Manulife Flexcare Plans Comparison

Core Health Plans

ComboPlus Plans (Health + Dental)

ComboPlus Starter

• Prescription Drugs: 70% coverage up to $500/year

• Dental: 70% coverage up to $500/year

• Vision: $150 every 2 years

• Paramedical Services: $300 per practitioner/year

• Travel Insurance: Not included

ComboPlus Basic

• Prescription Drugs: 70% coverage up to $1,000/year

• Dental: 80% coverage up to $750/year

• Vision: $150 every 2 years

• Paramedical Services: $300 per practitioner/year

• Travel Insurance: Not included

ComboPlus Enhanced

• Prescription Drugs: 90% coverage up to $2,400/year

• Dental: 100% coverage up to $1,500/year

• Vision: $250 every 2 years

• Paramedical Services: $400 per practitioner/year

• Travel Insurance: 9-day emergency coverage

Drug Coverage Comparison

Manulife Flexcare offers three distinct drug coverage options under its ComboPlus™ plans. Each plan caters to different medical needs and provides varying levels of reimbursement for prescription medication:

1. ComboPlus™ Starter: This plan provides drug coverage for generic medications only, establishing a maximum dispensing fee and specific exclusions on certain medication types.

2. ComboPlus™ Basic: Targeted primarily at seniors, this plan covers generic medications and broadens the reimbursement structure, allowing coverage for a larger portion of prescription costs.

3. ComboPlus™ Enhanced: This plan offers the most flexibility, allowing coverage for brand-name and generic drugs with higher reimbursement limits, especially for seniors.

Comparison of Drug Coverage Options:

ComboPlus™ Starter

• Generic drugs only

• Maximum dispensing fee: $6.50

• Exclusions: Covers all drugs, excluding smoking cessation, over-the-counter drugs, fertility drugs, and erectile dysfunction drugs.

• Reimbursement of eligible prescription costs: 70% of the first $750.

• Maximum per year: $525.

ComboPlus™ Basic

• Generic drugs only; no maximum for seniors' adjustments (65+).

• Covers smoking cessation and over-the-counter drugs.

• Reimbursement: 100% of the first $750, 70% of the next $4,972.

• Maximum per year: $5,000.

ComboPlus™ Enhanced

• Brand-name or generic drugs.

• Maximum dispensing fee: No maximum.

• Reimbursement: 90% of the first $2,222, 100% of the next $8,000.

• Maximum per year: $10,000.

Dental Coverage Comparison

Manulife Flexcare offers three different dental coverage options under its ComboPlus™ plans. Each plan is tailored to provide varying levels of dental care reimbursement, while also accommodating basic and major dental needs:

1. ComboPlus™ Starter: This plan covers essential dental maintenance services and provides a reimbursement rate for ongoing treatments, making it suitable for basic dental care.

2. ComboPlus™ Basic: This plan enhances coverage for a wider range of dental services while including additional reimbursement benefits for both routine and complex treatments.

3. ComboPlus™ Enhanced: This plan offers the most comprehensive dental coverage, covering a broader range of services, including major treatments over multiple years, and ensures higher reimbursement rates.

Comparison of Dental Coverage Options:

ComboPlus™ Starter

• Reimbursement for maintenance services: 70% of the first $575.

• Anniversary maximum for basic services: $400.

• Recall visits: Every 9 months.

ComboPlus™ Basic

• Reimbursement for maintenance services: 80% of the first $400, 50% of the next $860.

• Anniversary maximum: $750.

• Oral surgery not covered.

ComboPlus™ Enhanced

• Reimbursement for maintenance services: 100% of the first $500, 60% of the next $700.

• Anniversary maximum: $920.

• Major restorative services covered after Year 2, with additional reimbursement for procedures like surgical extractions and orthodontics.

Vision Care Coverage

Manulife Flexcare provides comprehensive vision care benefits through its ComboPlus™ plans. Each plan addresses different vision care needs, covering costs related to eye exams, corrective lenses, and laser eye surgery, ensuring flexibility for various visual health requirements:

1. ComboPlus™ Starter: This plan offers basic coverage for vision care, focusing on routine eye exams and simple corrective lenses.

2. ComboPlus™ Basic: This plan enhances the coverage limits for vision-related expenses, allowing for more comprehensive services while maintaining affordability.

3. ComboPlus™ Enhanced: This plan provides the highest level of vision care benefits, including substantial coverage for corrective lenses and advanced vision correction procedures such as laser eye surgery.

Comparison of Vision Care Options:

ComboPlus™ Starter

• Covers costs towards prescription lenses and frames: Maximum of $150 every 2 consecutive benefit years.

