Blue Cross Complete Health Plan Details
Blue Cross Complete Health is a comprehensive health insurance plan designed for individuals and families in Ontario. This plan provides extensive coverage for a wide range of healthcare needs, including hospital stays, prescription drugs, paramedical services, and more. With different tiers available—Complete Health Entry, Complete Health Essential, and Complete Health Enhanced—members can choose the level of coverage that best fits their needs. Each plan offers various benefits, including coverage for mental health services, dental care, vision care, and specialized treatments. The Blue Cross Complete Health plans aim to ensure members have access to the healthcare services they need to maintain their well-being and quality of life.
Health Benefits Comparison
Coverage Overview
Below is a comparison of health benefits across the Complete Health Entry, Complete Health Essential, and Complete Health Enhanced plans, highlighting the coverage limits for various health practitioners and services.
Health Practitioners
Psychologist:
Complete Health Entry: $55 per visit, with a maximum of $250 per calendar year.
Complete Health Essential: $80 per visit, with a maximum of $400 per calendar year.
Complete Health Enhanced: $95 per visit, with a maximum of $500 per calendar year.
Massage Therapist:
Complete Health Entry: Not covered.
Complete Health Essential: $55 per visit, with a maximum of $400 per calendar year.
Complete Health Enhanced: $70 per visit, with a maximum of $500 per calendar year.
Physiotherapist:
Complete Health Entry: $40 per visit, with a maximum of $250 per calendar year.
Complete Health Essential: $55 per visit, with a maximum of $400 per calendar year.
Complete Health Enhanced: $70 per visit, with a maximum of $500 per calendar year.
Chiropractor:
Complete Health Entry: $40 per visit, with a maximum of $250 per calendar year.
Complete Health Essential: $55 per visit, with a maximum of $400 per calendar year.
Complete Health Enhanced: $70 per visit, with a maximum of $500 per calendar year.
Acupuncturist:
Complete Health Entry: Not covered.
Complete Health Essential: $55 per visit, with a maximum of $400 per calendar year.
Complete Health Enhanced: $70 per visit, with a maximum of $500 per calendar year.
Dietitian:
Complete Health Entry: $40 per visit, with a maximum of $250 per calendar year.
Complete Health Essential: $55 per visit, with a maximum of $400 per calendar year.
Complete Health Enhanced: $70 per visit, with a maximum of $500 per calendar year.
Naturopath:
Complete Health Entry: Not covered.
Complete Health Essential: $55 per visit, with a maximum of $400 per calendar year.
Complete Health Enhanced: $70 per visit, with a maximum of $500 per calendar year.
Audiologist:
Complete Health Entry: $40 per visit, with a maximum of $250 per calendar year.
Complete Health Essential: $55 per visit, with a maximum of $400 per calendar year.
Complete Health Enhanced: $70 per visit, with a maximum of $500 per calendar year.
Occupational Therapist:
Complete Health Entry: $40 per visit, with a maximum of $250 per calendar year.
Complete Health Essential: $55 per visit, with a maximum of $400 per calendar year.
Complete Health Enhanced: $70 per visit, with a maximum of $500 per calendar year.
Osteopath:
Complete Health Entry: $40 per visit, with a maximum of $250 per calendar year.
Complete Health Essential: $55 per visit, with a maximum of $400 per calendar year.
Complete Health Enhanced: $70 per visit, with a maximum of $500 per calendar year.
Podiatrist/Chiropodist:
Complete Health Entry: $40 per visit, with a maximum of $250 per calendar year.
Complete Health Essential: $55 per visit, with a maximum of $400 per calendar year.
Complete Health Enhanced: $70 per visit, with a maximum of $500 per calendar year.
Speech Therapist:
Complete Health Entry: $40 per visit, with a maximum of $250 per calendar year.
Complete Health Essential: $55 per visit, with a maximum of $400 per calendar year.
Complete Health Enhanced: $70 per visit, with a maximum of $500 per calendar year.
Additional Coverage
Ambulance Services:
Complete Health Entry: Not covered.
Complete Health Essential: Coverage up to $420 per calendar year.
Complete Health Enhanced: Coverage up to $420 per calendar year.
Hearing Aids:
Complete Health Entry: Not covered.
Complete Health Essential: Coverage up to $400 every 5 years.
Complete Health Enhanced: Coverage up to $500 every 5 years.
Orthotics:
Complete Health Entry: Coverage up to $150 per calendar year.
Complete Health Essential: Coverage up to $150 per calendar year.
Complete Health Enhanced: Coverage up to $225 per calendar year.
Vision Care:
Complete Health Entry: Coverage up to $100 every 2 calendar years.
Complete Health Essential: Coverage up to $150 every 2 calendar years.
Complete Health Enhanced: Coverage up to $300 every 2 calendar years.
Diabetic Supplies:
Complete Health Entry: Not covered.
Complete Health Essential: No overall maximum, covering $2,280 per calendar year for Continuous Glucose Monitoring Supplies.
Complete Health Enhanced: No overall maximum but combined maximum of $2,500 per calendar year with medical equipment, nursing, and prosthetics.
Medical Equipment:
Complete Health Entry: Not covered.
