Plan Details
Guaranteed Acceptance
The ZONE Fundamental health insurance plan provides modest coverage for prescription drugs and dental care, plus vision care, extended health care and emergency medical travel coverage. Best of all, with the Fundamental plan, acceptance is guaranteed* with no medical questions asked when you apply.
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Guaranteed Acceptance
No medical questions or exams. Yes, this plan even covers pre-existing conditions. Applying is quick and easy!
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Prescription Drugs
SureHealth 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.
MaximumsPays 70% up to
Year 1: $550
Year 2: $600Year 3+: $650 per person per year
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Overall Maximums
$450 per person per year
Recall Frequency9 monthsBasic ServicesBasic 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 ServicesComprehensive 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 ServicesMajor Services include coverage towards:
- Crowns and onlays
- Dentures
- Bridgework
Not included
Orthodontic ServicesOrthodontic Services include coverage towards:
- Straightening teeth and correcting the bite
Not included
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Prescription eyeglasses, contact lenses, laser eye surgery
Maximum:
$150 per person every 2 years
Eye ExaminationMaximum:
$80 per person every 2 years
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Telemedicine
Maple Online Services:
4 virtual visits per family every year with a licensed general health care practitioner, available 7 days a week, 365 days a year (7 am – midnight, local time)
Professional Services / Registered TherapistsChiropractor, Massage Therapist, Physiotherapist, Acupuncturist, Chiropodist / Podiatrist, Dietitian, Naturopath, Osteopath
Maximums:
$20 per visit
$400 per person per practitioner, per year
Speech Therapist
Maximum:
$400 per person per year
Mental Health ServicesPsychologist / Psychotherapist / Registered Social Worker
Maximum:
$400 per person per year, combined
Inkblot™† Therapy:
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
Accidental DentalMaximum:
$3,000 per person per year
Ambulance TransportationIncludes land and airHearing AidsMaximums:
Year 1-4: $350
Year 5+: $500 per person every 4 years
Medical ServicesDiagnostic tests and x-rays, dialysis equipment, laboratory tests
Maximum:
$2,000 per person per year
Medical Items and Home Support Services (in-home nursing)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.
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Multi-Trip Emergency Medical Travel Coverage out-of-province or country
Maximums:
15 days per trip
$5,000,000 per person per year
What's More
- 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.