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Manulife Flexcare® DentalPlus, ComboPlus Starter Plans
This is not a contract. Actual terms and conditions are detailed in the policy issued upon application approval.
If you have questions please call us at 1-800-474-4474, or email us at inquiries@healthquotes.ca
Table of Contents (you can click on any coloured text to go to that section)
  - General Information
       - Effective Date of Coverage
       - Acceptance Period
       - Hospitalization/Pregnancy
       - Maximums
       - Newborns
       - Core Benefits Variations
  - Health Care Plans
       - Snapshot of Plans and Benefits (very useful when comparing the different plans, includes Seniors Adjustments)
       - DentalPlus™ (Dental Care Plans with Core Benefits) 
            - Basic
            - Enhanced
            - Core Benefits (Basic and Enhanced Plans)
       - ComboPlus™ (Prescription Drug and Dental Care Plans with Core Benefits) 
            - Starter
                - Core Benefits (Starter Plan)
  - Seniors' Adjustments
       - DentalPlus (Basic/Enhanced), Vision, Hospital
       - Travel
       - ComboPlus Starter (Drug Coverage)

GENERAL INFORMATION
Effective Date of Coverage
  • Coverage is effective no earlier than the first day of the month following final approval of the application.
Acceptance Period
  • If you and/or your family's medical history is such that a higher premium is required or that special
    conditions be applied to benefits (see Medically Underwritten), you will be notified  in writing prior to your
    decision to accept the coverage.  If at that time you decide not to proceed with the coverage, any initial
    payment will be returned and your application cancelled.
Hospitalization/Pregnancy
  • Full coverage is available for expectant mothers who qualify for a Flexcare Core plan and the additional
    Hospital Coverage benefit within the first 20 weeks of pregnancy (Maternity Hospital stay is limited to
    2 days).  Manulife cannot guarantee the availability of private or semi-private hospital 
    accommodation.
         - Table of Contents -
Maximums
  • Unused portions of benefits cannot be accumulated and added to coverage in future months or years.
    All maximums are per person, and not per family, unless otherwise stated.
Newborns
  • Newborns of parents who are enrolled in the FlexCare plan are automatically added to the same coverage
    if an application is made within 30 days of birth.  If the application is after their 30th day, medical
    information will be required.
Core Benefits Variations
  • Although Core Benefits come with all FlexCare Plans there is a very slight variation in Core Benefits, 
     depending on the type of FlexCare Plan you choose (e.g. DrugPlus Basic, DentalPlus Enhanced, etc.) 
 HEALTH CARE PLANS
Snapshot of Plans and Benefits
        
         CORE BENEFITS
                                                                 CORE PLANS (Note: All plans come with core benefits)          
  DentalPlus™
Basic
DentalPlus™
Enhanced
ComboPlus™
Starter
Vision (Basic), Chiropractor,
Chiropodist, Osteopath, Naturopath, Podiatrist,
Registered Massage Therapist, Acupuncturist, Psychologist,
Speech Pathologist/Therapist, Physiotherapist,
HomeCare and Nursing,
Prosthetic Appliances,
Durable Medical Equipment, Lifeline, Accidental Dental, Ambulance,
Hearing Aid,
Emergency Travel Health Coverage, Accidental Death and Dismemberment, Survivor Benefits
 
Solutions Services

(Vision Care does not come with 
ComboPlus™  Starter Plan
)

Ongoing Maintenance
9 month recall
 
Total Benefits Payable:
Year 1:
50% of first $1,150.
Total payable per anniversary year: $575
  
Year 2+:
80% of first $400, 50% of next $860.
Total payable per aniversary year: $750

DentalPlus Basic and Enhanced have an escalating yearly maximum for Home Support, Durable Medical Supplies and Prosthetic Appliances



No medical questionnaire required


Ongoing Maintenance

6 month recall
 
Total Benefits Payable:
Year 1:
70% of first $1,200.
Total payable per anniversary year: $840 

Year 2+:
100% of first $500, 60% of next $700)
Total payable per anniversary year: $920

Combined maximum of $1,250/3 year period for: Oral Surgery, Endodontics, Periodontics:
Year 1: 0%; Year2: 60%
Year 3+:80%

