To be eligible for coverage, the medication needs to be approved for use in Canada, must require a prescription and be prescribed by an authorized medical or dental practitioner (as you might expect). Most generic prescription medications are eligible for coverage, as long as they are on GreenShield’s formulary. Some drugs may require GreenShield Special Pre-Authorization.

Please keep in mind that prescription drug coverage is subject to medical underwriting (if you apply for a medically underwritten plan), to reasonable and customary charges, and to the co-pay and maximum of the plan you select.

This is certainly a reasonable question. If you want to confirm prescription drug coverage eligibility before you purchase your plan, just give us a call. Make sure that you have the drug names and DIN’s (Drug Identification Numbers) for the medications so that we can verify for you.

Please keep in mind that prescription drug coverage is subject to medical underwriting (if you apply for a medically underwritten plan), to reasonable and customary charges, and to the co-pay and maximum of the plan you select.

GreenShield Insurance drug benefits are designed to provide coverage for generic prescription drugs. However, they will provide coverage for brand name drugs if no generic equivalent exists. If you submit a claim for a brand name drug instead of the generic, the plan benefit will pay to the price of the lower cost equivalent. (Example: If your benefit pays 70% of eligible prescription costs, the brand name drug costs $100 and the generic equivalent costs $80, your benefit would pay 70% of $80.)

Please keep in mind that prescription drug coverage is subject to medical underwriting (if you apply for a medically underwritten plan), to reasonable and customary charges, and to the co-pay and maximum of the plan you select.

'Co-payment' is a fixed amount (for example $15) you'll pay for a covered health care service, when you receive the service.

GreenShield Insurance plans with dental benefits offer coverage towards Basic Services and Comprehensive Basic Services like routine cleaning, exams, x-rays, fillings, extractions, scaling and more.  

All dental services have dental services codes. If you have a specific question, ask your dentist for the service code and give us a call. We’ll be happy to verify for you.

CPAP machines are eligible for coverage under the Medical Items benefit of GreenShield Insurance plans, with a few requirements.

Test strips, diabetic syringes, diabetic needles, and diabetic testing agents are eligible for coverage under prescription drug benefits. Auto injectors, insulin pen injectors, lancets and blood glucose monitors are eligible for coverage under the Medical Items benefit of GreenShield Insurance plans.

Yes, continuous glucose monitors like the Free Style Libre and Dexcom, are eligible for coverage under the Medical Items benefit included in GreenShield Insurance plans.  This is subject to GreenShield Special Pre-Authorization and approval which includes documentation that confirms medical criteria (like insulin dependence and testing requirements), to reasonable and customary fees and to the maximums of the plan you select.

The rates for GreenShield Insurance plans are subject to change.

GreenShield continuously monitors the Canadian health marketplace. When the cost of providing health and dental services increases, we have to adjust our rates accordingly so that we can continue to provide you with the benefits you rely on. You can rest assured we keep any rate increases as minimal as possible. Rates also increase as the age of the person listed as the primary applicant on your plan increases and shifts from one age band to the next. These rate changes will take place on the anniversary of your effective date. We’ll notify you in writing 30 days before the new rates are due.

Rates will change when your rate category changes – for example, from single to couple, from couple to family, etc. When you contact us to request a category change, we’ll confirm your new rate for you.

Rates may change if you move from one province to another. When you contact us to let us know, we’ll confirm your rate for you.

Definitely. That’s why we’ve designed this website to walk you through the entire process from start to finish. You can explore our plans, find the one that’s right for you, get a quote and apply, all online. We all have busy lives, which is why we want to ensure easy access to the information you need, and that getting the insurance plan that’s right for you is as simple as can be.

Yes — when your rate category changes from family to couple, or from couple to single. And in the majority of cases, if your GreenShield Insurance plan includes prescription drug coverage, your rates will decrease when the primary applicant on your plan reaches 65 years of age. 

Coverage starts on the first of the month following GreenShield’s approval of your application. The length of time approvals takes depends on the type of plan you choose and how you apply.

If you apply for a guaranteed acceptance plan, like LINK or ZONE 2, 3 or the ZONE Fundamental plan, there are no health questions to answer, there is no medical underwriting. If you apply online or over the phone, your application is approved as soon as GreenShield receives your payment, which could be within a day or two.

When you apply for a medically underwritten plan like ZONE 5, 6 or 7, you’re required to complete a health questionnaire. The GreenShield Medical Underwriting team evaluates your health info. If you apply online or over the phone, please allow two weeks for us to process your application and get back to you. The team evaluates each application on a case-by-case basis.

If you apply by completing a paper application and mailing it to us, please allow three weeks for processing. (It’s so much more efficient to apply online! Or give us a call – we’ll be happy to take your application over the phone. Easy!)

An Emergency Medical Travel benefit is included in all GreenShield Insurance plans. The benefit covers multiple trips during a year (which is very convenient). The number of days covered depends on the GreenShield Insurance plan you chose. 

No, your Emergency Medical Travel benefit continues along with your other GreenShield Insurance benefits, regardless of your age (as long as your premiums are paid, of course!). 

There are no waiting periods with GreenShield Insurance plans. Your coverage begins on your effective date, which is generally the first of the month following approval of your application. (You can request to postpone your coverage effective date for a month or two, if you’re applying earlier than you need your coverage to start.)