The PetSmart Extended Health Care Benefits plan covers services and supplies typically not covered under your provincial health care plan, such as:
- prescription drugs
- out-of-country emergency
- out-of-country referral
- professional services
- medical supplies
- private duty nursing
- accidental dental
- vision care
Your weekly costs for coverage, by province, can be found here.
Reimbursement at 90% and dispensing fee cap of $12.00
Mandatory Generic Drug Program
This plan feature helps manage the costs associated with prescription drugs. Since you share in the cost of your prescription, switching to generics may help you save some money! “Generic” is the term used to describe a drug product that is equivalent to a brand-name drug.
Pharmaceutical manufacturers can produce and sell generic drugs after the patent on the brand-name drug has expired. The generic drug must use the same active ingredients as the brand-name drug, and Health Canada monitors this to ensure they are equally safe and effective.
With mandatory generic substitution, your prescription will be filled with a generic drug, when available, even if the physician indicates a brand name in the prescription. If the drug you are prescribed is a brand name and there is no alternative drug, then the plan will continue to allow the brand-name medication at the same reimbursement level.
In rare instances, an individual may not be able to tolerate the generic drug, or it may be therapeutically ineffective. When this happens, you can work with your physician and submit an appeal with medical evidence to Manulife for consideration of a brand-name drug.
The plan pays 100% of the cost of a semi-private hospital room.
If you become sick or injured while traveling outside Canada, 100% of your emergency health care costs are covered. The maximum lifetime coverage is $1 million.
If your doctor sends you outside of Canada for treatment of an illness or injury, the plan pays 50% of the costs for the treatment. The maximum coverage is $3,000 every three calendar years.
After any eligible expenses have been paid by your Provincial Health Plan, the plan pays 80% of the cost up to a combined $1,000.00 maximum per calendar year per family member for the following services:
- Social Worker
- Speech Therapist
$150 each calendar year
$500 every 3 calendar years
$500 every 5 calendar years
The plan pays 80% of the cost with a maximum of $10,000 each calendar year.
Accident-Related Dental Services
If you need dental work as a result of an accident, the plan pays 100% of the cost. There is no maximum coverage.
Glasses or contacts
The Plan pays:
- up to 100% with a maximum of $250 every 12 months if under 18.
- up to 100% with a maximum of $250 every 25 months if over 18.
The Plan pays:
- 100% of the cost of one eye exam per year (not included in the overall vision maximum).
- a maximum of $250 every 24 months if over the age of 18