• Optometrist visit reimbursement: Maximum of $70 per 2 consecutive benefit years.

ComboPlus™ Basic

• Covers costs towards prescription lenses and frames: Maximum of $250 every 2 consecutive benefit years.

• Optometrist visit reimbursement: Maximum of $70 per 2 consecutive benefit years.

ComboPlus™ Enhanced

• Covers costs towards prescription lenses and frames: Maximum of $250 every 2 consecutive benefit years.

• Optometrist visit reimbursement: Maximum of $70 per 2 consecutive benefit years, ensuring regular eye care needs are met.

Extended Health Care Benefits

Manulife Flexcare provides a robust range of extended health care benefits through its ComboPlus™ plans. These benefits are designed to support various healthcare needs beyond what is offered by provincial health insurance, including paramedical services, homecare, and more. Each plan offers different coverage levels and maximum amounts, ensuring flexibility for individuals with varying health requirements:

1. ComboPlus™ Starter: This plan offers essential extended health care coverage, focusing on basic medical services and therapies to support overall health.

2. ComboPlus™ Basic: This plan enhances the coverage with additional benefits for paramedical services and greater reimbursement limits, catering to a wider array of healthcare needs.

3. ComboPlus™ Enhanced: This plan provides the most comprehensive coverage, ensuring extensive support for various medical services, therapies, and necessary medical equipment.

Comparison of Extended Health Care Benefits:

ComboPlus™ Starter

• Lifetime maximum coverage per person: $250,000.

• Paramedical services (e.g., chiropractor, massage therapist): Dollar maximum of $25 per visit, with a maximum of 20 visits per specialist.

• Registered psychologist visits: Maximum visits of 10, first visit $80, subsequent visits $65.

ComboPlus™ Basic

• Lifetime maximum coverage per person: $260,000 for seniors (65+).

• Paramedical services: Same dollar maximum of $25 per visit, maximum of 20 visits per specialist.

• Registered psychologist visits: Maximum visits of 15, first visit $80, subsequent visits $65.

ComboPlus™ Enhanced

• Lifetime maximum coverage per person: $500,000.

• Paramedical services: Same dollar maximum of $25 per visit, maximum of 20 visits per specialist.

• Registered psychologist visits: Maximum visits of 15, first visit $80, subsequent visits $65.

Homecare & Nursing Services:

• Coverage: Registered health professionals and necessary medical equipment.

  • Year 1: $1,000; Year 2: $1,300; Year 3: $1,500; Year 4: $1,700; Year 5+: $3,000.

DrugPlus™ and DentalPlus™ Coverage Comparison

Manulife Flexcare offers specialized DrugPlus™ and DentalPlus™ plans to provide comprehensive coverage for both prescription medications and dental care. These plans cater to different healthcare needs, ensuring members have access to essential drugs and dental services while maximizing flexibility and affordability:

Drug Coverage Options:

1. DrugPlus™ Basic: This plan is a guaranteed issue plan that provides essential coverage for prescription drugs and is designed for semi-regular medication needs, making it accessible for individuals without extensive medical underwriting.

2. DrugPlus™ Enhanced: This plan requires medical underwriting and offers expanded coverage for a wider array of medications and higher reimbursement limits, suited for those with more significant medical needs.

Comparison of DrugPlus™ Coverage Options:

DrugPlus™ Basic

• Requires Medical Underwriting: No, this is a guaranteed issue plan.

• Provides coverage for: Drug, Vision Care, and Extended Health Care Benefits at the same levels as the ComboPlus™ Basic plan.

• Maximum coverage limit: Matches ComboPlus™ Basic plan levels.

DrugPlus™ Enhanced

• Requires Medical Underwriting: Yes.

• Provides coverage for: Drug, Vision Care, and Extended Health Care Benefits at the same levels as the ComboPlus™ Enhanced plan.

• Maximum coverage limit: At the same levels as ComboPlus™ Enhanced plan.

Dental Coverage Options:

1. DentalPlus™ Basic: This plan is a guaranteed issue plan focusing on basic dental services for essential care, offering straightforward reimbursement levels for routine services.

2. DentalPlus™ Enhanced: This plan requires medical underwriting and provides expanded dental coverage, accommodating various dental needs, including more complex procedures.

Comparison of DentalPlus™ Coverage Options:

DentalPlus™ Basic

• Requires Medical Underwriting: No, this is a guaranteed issue plan.

• Covers services for: Fillings, cleanings, scaling, examinations, polishing, and select extractions.