Major Restorative
First 2 Years: 0%, Subsequent Years: 60%


No medical questionnaire required


DENTAL: 
Ongoing Maintenance
-
9 month recall
- 70% of 1st $575

PRESCRIPTION DRUGS:
- Generic Drug Plan
-
70% of 1st $750
- Dispensing Fee Cap is $6.50

- Now comes with $100 of Vision Care


Escalating yearly maximum for Home Support, Durable Medical Supplies and Prosthetic Appliances


No medical questionnaire required



 Seniors Adjustments      
    (Age 65 and up)

    No travel coverage available

    AD&D decreases to $10,000
Travel coverage not available
  
  
 
Travel coverage not available
 
 
 

Dental: Increases to 70% of first $575.
 
Prescription Drugs: 100% of first $750.
 
   
Residents of Nova Scotia
-
Drugs increased to 100% of first $300.
- Dental increases to 70% of first $575.
  
  
Travel coverage not available
 
 
 

 NOTE: Unless otherwise mentioned benefits are based on anniversary year except for Vision and Hearing Aid benefits, which are based on Benefit year.
         - Table of Contents -
DentalPlus (Dental and Core Benefits)
(You can choose either the Basic or Enhanced Plan, both come with Core Benefits)
IMPORTANT - Dental coverage commences at age 17 for residents of Prince Edward Island, age 13 for
                           residents of Newfoundland and age 11 for residents of Nova Scotia.
                        - Coverage is designed to concur with your current provincial Dental Association Fee Guide
                           for General Practitioners.  The FlexCare DentalPlus coverage will be adjusted to match any
                           increases in the fee guide
    Basic Plan (DentalPlus)
    • No medical questionnaire required, guaranteed acceptance.
    • Coverage for fillings, cleanings, scalings, examinations, polishings, and certain extractions. 
    • Recall visits every 9 months.
    Coverage Table:
Year   Copay  To a maximum of
(per anniversary year)
One First $1,150: 50% $575
Subsequent years First $400: 80%
Next $860: 50%  
$750
   • Core Benefits are listed beneath the Enhanced Plan details.
         - Table of Contents -
    Enhanced Plan (DentalPlus)
    • No medical questionnaire required, guaranteed acceptance.
    • Coverage for fillings, cleanings, scalings, examinations, polishing, and certain extractions. 
    • Recall visits every 6 months.
    Coverage Table:
Year  Copay  To a maximum of
(per anniversary year)
One First $1,200: 70% $840
Two and after First $500:100%
Next $700: 60%
$920
   • The following 6 dental services (Enhanced plan only) have a combined maximum of $1,250 per
      3 year period.  For oral surgery, periodontics and endodontics (root canal), benefits are available
      beginning Year 2; for orthodontics, crowns, bridges and dentures. No benefit is available until
      Year 3.  The payment percentage increase from the effective date of contract is as follows:
   Anniversary
Year 1
 
Anniversary
Year 2
Anniversary
Year 3 and beyond
Oral Surgery 0% 60% 80%
Periodontics 0% 60% 80%
Endodontics
(Root Canal)
0% 60% 80%
Orthodontics 0% 0% 60%
Crowns, Bridges 0% 0% 60%
Dentures 0% 0% 60%
         - Table of Contents -
    Core Benefits (Included with DentalPlus Basic and Enhanced Plans)
    Vision (Basic)
    • $250 maximum per 2 consecutive benefit years to cover the cost towards prescription lenses,
       frames, contact lenses and laser eye surgery. 
    • $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after Government
       Health Insurance Plan maximum has been reached, if applicable)
     • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2
       benefit years.  This warranty applies to lenses and frames purchased with the Vision benefit of
       FlexCare.
    • No deductible is charged to you if your eyeglasses can be repaired.  If beyond repair, your glasses
       will be replaced and; a $50 deductible charged for eyeglasses originally purchased for up to $250;
       or a $75 deductible, if the original purchase price was $251 to $300; or a $100 deductible, if your 
       eyeglasses originally cost $301 or more. 
         - Table of Contents -
    Extended Health Care (Starter)
    • $250,000 lifetime maximum.
    • Best Doctors® Solutions Services – upon diagnosis of a serious illness or injury, you can receive an
      evaluation of your medical records by world-class specialists who confirm the initial diagnosis and 
      recommend appropriate treatment options. This fast, yet indepth review can reduce potentially
      serious complications from a misdiagnosis and help your local physician determine the proper course
      of action. In addition to medical advice, Best Doctors® provides the following services: treatment planning,
      identification of the most appropriate care provider, and care management.
    • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist:
       - $20 max. per visit, 20 visit maximum per person per discipline per anniversary year.
    • Chiropractic X-ray - $35 maximum per anniversary year.
    • Psychologist - $80 max. first visit, $65 max. subsequent visits, 15 visit max. per anniversary year.
    • Speech Pathologist/Therapist - $65 max. first visit, $45 max. subsequent visits, 10 visit maximum
                                                 per anniversary year.
    • Physiotherapist - $250 max. per anniversary year.
    • HomeCare and Nursing, Prosthetic Appliances, Durable Medical Equipment:
      - maximum per anniversary year for each of these 3 categories of benefits separately, is according to
        the following table:        
Year 1 Year 2 Year 3 Year 4 Year 5
$1,000 $1,300 $1,500 $1,700 $3,000

