About PolicyMe’s
Health and Dental Insurance

Name: PolicyMe
Address: 60 Adelaide St E, Toronto, ON, M5C 3E4, Canada
Telephone: +1-866-999-7457
Price range: $$$

Get comprehensive coverage for medical expenses your provincial healthcare plan won’t cover.

Choose a health and dental insurance plan to learn more:

Are you planning on replacing or supplementing any existing health and dental insurance plans?

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Here’s how much value you get for your monthly premium

ÉG Soins dentaires

Based on public rates for a 32-year-old person from Ontario.

Compare PolicyMe with other insurance providers
Covered Benefit	Value Per Person
Dental (first year)	$500
Prescription drugs	$1,000
Vision (per two benefit years)	$260
Professional services/registered therapists	$600
Mental health services	$500
Speech therapist	-
Accidental dental	$10,000
Homecare, nursing & equipment (first year)	-
Total benefits	$12,860
Your total monthly premium:	$173/_month

What’s covered in this plan

Each covered person on this plan will receive the following benefits:

Dental Benefits

Prescription Drugs benefits
Annual maximum for all dental benefits combined	$500 every anniversary year
Basic preventative and restorative services ‍cleanings, basic services, oral exams and basic oral surgery	‍
Reimbursement rate	70%
Additional parameters	‍
Complete oral examinations Emergency and specific oral examinations Full-series X-rays and panoramic X-rays	1 every 3 anniversary years
Bitewing X-rays	1 every anniversary year
Recall examinations	1 every 9 months
Preventative teeth cleaning	1 every 9 months (up to 1 unit of polishing and up to 1 unit of scaling at recall exam)
Topical application of fluoride	1 every 9 months (for age 19 and under only)
Comprehensive services ‍endodontic, periodontal treatment and denture services	Not included in this plan
Major services ‍crowns, bridges, dentures on natural teeth	Not included in this plan
Orthodontics treatments to correct the bite	Not included in this plan

Prescription Drug Benefits

Prescription Drugs benefits
Annual maximum	$1,000   per anniversary year
Reimbursement rate	Covers 80% of the cost of eligible prescription drugs
Eligible prescription drugs	Non-Québec residents: Provincial formulary Québec residents: Covers generic name drugs
Dispensing fee	Covers $10 per perscription
Medications covered	This plan uses the Essentials Formulary. The Essentials Formulary covers drugs based on your provincial/territorial pharmacare formulary (excluding Quebec) and are within our managed formulary. It is meant for those who are not already covered by provincial drug plans. ‍ Quebec residents will have full coverage of generic prescriptions that have a Drug Identification Number (DIN) within our managed formulary. ‍ We do not cover prescription drugs used for lifestyle purposes, including but not limited to: • Erectile dysfunction • Infertility • Medicinal marijuana • Quitting smoking • Weight loss
Pre-existing medication use	Includes any pre-existing medication you take based on medical needs if they are listed in our approved drug formulary and meet coverage criteria.
Coordination with RAMQ	For Quebec residents to be eligible for prescription drug coverage under this policy, you must be registered under the RAMQ Public Prescription Drug Insurance Plan

Vision Benefits

Prescription Drugs benefits
Eye examination	$60 every 2 benefit years
Eyewear	$200 every 2 benefit years
List of covered items	• Prescription eyeglasses, including lenses and frames • Prescription contact lenses • Laser eye surgery

Extended Health Benefits

Prescription Drugs benefits
Professional services	‍
Annual combined maximum for all professional services	$600 per anniversary year ‍ Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	50%
List of covered licensed and registered practitioners	• Acupuncturist • Chiropodist • Chiropractor • Dietitian • Massage therapist • Naturopath • Osteopath • Physiotherapist • Podiatrist
Mental health services	‍
Annual combined maximum for mental health services	$500 per anniversary year ‍ Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	$75 per session
List of covered licensed and registered mental health practitioners	• Clinical counselor • Professional with a Master of Social Work • Registered psychologist • Registered psychotherapist • Registered social worker
Speech therapist	Not included in this plan
Accidental dental benefits	‍
Maximums	$10,000 per anniversary year
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
In-province emergency ambulance transportation benefits	‍
Maximums	Covers the difference between the amount allowed under the provincial government health insurance plan and the reasonable and customary limit
Medical services Diagnostic services benefits (Quebec only) services like diagnostic tests, x-rays, ultrasounds and laboratory tests	Not included in this plan
Home support service, medical items and medical equipment	Not included in this plan
Home support service	Not included in this plan
CPAP, BIPAP and APAP	Not included in this plan
Compression stockings	Not included in this plan
Custom-made orthotics	Not included in this plan
Custom-made footwear	Not included in this plan
Diabetic, blood glucose meter, glucose monitoring system and supplies	Not included in this plan
Hearing aids	Not included in this plan
Mobility aids canes, crutches, walkers and wheelchairs (including wheelchair batteries)	Not included in this plan

