Community Agencies Benefit Plans

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Overview of Extended Healthcare Coverage

Health Care coverage provides members and their dependents with financial assistance for medical expenses incurred, which are not covered by the provincial healthcare plan.

On April 1, 2014 Community Agencies Benefit Plans implemented a New Plan design that offers enhanced coverage and more options to non-profit agencies in Manitoba.  This New Plan Design has three different extended health plan options that provide varying levels of coverage. All extended health options include coverage for prescription medication, hospital  and ambulance coverage, paramedical practitioners, nursing care and out-of-country emergency medical. Two of the three options include a vision coverage component.

Agencies that were already participating in the Community Agency Group Benefits Plan had the option to grandfather their existing plan. 

Prescription Drugs

Depending on which option(s) your agency participates in extended health care coverage, Prescription Drugs listed in the Manitoba Drug Benefits and Interchangeability Formulary are covered 70%, 80% or 90% and dispensing fees are covered starting at a cap maximum of $6.00, $8.00 or no cap maximum on each prescription charged by your pharmacy. You will be responsible for any amount in excess of the cap maximum charged by your pharmacy for the dispensing fee. There is no overall maximum but once you reach your Pharmacare deductible you will be eligible to have your drugs covered under the Provincial plan at 100%.

Exception Drug Status

If your doctor has prescribed a drug that is not on the Manitoba Pharmacare list it may be beneficial to apply for exception drug status (EDS). Your doctor will need to send a request to Manitoba Health on your behalf. Once you receive the approval from Manitoba Health, you are required to take the approval to your pharmacist and ask him/her to indicate the DIN (drug identification number) beside the name of the drug. Once this has been completed, it is important to send a copy to our office so that we can request Canada Life to make an exception to your file so that future claims will be processed. Do not send your EDS directly to Canada Life.

Manitoba Health Website

Paramedical Services

Depending on which option(s) your agency participates in extended health care, coverage starts at 70% to an overall combined maximum of $700 each calendar year per person up to 90% to an overall combined maximum of $1000 each calendar year per person. 

Covered Paramedical Services are:

  • Acupuncture
  • Chiropractor
  • Dietician
  • Massage Therapist
  • Osteopath
  • Physiotherapy
  • Psychologist

Medical Services and Equipment

Depending on which option(s) your agency participates in extended health care, coverage starts at 70% up to 90% for;

  • semi-private hospital room, private duty nursing, orthotics, and hearing aids. Please refer to your group benefits booklet for the complete listing and maximums.

All the extended health care options coverage is 100% for;

  • Ambulance

Global Medical Assistance

This program provides medical assistance through a worldwide communications network which operates 24 hours a day. The network locates medical services and obtains Canada Life’s approval of covered services, when required as a result of a medical emergency arising while you or your dependent is traveling for vacation, business or education.  Coverage for travel within Canada is limited to emergencies arising more than 500 kilometers from home.  You must be covered by the government health plan in your home province to be eligible for global medical assistance benefits.

In an emergency situation, contact the nearest Assistance Co-ordination Centre immediately.

AVAILABLE WORLDWIDE – 24 HOURS A DAY

If you need medical assistance in Cuba or outside of Canada and the US please submit a claim for reimbursement later to cover the costs of long distance charges.

Out-of-Country Care

  • Emergency Care Maximum $5,000,000/lifetime
  • Non-Emergency Care Maximum $3,000/3 calendar years
  • Maximum trip duration 180 days
  • Benefit terminates age 70

Forms