Benefits Included

Paragon Health Solutions
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Paragon Health Solutions
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Paragon Health Solutions
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EHC BENEFITS

Echelon General Insurance Co.

100% Reimbursement except Drugs

100% Reimbursement except Drugs

80% Reimbursement NO DEDUCTIBLE

Prescription Drugs

70% 1st 500/calendar year,
100% of next $3,000
Generic Drugs. Dispensing fee cap of $7.50 per prescription.
ESI Pay Direct card.

80% Reimbursement of first $500, 100% of next $4,000 per calendar year, Brand name drugs
ESI Pay Direct card.

80% to $5,000/calendar Yr.
Generic Drugs unless Physician indicates “no substitution”
ESI Pay-Direct Drug card

Accidental Dental

$2,500 per calendar year

$2,500 per calendar year

Up to $2,500/calendar year

Ambulance

Ground UNLIMITED; $4,000 air ambulance per calendar year.

Ground UNLIMITED; $4,000 air ambulance per calendar year.

Ambulance services not covered by Provincial Plan  up to $250/trip

Home Support

$3,000 per calendar year

Combined calendar year maximum of $7,500 for Home Support & Durable Medical Equipment, Private Duty Nursing, and Prosthetic appliances and orthotics

See Private Duty Nursing

Durable Medical Equipment

$3,000 per calendar year

$1,750/calendar year for Durable Medical Equipment

Prosthetics

$3,000 per calendar year

Included above

Included Above

Medical Supplies

Included

Included

$1,500/calendar year

Orthopedic footwear or Orthotics

Custom Orthotics to $225 per calendar year

Custom Orthotics to $225 per calendar year as part of Durable Medical Equipment maximum

Reasonable & Customary charges for Orthopedic footwear or Orthotics prescribed by a Chiropodist or Physician to a maximum of $150/calendar year

Private Duty Nurse

Included in Home Support up to $3,000 per policy year

Included in Home Support and Durable Equipment maximum of $7,500 per calendar year

$2,000/calendar year

Paramedical Services

$450/mamimum per practitioner per calendar year – $50 maximum per visit
Acupuncturist;
Chiropractor;
Chiropodist;
Naturopath;
Osteopath;
Physiotherapist;
Podiatrist;
Registered Massage Therapist.
$35 for Chiropractic X-rays per policy year.
Psychologist limited to 15 visits per year, maximum of $75 first visit and $60 subsequent; Speech Therapist $60 and $40.

$500 maximum per practitioner per calendar year with a $50 per visit maximum for:
Acupuncturist;
Chiropractor; Chiropodist;
Naturopath; Osteopath;
Podiatrist;
Physiotherapist;
Registered massage Therapist.
Psychologist  limited to 15 visits per year, maximum of $75 first visit and $60 subsequent for Psychologist; Speech Therapist $60 and $40

Up to $300/practitioner per calendar year with a $50 per visit maximum on a “top up” basis to any Provincial benefits, including: Chiropractors, Chiropodist, Nutritionist, Podiatrist, Physiotherapist, Speech Therapist, Osteopath, Reg. Massage Therapist,

Up to $360 for Psychologist per policy year.

Hearing Aids

$400/4 calendar years.

$400/4 calendar years.

$300/ 5 calendar years

Vision

Eye glasses - $150/2 calendar years
$100 Eye Examinations/24 months
After 6 month waiting period

$250/2 calendar years.
$100 Eye Examinations/24 months
After 6 month waiting period

Eye Glasses up to $150 every 2 calendar years, after 6 month waiting period. $100 for Eye Examinations/24 months

Hospital

Semi-private $150/day to a maximum of $4,500 per calendar year.

Semi-private or private up to $200/day –maximum $25,000 per calendar year.

Semi-Private room up to $170 per day for 30 days ($5,100 maximum/calendar year)

Maximum per person

Benefit maximums

Benefit maximums

$25,000 per calendar year

Lifetime Maximum

$250,000

$250,000

No Maximum

Out-of-Province/Country
Travel Insurance Coordinators Ltd.

100% up to $1M for trips of up to 30 days plus Emergency Travel Assistance Services

100% up to $1M for trips of up to 30 days plus Emergency Travel Assistance Services

100% up to $1M for trips of up to 30 days plus Emergency Travel Assistance Services

DENTAL

Echelon General Insurance Company

Preventive Services

80% reimbursement
8 units scaling
9 month recall
Oral Surgery, Endodontics, Periodontics

80 % reimbursement up to $1,250/calendar year – no waiting period: Exams, cleaning, scaling every 9 months; filings, x-rays, fluoride, space maintainers extractions, anesthesia, endodontics, periodontics, denture repairs

Must be purchased with EHC. No deductible, 80% reimbursement up to $1,000 per person per calendar year. Basic Care including fillings, oral surgery, anesthetic and minor restorations; Periodontics covered at 50% reimbursement

Major Restorative Services

Not included

Crowns, bridges, dentures & orthodontics
Available Year 3+ at 60% reimbursement

Not Included

Orthodontia

Not included

See above

Not Included

Maximum

80% to $500 year One;
80% to $750 year Two+

80% up to $500Year One;
80% to $750 Year Two
80% up to $1,000 Year Three and Year Four and $1,250 Year Five incl. combined Perio/Endo max. of $500/year; 50% Perio. Reimbursement.

80% up to $1,000 per person per calendar year

Critical Illness
ACE INA Insurance

Optional Benefit of $10,000; $25,000 or $50,000 covering TEN Life threatening conditions

Optional Benefit of $10,000; $25,000 or $50,000 covering TEN Life threatening conditions

Optional Benefit of $10,000; $25,000; or $50,000 cover TEN life threatening conditions

Disability Insurance
Lloyd’s of London

Individual Disability Insurance Program available as an option

Individual Disability Insurance Program available as an option

Individual Disability Insurance Program available as an option

AD&D
ACE INA Insurance

Optional Employee/Family Program in units of $50,000 to $300,000 full benefit schedule

Optional Employee/Family Program in units of $50,000 to $300,000 full benefit schedule

Optional Employee/Family Program in units of $50, 000 to $300,000 full benefit schedule