In-Province Hospital Accommodation Benefits

Prescription Drugs benefits
Room coverage in a public hospital	Not included in this plan

Additional Mental Health Support

Prescription Drugs benefits
Available services	Confidential online peer support and self-guided mental wellness resources available 24/7 via TogetherAll
Plan member access	Available to all household members aged 16 and older, including spouses, children and extended family

Benefit year: Each successive 12-month period following the date a claim for a specified benefit is first incurred under the policy.

Anniversary year: Each successive 12-month period following the effective date of the policy.

This information is for informational purposes only and is not an insurance contract or offer of coverage. It is intended to provide a general overview of the insurance product available to help you make an informed decision. The information presented is subject to change and may differ from the actual policy issued. For full details on the insurance coverage, including terms and conditions, please refer to the final policy contract issued to you or speak with one of our licensed insurance advisors. PolicyMe Life, Critical Illness, and Health & Dental insurance plans are underwritten by Canadian Premier Life Insurance Company of Canada and sales are conducted by PolicyMe Corp. The insurance transaction is between the client and Canadian Premier Life Insurance Company. Securian Canada is the brand name used by Canadian Premier Life Insurance Company to do business in Canada. PolicyMe Corp., doing business as PolicyMe, a licensed Life and Accident & Sickness insurance agency, acts as the administrator and technology provider of PolicyMe Life, Critical Illness and Health & Dental insurance plans on behalf of Securian Canada. PolicyMe is compensated by way of commissions by Securian Canada for sales of insurance. For our full disclosure notices, please visit policyme.com/legal

Here’s how much value you get for your monthly premium

Classic Plan - Protect

Based on public rates for a 32-year-old person from Ontario.

Compare PolicyMe with other insurance providers
Covered Benefit	Value Per Person
Dental (first year)	$750
Prescription drugs	$1,600
Vision (per two benefit years)	$310
Professional services/registered therapists	$750
Mental health services	$800
Speech therapist	$500
Accidental dental	$10,000
Homecare, nursing & equipment (first year)	$500
Total benefits	$15,210
Your total monthly premium:	$214/_month

What’s covered in this plan

Each covered person on this plan will receive the following benefits:

Dental Benefits

Prescription Drugs benefits
Annual maximum for all dental benefits combined	Per anniversary year – ‍ Year 1 $750 ‍ Year 2+ $900
Basic preventative and restorative services cleanings, basic services, oral exams and basic oral surgery	‍
Reimbursement rate‍	80%
Additional parameters	‍
Complete oral examinations Emergency and specific oral examinations Full-series X-rays and panoramic X-rays	1 every 3 anniversary years
Bitewing X-rays	1 every anniversary year
Recall examinations	1 every 9 months
Preventative teeth cleaning	1 every 9 months (up to 1 unit of polishing and up to 1 unit of scaling at recall exam)
Topical application of fluoride	1 every 9 months (for age 19 and under only)
Comprehensive services ‍endodontic, periodontal treatment and denture services	‍
Reimbursement rate	60%
Additional parameters	‍
Periodontal scaling and/or root planing Occlusal equilibration	6 units every anniversary year
Standard relining or rebasing of dentures	1 every 3 anniversary year
Major services crowns, bridges, dentures on natural teeth	‍
Reimbursement rate	Year 3+ 50%
Additional parameters	‍
Denture cleaning	1 every anniversary year
Additional details	An estimate completed by a legally qualified Dental Practitioner must be submitted for assessment and pre-approval
Orthodontics treatments to correct the bite	Not included in this plan

