What is Provincial Plan Replacement Coverage? Provincial Plan Replacement Coverage is for individuals or plan members and their dependents who reside in Canada and are not covered by their Provincial Health Plan. Who needs Provincial Plan Replacement Coverage? Each province has guidelines for provincial plan health coverage eligibility. Typically there is a three-month waiting period for provincial plan health coverage for employees and their dependants who are:
- entering the country, or
- returning after a period away from Canada, or
- foreign employees who are temporarily residing in Canada.
What expenses are covered by Provincial Plan Replacement Coverage?
- Benefits duplicate provincial plan coverage to a $1,000,000 lifetime maximum. (Typical expenses include physician fees, hospital expenses, lab charges and ambulance.)
- Covered persons electing to have services performed outside of Canada will not be covered (e.g. an American working in Canada who has a heart attack and elects to return to the US for surgery has no coverage under this plan).
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