NOTE: $225 max. per anniversary year for custom-made Orthotics, which are included as part of Prosthetic Appliances.
    • Lifeline® Personal Response Service - max. of 6 months of service every 3 anniversary years. 
    • Accidental Dental - $2,000 maximum per anniversary year.
    • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance
                        transportation per anniversary year.
    • Hearing Aid - $400 maximum per 4 consecutive benefit years.
         - Table of Contents -
    Travel
    • $5 million emergency health coverage for trips lasting a maximum of 9 days. (A $100 deductible applies per claim). 
      Additional coverage for either 8 or 21 days can be purchased as an Add-On.  
    • NOTE: Coverage may be limited or excluded for any illness or condition which first manifested itself within the 9-month period preceding
                       the effective date of coverage.  Not available to persons age 65 and over; 8 or 21 day Add-On Travel coverage now available with
                       ComboPlus Starter Plan.
    Accidental Death & Dismemberment
    • $25,000 for adults under the age of 65; $10,000 for children and adults age 65 and over, or a child. Additional
       coverage can be purchased as an Add-on.
         - Table of Contents -
    Survivor Benefits
    • Provides for coverage to be continued for 1 year, following the death of an adult policyholder.
    • Available 1 year after policy effective date.
         - Table of Contents -
ComboPlus (Prescription Drug, Dental and Core Coverage)
    • You can choose either the Starter, Basic or Enhanced Plan, all come with Core Benefits Note that
       Core Benefits for the Starter Plan are different than the Core Benefits that come with both the 
       Basic and Enhanced Plan (Core is the same for both Basic and Enhanced).
    • For drug and dental coverage with Core Benefits, without a medical questionnaire, choose the 
       Starter Plan.
    • For more extensive drug and dental coverage with Core Benefits, select either the Basic or 
       Enhanced Plan.
    Starter Plan (ComboPlus™)
    (No medical questionnaire - guaranteed acceptance)
        Starter Drug Coverage
        • Generic drug plan (name brand drugs allowed, but price paid will be deemed to be the generic
           equivalent price).
        • Shared dispensing fee to a maximum of $6.50.
        • 70% on the first $750.
        • Exclusions - smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs,
                           and drugs not requiring a prescription.
        • British Columbia and Saskatchewan residents: Prescription drug benefit maximums based on
                                                                               calendar year.
        Starter Dental Coverage
          • Dental coverage with a 70% payment for fillings, cleanings, scalings, examinations and polishing
           on the first $575 of these services.
        • Recall visits every 9 months.
        IMPORTANT - Dental coverage commences at age 17 for residents of Prince Edward Island, age 13 for
                                        residents of Newfoundland and age 11 for residents of Nova Scotia.
         - Table of Contents -
Starter Core Benefits
        Extended Health Benefits (Starter)
        • $250,000 lifetime maximum.
       • Best Doctors® Solutions Services – upon diagnosis of a serious illness or injury, you can receive an
         evaluation of your medical records by world-class specialists who confirm the initial diagnosis and 
         recommend appropriate treatment options. This fast, yet indepth review can reduce potentially
         serious complications from a misdiagnosis and help your local physician determine the proper course
         of action. In addition to medical advice, Best Doctors® provides the following services: treatment planning,
         identification of the most appropriate care provider, and care management.
        • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist:
           - $20 max. per visit, 20 visit maximum per discipline per anniversary year (payable only after Government
             Health Insurance Plan maximums have been reached, if applicable).
        • Chiropractic X-ray - $35 maximum per anniversary year.