Prescription Drug Benefits

Prescription Drugs benefits
Annual maximum	$1,600 per anniversary year
Reimbursement rate	Reimbursement is provided up to the reasonable and customary limit
Eligible prescription drugs	Covers generic name drugs
Dispensing fee	Reimbursement is provided up to the reasonable and customary limit.
Medications covered	We fully cover birth control and any generic prescriptions that have a Drug Identification Number (DIN), are dispensed by a licensed pharmacist and are listed in our approved drug formulary. ‍ Some drugs require pre-approval through our review process before reimbursement. ‍ Pre-existing conditions do not guarantee coverage, and only drugs listed in our formulary are eligible. Brand name medications will only be covered if no generic option exists. ‍ We do not cover prescription drugs used for lifestyle purposes, including but not limited to: • Erectile dysfunction • Infertility • Medicinal marijuana • Quitting smoking • Weight loss
Pre-existing medication use	Includes any pre-existing medication you take based on medical needs if they are listed in our approved drug formulary and meet coverage criteria
Coordination with RAMQ	For Quebec residents to be eligible for prescription drug coverage under this policy, you must be registered under the RAMQ Public Prescription Drug Insurance Plan

Vision Benefits

Prescription Drugs benefits
Eye examination	$60 every 2 benefit years
Eyewear	$250 every 2 benefit years
List of items covered	• Prescription eyeglasses, including lenses and frames • Prescription contact lenses • Laser eye surgery

Extended Health Benefits

Prescription Drugs benefits
Professional services	‍
Annual combined maximum for all professional services	$750 per anniversary year Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	80%
List of covered licensed and registered practitioners	• Acupuncturist • Chiropodist • Chiropractor • Dietitian • Massage therapist • Naturopath • Osteopath • Physiotherapist • Podiatrist
Mental health services	‍
Annual combined maximum for mental health services	$800 per anniversary year ‍ Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	$100 per session
List of covered licensed and registered mental health practitioners	• Clinical counselor • Professional with a Master of Social Work • Registered psychologist • Registered psychotherapist • Registered social worker
Speech therapist	‍
Maximums	$500 per anniversary year
Reimbursement rate	70%
Accidental dental benefits	‍
Maximums	$10,000   per anniversary year
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
In-province emergency ambulance transportation benefits	‍
Maximums	Covers the difference between the amount allowed under the provincial government health insurance plan and the reasonable and customary limit
Medical services Diagnostic services benefits (Quebec only) services like diagnostic tests, x-rays, ultrasounds and laboratory tests	‍
Maximums	$1,000 per anniversary year
Home support service, medical items and medical equipment	‍
Annual combined maximum for homecare and nursing, prosthetic appliances and durable medical equipment	Per anniversary year – ‍ Year 1 $500 ‍ Year 2 $1,000 ‍ Year 3+ $2,000
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
Waiting period (if applicable)	3 month waiting period applies (except diabetic supplies)
Home support service	‍
List of covered professionals	• Registered Nurse (R.N.) • Registered Practical Nurse (R.P.N.) • Licensed Practical Nurse (L.P.N) • Personal Support Worker (PSW) • Occupational Therapist
Additional details	• Pre-authorization form must be submitted and approved before any reimbursement* • Services must be done in the home (per visit) to be eligible and virtual home services is not covered
CPAP, BIPAP and APAP	‍
Maximums	Combined device and supply maximum per anniversary year – ‍ Year 1 $250 ‍ Year 2 $250 ‍ Year 3+ Included as part of overall maximum for home support service, medical items and medical equipment ‍ Reimbursement is provided up to the reasonable and customary limit
Compression stockings	‍
Maximums	2 pairs every 2 benefit years
Custom-made orthotics	‍
Maximums	$225 every 2 benefit years
‍Custom-made footwear	‍
Maximums	$500 every 2 benefit years
‍Diabetic, blood glucose meter, glucose monitoring system and supplies	‍
Maximums	$500 per benefit year
‍Hearing aids	‍
Maximums	$400 every 4 benefit years
‍Mobility aids ‍ canes, crutches, walkers and wheelchairs (including wheelchair batteries)	‍
Maximums	• Subject to $2,500 lifetime maximum • Included within the annual combined maximum for home support service, medical items and medical equipment

In-Province Hospital Accommodation Benefits

Prescription Drugs benefits
Room coverage in a public hospital	Semi-private hospital room covered at 100% for first 60 days (up to $200 every day) and 50% for next 90 days (up to $100 every day)

Additional Mental Health Support

Prescription Drugs benefits
Available services	Confidential online peer support and self-guided mental wellness resources available 24/7 via TogetherAll
Plan member access	Available to all household members aged 16 and older, including spouses, children and extended family

Benefit year: Each successive 12-month period following the date a claim for a specified benefit is first incurred under the policy.