• Reimbursement:

  • Year 1: 50% payment of the first $1,150 (anniversary year maximum of $575).

  • Year 2+: 80% of the first $400 and 50% of the next $860 (anniversary year maximum of $750).

  • Recall visits: Every 9 months.

DentalPlus™ Enhanced

• Requires Medical Underwriting: Yes.

• Covers services for: Fillings, cleanings, scaling, examinations, polishing, and select extractions, with added coverage for major restorative services.

• Reimbursement:

  • Year 1: 70% payment of the first $1,200 (anniversary year maximum of $840).

  • Year 2+: 100% of the first $500 and 60% of the next $700 (anniversary year maximum of $920).

  • Recall visits: Every 6 months.

Add-Ons Coverage Comparison

Manulife Flexcare offers several add-on options that enhance your existing health insurance plans, providing additional coverage tailored to specific needs. These add-ons are designed to address various healthcare, travel, and emergency situations, ensuring that you have comprehensive protection.

Vision Coverage Add-On:

1. Vision Enhanced: This add-on increases vision care coverage, providing greater reimbursement limits for vision-related expenses, suitable for members seeking more comprehensive eye care support.

Comparison of Vision Enhanced Add-On:

Vision Enhanced

• Coverage Increase: Increases total maximum vision coverage to $500 per person for 3 consecutive benefit years.

• Laser eye surgery: Includes $100 towards laser eye surgery.

• Optometrist visit reimbursement: Remains at a maximum of $70 per 2 consecutive benefit years.

Accidental Death and Dismemberment Coverage Add-On:

1. Accidental Death and Dismemberment Enhanced: This add-on significantly boosts the accidental death and dismemberment coverage, making it ideal for those seeking enhanced financial security.

Comparison of Accidental Death and Dismemberment Enhanced Add-On:

Accidental Death and Dismemberment Enhanced

• Coverage Amount: Increases coverage to a maximum of $50,000 for adults under 65.

• Coverage for children and adults: Maximum of $20,000 for children or adults aged 65 and over.

• Additional coverage can be purchased as an add-on.

Travel Coverage Add-On:

1. Travel +8 Days: This add-on extends emergency health coverage for travel, allowing for greater flexibility for those who travel frequently.

2. Travel +21 Days: This add-on offers an extended travel duration for emergency health coverage, accommodating longer trips.

Comparison of Travel Coverage Add-Ons:

Travel +8 Days

• Coverage: Adds 8 days of additional coverage to the existing 9-day coverage plan.

• Total trip coverage: Allows for trips lasting up to 17 days, with emergency health coverage of up to $5,000,000 per covered person.

Travel +21 Days

• Coverage: Adds 21 days of additional coverage to the existing 9-day coverage plan.

• Total trip coverage: Allows for trips lasting up to 30 days, with emergency health coverage of up to $5,000,000 per covered person.

Catastrophic Coverage Add-On:

1. Catastrophic Coverage: This add-on serves as a safety net for high medical expenses, ensuring that members are protected from significant out-of-pocket costs.

Comparison of Catastrophic Coverage Add-On:

Catastrophic Coverage

• Coverage Details: Designed for persons under 65; provides significant protection against substantial medical expenses.

• Deductible options: Includes options that cover all drug costs after a person pays a specified annual deductible.

Hospital Coverage Add-Ons:

1. Hospital Basic: This add-on provides essential coverage for hospital stays, ensuring that members receive care without excessive out-of-pocket costs.

2. Hospital Enhanced: This option offers expanded coverage, including higher-level reimbursement for services associated with hospital stays.

Comparison of Hospital Coverage Add-Ons:

Hospital Basic

• Coverage Details: Provides coverage for a semi-private room for the first 30 days (up to $150 every day) and 50% for the next 100 days (up to $75 every day).

• Additional benefits: $25 ($15 for Alberta) every day starting on day 4 if a semi-private room is not available (up to $750).

Hospital Enhanced

• Coverage Details: Provides coverage for a semi-private or private room with 100% coverage for every day in the hospital (up to $200 every day).

• Additional benefits: $50 ($20 for Alberta) every day starting on day 4 if a semi-private or private room is not available (up to $3,000).

Summary

Whether you're looking for comprehensive health and dental coverage or just the essentials, Manulife's FlexCare plans offer flexible and affordable options. ComboPlus plans are great for those wanting bundled health and dental benefits, while DrugPlus and DentalPlus plans allow for focused coverage depending on your needs. Optional add-ons like hospital and travel coverage let you customize your plan even further.

Have questions or need help selecting the best plan for your needs? Contact us today to get personalized guidance.