II – Extended Health Care

Extended Health Care Eligible Expenses

“Eligible” expenses must be considered medically necessary for the treatment of an illness or injury and recommended by a Medical Doctor.

Extended Health Care

Reimbursement Percentage

70% for each Insured Person

Annual Maximum for Each Insured Person*

Year One	Year Two	Year Three
$7,500*	$7,500*	$7,500*
*Maximum includes benefits paid for Vision/Paramedical Care

Your Writers’ Coalition Program covers the following medical supplies and services:

This image indicates that a written recommendation from your Medical Doctor must be submitted specifying the condition for which treatment is being prescribed. This written recommendation must be provided each Benefit Year and before any benefit is paid.

	BENEFIT	Coverage Limits for Each Insured Person Benefit Year – As indicated on your Certificate of Insurance
	Transportation to Hospital by Ground Ambulance	Covered when not paid by the provincial plan.
	Air Ambulance	Maximum of $4,000 each Benefit Year when not paid by the provincial plan. Only payable for flights originating and terminating in Canada.
	Private Duty Nursing	Maximum of $2,500 each Benefit Year.
	Hospitalization	Reimbursed at 70% for the first 5 days and 100% thereafter each Benefit Year. Semi-private room for acute illness and rehabilitation only. Rehabilitation is covered only when followed immediately after a minimum of three days of acute care and for a maximum of 6 weeks. Where rehabilitation is expected to exceed 6 weeks, prior approval must be obtained from AFBS.
	Home Care following Hospitalization	Maximum of $30 each day for a maximum of 30 days each Benefit Year.
	Wigs	Lifetime maximum of $1,000 only for cancer patients undergoing chemotherapy.
	Artificial Limbs and Eyes	Maximum of $5,000 every 5 Benefit Years, or every 3 years of continuous coverage for a dependant child under 18 years of age.
	Hearing Aids	Maximum of $500 per ear every 4 Benefit Years, or every 2 Benefit Years for a dependant child under age 18.
	Physiotherapist	Maximum of $750 each Benefit Year.
	Audiologist, Speech Therapist	Combined maximum of $750 each Benefit Year.
	Eye Examinations	Maximum $80 every two Benefit Years.
	Medical Equipment – Hospital Bed – Wheelchair – Oxygen Set	Rental or purcahse to lifetime maximum of $1,500. Rental or purcahse to lifetime maximum of $1,000. Rental or purcahse.
	Accidental Dental	Reimbursed at 70% of dental expenses.

Assistive Devices

This image indicates that a written recommendation from your Medical Doctor must be submitted specifying the condition for which treatment is being prescribed. This written recommendation must be provided each Benefit Year and before any benefit is paid.

The purchase or rental of assistive devices, mobility aids and medical equipment is limited to the items specified below. Where no maximum is stated, the Program reimburses 70% up to the usual and customary cost of these items.

	BENEFIT	Coverage Limits for Each Insured Person Benefit Year – As indicated on your Certificate of Insurance
	Walker	Covered up to the usual customary charges.
	Urethral Catheters	Covered up to the usual customary charges.
	Casts, Splints, Walking Cane, Crutches	Covered up to the usual customary charges.
	Cervical Collar	Covered up to the usual customary charges.
	Tracheostoma Tubes	Covered up to the usual customary charges.
	Colostomy and Ostomy Supplies Where Surgical Stoma Exists	Covered up to the usual customary charges.
	Abdominal, Back or Knee Brace	Knee brace lifetime maximum of $500/knee.
	CPAP (continuous positive airway pressure) Machine	Lifetime maximum of $500.
	IPPB (intermittent positive pressure breathing) Machine	Lifetime maximum of $500.
	Apnea Monitors for Respiratory Dysrhythmias	Lifetime maximum of $500.
	Light Therapy Where SADD is Diagnosed	Lifetime maximum of $200.
	CPAP and IPPB Supplies	Maximum of $100 each Benefit Year.
	Devices and Medical Aids Necessitated After Surgery	Covered up to the usual customary charges.
	Tens Machine (transcutaneous nerve stimulator for chronic pain)	Lifetime maximum of $500.
	Support Hose and Compression Stockings	Maximum 4 pairs each Benefit Year.
	Surgical Brassieres	Maximum 2 each Benefit Year.
	Blood Glucose Monitoring Machine	Maximum of one each 5 years.
	Insulin Pump	Lifetime maximum of $1,000.
	External Breast Prosthesis (when required as a result of a total or radical mastectomy)	Maximum of one each Benefit Year.
	Stump Socks	Maximum 4 pairs each Benefit Year.

Program Handbook