
Lifetime Maximum	$100,000	$100,000	$100,000	$100,000
Diagnostic Services
CAT Scans	$200 per anniversary year	$200 per anniversary year	$200 per anniversary year	$200 per anniversary year
CA 125 Test	$75 per anniversary year	$75 per anniversary year	$75 per anniversary year	$75 per anniversary year
PSA Test	$75 per anniversary year	$75 per anniversary year	$75 per anniversary year	$75 per anniversary year
Ultrasound Scans	$50 per anniversary year	$50 per anniversary year	$50 per anniversary year	$50 per anniversary year
Magnetic Resonance Imaging	$500 per anniversary year	$500 per anniversary year	$500 per anniversary year	$500 per anniversary year
Audiologist	$500 per anniversary year	$500 per anniversary year	$500 per anniversary year	$500 per anniversary year
Laboratory Tests	$100 per category, per anniversary year	$100 per category, per anniversary year	$100 per category, per anniversary year	$100 per category, per anniversary year

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