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ZONE Fundamental

ZONE Fundamental

Health Questionnaire Required
Guaranteed Acceptance

This plan offers essential coverage for prescription drugs, dental care, vision care, extended health care, and emergency medical travel. With guaranteed acceptance* and no medical questions when you apply, the Fundamental plan makes it easier — especially for people with pre-existing conditions — to get the coverage and care you need

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A Few Details

  • Basic coverage for prescription drugs and dental care
  • Modest coverage for pre-existing conditions
  • Includes coverage for vision care and professional services, and registered therapists
  • Emergency medical travel coverage
Value
Your Total Monthly Premium
Potential Benefit Value of this Plan, Per Year
Per Person
Prescription Drugs
550
Dental (first year)
450
Vision (first year)
230
Registered Specialists and Therapists
4000
Subtotal of benefits available in the first year
[$00,000]

Coverage

Expand all [+]
Prescription Drugs

Prescription Drugs

GreenShield Insurance plans offer coverage for generic prescription medications that are approved for use in Canada, have a DIN, require a prescription by law and have been prescribed by an authorized medical practitioner. Brand name prescription medications may be covered if no generic equivalent exists. Smoking cessation products and drugs for the treatment of obesity, infertility and erectile dysfunction are not covered.

Quebec residents must be covered by the RAMQ (Régie de l’assurance maladie du Québec) plan. Prescription drug claims must be submitted to RAMQ first. When RAMQ reimburses a portion of the drug cost, unpaid balances (including co-payments and deductibles) will be co‑ordinated so that you may be reimbursed up to 100% of the eligible expense incurred. If the drug is not covered by RAMQ, the standard co-pay applies.

Maximums

Pays 70% up to

Year 1: $550

Year 2: $600

Year 3+: $650 per person per year

Dental

Overall Maximums

$450 per person per year

Recall Frequency

9 months

Basic Services

Basic Services

include coverage towards:

  • Preventive cleaning
  • Routine examinations, x-rays
  • Fillings and extractions
  • Flouride treatment for children

Pays 70%, subject to annual maximum

Comprehensive Basic
Services

Comprehensive basic services

Include coverage towards:

  • Endodontic treatment – root canal therapy
  • Periodontal treatment – scaling and root planing, occlusal adjustment, equilibration
  • Denture repairs, rebasing, relining

Pays 70%, subject to annual maximum

Major Services

Major Services

include coverage towards:

  • Crowns and onlays
  • Dentures
  • Bridgework

Not included

Orthodontic Services

Orthodontic Services

include coverage towards:

  • Straightening teeth and correcting the bite

Not included

Vision

Prescription Eyeglasses,
Contact Lenses,
Laser Eye Surgery

Maximum:

$150 per person every 2 years

Eye Examination

Maximum:

$80 per person every 2 years

Extended Health Coverage

Professional Services and Registered Therapists

Chiropractor, Massage Therapist, Physiotherapist, Acupuncturist, Chiropodist or Podiatrist, Dietitian, Naturopath, Osteopath

Maximums:

$40 per visit

$400 per person per practitioner, per year

‍

Speech Therapist

Maximum:

$400 per person per year

Accidental Dental

Maximum:

$3,000 per person per year

Ambulance Transportation

Includes land and air

Hearing Aids

Maximums:

Year 1-4: $350

Year 5+: $500 per person every 4 years

Medical Services

Diagnostic tests and x-rays, dialysis equipment, laboratory tests

Maximum:

$2,000 per person per year

Medical Items and Home Support Services (in-home nursing)

Extended Health Care

Medical Items include diabetic supplies (like blood glucose monitors and lancets), custom made boots or shoes, custom made foot orthotics, mobility aids (like canes, crutches, walkers, wheelchairs), prosthetics, aids for daily living (like hospital style beds, IV stands, a trapeze, a bedpan), braces, casts, catheters and ostomy supplies, compression stockings, respiratory/cardiology items like breathing and heart monitors for infants, compressors and oxygen.

Separate maximums for Medical Items and Home Support Services

Maximums:

Year 1: $1,500

Year 2: $2,000

Year 3: $3,000

Year 4+: $4,000 per person per benefit category, per year

‍

Please note: CPAP, BiPAP, APAP and/or AMP machines and supplies are eligible for coverage with a max. of $500 in Year 1 and $500 in Year 2.

Travel

Multi-Trip Emergency Medical Travel Coverage Out-of-province or Country

Maximums:

15 days per trip

$5,000,000 per person per year

Optional Hospital Accommodation

Not Available

Preferred Hospital Accomodation

Maximums:

Care

Telemedicine

GreenShield Telemedicine

4 virtual visits per family every year with a licensed general health care practitioner, available 24/7, 365 days a year

Mental Health Services

Psychologist, Psychotherapist, Registered Social Worker

Maximum:

$400 per person per year, combined

‍

GreenShield Mental Health

4 hours of virtual counselling (2 hours for individual therapy, 2 hours for couples therapy) per person per year. Additional therapy is eligible for coverage under the Psychology benefit.

Pharmacy

GreenShield Pharmacy makes it easy for you to access all your pharmacy services from the comfort and privacy of home. Book a clinical consultation with our pharmacists, receive refill reminders, access to your medication information online and get free delivery of your prescription medications anywhere in Canada.

‍

* Pharmacy services in Quebec provided by Medzy | Pharmacie Sonia Boutin Inc.

Additional plan details

  • This plan is specially designed to cover pre-existing conditions you may have.
  • Multi-trip emergency medical travel coverage (up to 15 days per trip)
  • No waiting period! Once your application is approved, your coverage will begin on the first day of the following month.
  • Get instant access to your benefits with the GreenShield pay-direct benefit card.
  • File a claim, review your coverage and locate a nearby health practitioner from anywhere, any time with GreenShield+ online services and the GreenShield+ mobile app.
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