Anniversary year: Each successive 12-month period following the effective date of the policy.

Here’s how much value you get for your monthly premium

Dental Care Plan - Guaranteed Issue

Based on public rates for a 32-year-old person from Ontario.

Compare PolicyMe with other insurance providers
Covered Benefit	Value Per Person
Dental (first year)	$750
Prescription drugs	-
Vision (per two benefit years)	$310
Professional services/registered therapists	$750
Mental health services	$800
Speech therapist	$500
Accidental dental	$10,000
Homecare, nursing & equipment (first year)	$500
Total benefits	$13,610
Your total monthly premium:	$135/_month

What’s covered in this plan

Each covered person on this plan will receive the following benefits:

Dental Benefits

Prescription Drugs benefits
Annual maximum for all dental benefits combined	Per anniversary year – ‍ Year 1 $750 ‍ Year 2+ $900
Basic preventative and restorative services cleanings, basic services, oral exams and basic oral surgery	‍
Reimbursement rate‍	80%
Additional parameters	‍
Complete oral examinations Emergency and specific oral examinations Full-series X-rays and panoramic X-rays	1 every 3 anniversary years
Bitewing X-rays	1 every anniversary year
Recall examinations	1 every 9 months
Preventative teeth cleaning	1 every 6 months (up to 1 unit of polishing and up to 1 unit of scaling at recall exam)
Topical application of fluoride	1 every 9 months (for age 19 and under only)
Comprehensive services ‍endodontic, periodontal treatment and denture services	‍
Reimbursement rate	60%
Additional parameters	‍
Periodontal scaling and/or root planing Occlusal equilibration	6 units every anniversary year
Standard relining or rebasing of dentures	1 every 3 anniversary year
Major services crowns, bridges, dentures on natural teeth	‍
Reimbursement rate	Year 3+ 50%
Additional parameters	‍
Denture cleaning	1 every anniversary year
Additional details	An estimate completed by a legally qualified Dental Practitioner must be submitted for assessment and pre-approval
Orthodontics treatments to correct the bite	Not included in this plan

Prescription Drug Benefits

Prescription Drugs benefits
Not included in this plan	‍

Vision Benefits

Prescription Drugs benefits
Eye examination	$60 every 2 benefit years
Eyewear	$250 every 2 benefit years
List of items covered	• Prescription eyeglasses, including lenses and frames • Prescription contact lenses • Laser eye surgery

Extended Health Benefits

Prescription Drugs benefits
Professional services	‍
Annual combined maximum for all professional services	$750 per anniversary year Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	80%
List of covered licensed and registered practitioners	• Acupuncturist • Chiropodist • Chiropractor • Dietitian • Massage therapist • Naturopath • Osteopath • Physiotherapist • Podiatrist
Mental health services	‍
Annual combined maximum for mental health services	$800 per anniversary year ‍ Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	$100 per session
List of covered licensed and registered mental health practitioners	• Clinical counselor • Professional with a Master of Social Work • Registered psychologist • Registered psychotherapist • Registered social worker
Speech therapist	‍
Maximums	$500 per anniversary year
Reimbursement rate	70%
Accidental dental benefits	‍
Maximums	$10,000   per anniversary year
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
In-province emergency ambulance transportation benefits	‍
Maximums	Covers the difference between the amount allowed under the provincial government health insurance plan and the reasonable and customary limit
Medical services Diagnostic services benefits (Quebec only) services like diagnostic tests, x-rays, ultrasounds and laboratory tests	‍
Maximums	$1,000 per anniversary year
Home support service, medical items and medical equipment	‍
Annual combined maximum for homecare and nursing, prosthetic appliances and durable medical equipment	Per anniversary year – ‍ Year 1 $500 ‍ Year 2 $1,000 ‍ Year 3+ $2,000
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
Waiting period (if applicable)	3 month waiting period applies (except diabetic supplies)
Home support service	‍
List of covered professionals	• Registered Nurse (R.N.) • Registered Practical Nurse (R.P.N.) • Licensed Practical Nurse (L.P.N) • Personal Support Worker (PSW) • Occupational Therapist
Additional details	• Pre-authorization form must be submitted and approved before any reimbursement* • Services must be done in the home (per visit) to be eligible and virtual home services is not covered
CPAP, BIPAP and APAP	‍
Maximums	Combined device and supply maximum per anniversary year – ‍ Year 1 $250 ‍ Year 2 $250 ‍ Year 3+ Included as part of overall maximum for home support service, medical items and medical equipment ‍ Reimbursement is provided up to the reasonable and customary limit
Compression stockings	‍
Maximums	2 pairs every 2 benefit years
Custom-made orthotics	‍
Maximums	$225 every 2 benefit years
‍Custom-made footwear	‍
Maximums	$500 every 2 benefit years
‍Diabetic, blood glucose meter, glucose monitoring system and supplies	‍
Maximums	$500 per benefit year
‍Hearing aids	‍
Maximums	$400 every 4 benefit years
‍Mobility aids ‍ canes, crutches, walkers and wheelchairs (including wheelchair batteries)	‍
Maximums	• Subject to $2,500 lifetime maximum • Included within the annual combined maximum for home support service, medical items and medical equipment