        • Psychologist - $80 max. first visit, $65 max. subsequent visits, 15 visit max. per anniversary year.
        • Speech Pathologist/Therapist - $65 max. first visit, $45 max. subsequent visits, 10 visit maximum
                                                     per anniversary year.
        • Physiotherapist - $250 max. per anniversary year.
        • HomeCare and Nursing, Prosthetic Appliances, Durable Medical Equipment:
          - maximum per anniversary year for each of these 3 categories of benefits separately, is according to
            the following table:        
Year 1 Year 2 Year 3 Year 4 Year 5
$1,000 $1,300 $1,500 $1,700 $3,000
            NOTE: $225 max. per anniversary year for custom-made Orthotics, which are included as part of Prosthetic Appliances.
        • Lifeline® Personal Response Service - max. of 6 months of service every 3 anniversary years. 
        • Accidental Dental - $2,000 maximum per anniversary year.
        • Ambulance - unlimited ground transportation to hospital and $4,000 maximum for air ambulance
                            transportation per anniversary year (only payable after Government Health Insurance
                            Plan maximums have been reached, if applicable).
        • Hearing Aid - $400 maximum per 4 consecutive benefit years.
         - Table of Contents -
        Travel
        • $5 million emergency health coverage for trips lasting a maximum of 9 days. (A $100 deductible applies per claim.)
          Additional coverage for either 8 or 21 days can be purchased as an Add-on.
        • NOTE: Coverage may be limited or excluded for any illness or condition which first manifested itself within the 9 month period
                             preceding the effective date of coverage.  Not available to persons age 65 and over; 8 or 21 day Add-On Travel coverage now
                             available with this ComboPlus Starter Plan.
        Accidental Death & Dismemberment
        • Up to$25,000 for adults under the age of 65; up to $10,000 for children and adults age 65 and over. Additional
           coverage can be purchased as an Add-On.
         - Table of Contents -
        Survivor Benefits
        • Provides for coverage to be continued for 1 year, following the death of an adult policyholder.
        • Available 1 year after policy effective date.
        IMPORTANT - Dental coverage commences at age 17 for residents of Prince Edward Island, age 13 for
                                   residents of Newfoundland and age 11 for residents of Nova Scotia.
                                - Coverage is designed to concur with your current provincial Dental Association Fee Guide
                                   for General Practitioners.  The FlexCare DentalPlus coverage will be adjusted to match any
                                   increases in the fee guide.
         - Table of Contents -
SENIORS' ADJUSTMENTS
    • If you are 65 years of age or over, you are likely to have special health priorities.  That is why the 
      Flexcare health plan coverage is adjusted to reflect your needs
    • Under the Seniors' Adjustments, all of your benefits are as outlined in your chosen Core plan with
      the following changes:
        DentalPlus
            • There is no change to these Core plan benefits from what has been previously described.
               - Table of Contents -
        Travel
            • Travel coverage not available.
        ComboPlus Starter (Drug Coverage)
            • 100% on the first $750 of eligible prescription costs.
            • Full coverage of reasonable and customary dispensing fees.
            • Residents of Nova Scotia: 100% generic drugs on first $300.
            • Residents of British Columbia and Saskatchewan: Prescription drug benefits based on calendar year.
            • IMPORTANT: For residents of New Brunswick, Manitoba and Saskatchewan prescription
                                 drug Seniors' adjustments do not apply.
               - Table of Contents -
™/® Trademarks are held by Manulife Financial.
® Lifeline is a trademark of Lifeline Systems Inc.
Best Doctors® is a registered trademark of Best Doctors, Inc. in the United States and other countries
and is used under license.


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