Complete Health Essential: No overall maximum.
Complete Health Enhanced: Combined maximum of $2,500 per calendar year with diabetic supplies, nursing, and prosthetics.
Nursing:
Complete Health Entry: Not covered.
Complete Health Essential: Coverage up to $3,500 every 2 calendar years.
Complete Health Enhanced: Coverage up to $5,600 every 2 calendar years.
Prosthetics:
Complete Health Entry: Not covered.
Complete Health Essential: Coverage up to $10,000 for a lifetime.
Complete Health Enhanced: Coverage up to $10,000 for a lifetime.
Accidental Dental:
Complete Health Entry: Coverage up to $7,000 for a lifetime.
Complete Health Essential: Coverage up to $7,000 for a lifetime.
Complete Health Enhanced: Coverage up to $7,000 for a lifetime.
Dental Benefits Comparison
Coverage Overview
Below is a comparison of dental benefits across the Complete Health Entry, Complete Health Essential, and Complete Health Enhanced plans, highlighting coverage limits for various dental services.
Dental Coverage
Fillings:
Complete Health Entry: Provides a combined maximum of $500 per calendar year, which includes coverage for dental exams, cleanings, and X-rays.
Complete Health Essential: There is no overall maximum for fillings, allowing for greater flexibility in dental care.
Complete Health Enhanced: There is also no overall maximum for fillings, providing extensive coverage for necessary dental work. However, it has a combined maximum of $1,000 per calendar year when including extractions and root canals.
Extractions and Root Canals:
Complete Health Entry: Not covered.
Complete Health Essential: There is no overall maximum, allowing for comprehensive coverage of extractions and root canal procedures.
Complete Health Enhanced: Coverage has a combined maximum of $1,000 per calendar year when including fillings.
Periodontal Services:
Complete Health Entry: Not covered.
Complete Health Essential: Not covered.
Complete Health Enhanced: Offers 60% coverage with a maximum of $1,200 per calendar year for periodontal services.
Major Dental Work:
Complete Health Entry: Not covered.
Complete Health Essential: Not covered.
Complete Health Enhanced: Provides 60% coverage with a maximum of $500 per calendar year for major dental work.
Orthodontics (for individuals aged 18 and under):
Complete Health Entry: Not covered.
Complete Health Essential: Not covered.
Complete Health Enhanced: Offers 60% coverage with a maximum reimbursement limit of $1,500 for lifetime coverage, with a monthly reimbursement limit of $125.
Accidental Death and Dismemberment Coverage Comparison
Coverage Overview
Below is a comparison of the Accidental Death and Dismemberment (AD&D) benefits across the Complete Health Entry, Complete Health Essential, and Complete Health Enhanced plans.
Accidental Death and Dismemberment Benefits
Complete Health Entry: This plan offers no coverage for accidental death and dismemberment.
Complete Health Essential: Provides coverage of up to $15,000 for the member or spouse, and $5,000 for each dependent child.
Complete Health Enhanced: Offers the highest coverage among the plans, providing up to $25,000 for the member or spouse, and $5,000 for each dependent child.
Drug Coverage Benefits Comparison
Drug Coverage Overview
Below is a comparison of health coverage benefits across the Complete Health Entry, Complete Health Essential, and Complete Health Enhanced plans, highlighting coverage limits for each category.
Drug Coverage Benefits
Maximum:
Complete Health Entry: Not applicable.
Complete Health Essential: Provides 70% coverage with no overall maximum.
Complete Health Enhanced: Offers 80% coverage with no overall maximum.
Complete Health Enhanced (additional note): Also provides coverage of $625 per calendar quarter for certain services.
Birth Control:
Complete Health Entry: Not covered.
Complete Health Essential: Covered.
Complete Health Enhanced: Covered.
Smoking Cessation:
Complete Health Entry: Not covered.
Complete Health Essential: Coverage up to $800 every 5 calendar years.
Complete Health Enhanced: Coverage up to $800 every 5 calendar years.
Allergy Serums:
Complete Health Entry: Not covered.
Complete Health Essential: Not covered.
Complete Health Enhanced: Coverage up to $500 per calendar year.
Vaccines:
Complete Health Entry: Not covered.
Complete Health Essential: Not covered.
Complete Health Enhanced: Coverage up to $250 per calendar year.
Erectile Dysfunction:
Complete Health Entry: Not covered.
Complete Health Essential: Not covered.
Complete Health Enhanced: Coverage up to $250 per calendar year.
Fertility:
Complete Health Entry: Not covered.
Complete Health Essential: Not covered.
Complete Health Enhanced: Coverage up to $1,500 per calendar year, with a total lifetime limit of $3,000.
Trip Duration Coverage Comparison
Coverage Overview
Below is a comparison of trip duration coverage across the Complete Health Entry, Complete Health Essential, and Complete Health Enhanced plans.
Trip Duration Benefits
Complete Health Entry: No coverage provided for trip duration.
Complete Health Essential: No coverage provided for trip duration.
Complete Health Enhanced: Coverage for trips lasting up to 30 days.
Complete Health Enhanced (additional option): Also includes the option for trips lasting up to 17 days.