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Extended health

Annual maximum

Coverage Level A Level B Level C Level D
Total for all extended health claims per year (excluding Accidental Death and Dismemberment, travel insurance and Term Life Insurance) $5,000 $5,000 $5,000 $7,500

Hospital

Coverage Level A Level B Level C Level D
Auxiliary care (per year) - - $1,000 $1,000
Hospital beds (per lifetime) - $1,000 $1,500 $1,500
Hospital cash (per day/per year) - $20/$400 $20/$600 $25/$800
Home nursing (per year) - - $2,500 $5,000
Preferred hospital accommodations (per year; semi-private or private rooms) $1,000 $2,000 $3,000 $6,000

Paramedical practitioners

Coverage Level A Level B Level C Level D
Ambulance services (ground and air) 100% 100% 100% 100%
Accidental dental care (per incident) $2,000 $2,500 $3,000 $5,000
Acupuncturist (per visit) - - $50 $105
Homeopath (per visit) - - $50 $180
Osteopath (per visit) - - $50 $150
Naturopath (per visit) - - $50 $190
Dietitian (per visit) - - - $175
Combined maximum (per year; includes acupuncturist, homeopath, osteopath and naturopath) - - $350 $650 and includes dietitian
Chiropractor (per visit) - $35 $35 $75
Physiotherapist (per visit) - $50 $50 $120
Massage therapist (per visit) - $50 $50 $100
Combined maximum (per year; includes chiropractor, physiotherapist and massage therapist) - $350 $500 $750
Podiatrist and chiropodist (per visit) - $25 $25 $105
Combined maximum (per year; includes podiatrist and chiropodist) - $300 $300 $500
Psychologist (including iCBT) (per visit/per year) $75/$150 $75/$450 $75/$750 $225/$1,000
Speech language pathologist (per visit/per year) - - $80/$500 $150/$600
Individual Assistance Program (IAP) (per calendar years) 12 sessions 12 sessions 12 sessions 12 sessions

Medical device supplies

Coverage Level A Level B Level C Level D
Blood pressure monitor (per five years) - - $150 $150
CPAP sleep apnea appliance (per five years) - $500 $750 $2,000
Custom braces (per two years) - 70%/$750 70%/$750 70%/$1,000
Foot orthotics (per year) - $200 $200 $300
Hearing aids (per four years) - $500 $750 $750
Ileostomy/colostomy, urinary catheters and supplies (per year) - $1,200 $1,200 $1,200
Mastectomy prosthesis (per two years) - $200 for single/$400 for double $200 for single/$400 for double $200 for single/$400 for double
Medical aids (per year; crutches, canes, casts, cervical collars, walkers, splints, trusses and traction kits) - $250 $250 $250
Orthopedic shoes (per year) - $250 $250 $400
Oxygen and equipment (per year) - - $1,000 $1,000
Prosthetics (per year) - $300 $300 $1,000
Surgical stockings (per year) - $200 $200 $250
Wheelchair (per three years) - $1,500 $1,500 $3,000

Vision care

Coverage Level A Level B Level C Level D
Vision care including eye exams (per two years) $100 $200 $300 $500

Travel

Coverage Level A Level B Level C Level D
Emergency Medical Care coverage per trip* $5 million $5 million $5 million $5 million
Trip length 10 days 17 days 30 days 30 days
Length of time pre-existing conditions must be stable before departure date 90 days 90 days 90 days 90 days

*This benefit is no longer available at 65 years old.

Learn more about underwriters for Alberta Blue Cross®.

Life

Coverage Level A Level B Level C Level D
Accidental Death and Dismemberment (AD&D)** $15,000 $20,000 $25,000 $25,000
Final Expenses**, terminates at age 65* (one year waiting period) - $4,000 $6,000 $6,000

* "Terminates at age" references the age when a benefit is no longer available for that specific individual

**Underwritten by Blue Cross Life Insurance Company of Canada®.

Wellness

Coverage Level A Level B Level C Level D
Balance®—online program that promotes wellness and helps you live a healthier lifestyle. Included Included Included Included
Blue Advantage®—discount program for health and wellness products. Included Included Included Included
Care navigation—lifestyle and chronic disease management through our website. Included Included Included Included

Optional dental*

Coverage Level A Level B Level C Level D
Basic and preventive care (three-month waiting period; includes checkups, cleanings, fillings, extractions and root canals 70% 75% 80% 90%
Dentures (one-year waiting period) - 50% 50% 60%
Periodontics (one-year waiting period) - 50% 80% 90%
Extensive; includes crowns, bridges and implants (two-year waiting period) - - 50% 60%
First year combined maximum (applies to basic and preventive care only) $600 $600 $600 $750
Second and subsequent years combined maximum (per year; includes basic, extensive, dentures and periodontics) - $1,250 $1,500 $2,000
Orthodontic (two-year waiting period; per lifetime) - - 50%/$2,000 50%/$2,500

*Alberta Blue Cross® Individual Health Plan Usual and Customary Dental Fee List.

Optional prescription drug

With Blue Assured®, you have the option of including prescription drugs in your benefit coverage.

If you had previous coverage through another plan, there may be no waiting periods for drug benefits. A waiting period is the amount of time that must pass before you're eligible for coverage.

Coverage Level A Level B Level C Level D
Maximum (per year; includes diabetic supplies and Glucose Monitoring Systems (GMS), contraceptives, smoking cessation and vaccines)
Please contact a Personal Benefit Consultant for higher prescription coverage options.
$250 $500 $1,500 $5,000 and includes fertility drugs, weight loss drugs, hair loss drugs and sexual dysfunction drugs
Coverage level (three month waiting period) 70% direct bill 70% direct bill 70% direct bill 80% direct bill
Blue Care™ (Pharmacist's advice to help navigate high-cost drug claims ) Included Included Included Included

Additional features

Blue Advantage®

You will also enjoy access to Blue Advantage®, a program that enables Alberta Blue Cross® plan members to save on medical, vision care and many other products and services regardless of whether the item is covered under your benefit plan or not.

Blue Advantage®