In-Province Hospital Accommodation Benefits

Prescription Drugs benefits
Room coverage in a public hospital	Not included in this plan

Additional Mental Health Support

Prescription Drugs benefits
Available services	Confidential online peer support and self-guided mental wellness resources available 24/7 via TogetherAll
Plan member access	Available to all household members aged 16 and older, including spouses, children and extended family

Benefit year: Each successive 12-month period following the date a claim for a specified benefit is first incurred under the policy.

Anniversary year: Each successive 12-month period following the effective date of the policy.

Here’s how much value you get for your monthly premium

Advanced Plan - Protect

Based on public rates for a 32-year-old person from Ontario.

Compare PolicyMe with other insurance providers
Covered Benefit	Value Per Person
Dental (first year)	$800
Prescription drugs	$2,800
Vision (per two benefit years)	$500
Professional services/registered therapists	$1,000
Mental health services	$1,300
Speech therapist	$500
Accidental dental	$10,000
Homecare, nursing & equipment (first year)	$1,000
Total benefits	$17,900
Your total monthly premium:	$315/_month

What’s covered in this plan

Each covered person on this plan will receive the following benefits:

Dental Benefits

Prescription Drugs benefits
Annual maximum for all dental benefits combined	Per anniversary year – ‍ Year 1 $800 ‍ Year 2+ $1,200
Basic preventative and restorative services ‍cleanings, basic services, oral exams and basic oral surgery	‍
Reimbursement rate	90%
Additional parameters	‍
Complete oral examinations Emergency and specific oral examinations Full-series X-rays and panoramic X-rays	1 every 3 anniversary years
Bitewing X-rays	1 every anniversary year
Recall examinations	1 every 6 months
Preventative teeth cleaning	1 every 6 months (up to 1 unit of polishing and up to 1 unit of scaling at recall exam)
Topical application of fluoride	1 every 6 months (for age 19 and under only)
Comprehensive services endodontic, periodontal treatment and denture services	‍
Reimbursement rate	80%
Additional parameters	‍
Periodontal scaling and/or root planing Occlusal equilibration	6 units every anniversary year
Standard relining or rebasing of dentures	1 every 3 anniversary years
Major services crowns, bridges, dentures on natural teeth	‍
Reimbursement rate	Year 2+ 60%
Additional parameters	‍
Denture cleaning	1 every anniversary year
Additional details	An estimate completed by a legally qualified Dental Practitioner must be submitted for assessment and pre-approval*
Orthodontics treatments to correct the bite	‍
Reimbursement rate	Year 2+ 60% ‍ Subject to $2,500 lifetime orthodontics maximum
Additional details	Pre-authorization form must be submitted and approved before any orthodontic treatment begins*

Prescription Drug Benefits

Prescription Drugs benefits
Annual maximum	$2,800   per anniversary year
Reimbursement rate	Reimbursement is provided up to the reasonable and customary limit
Eligible prescription drugs	Covers generic name drugs
Dispensing fee	Reimbursement is provided up to the reasonable and customary limit
Medications covered	We fully cover birth control and any generic prescriptions that have a Drug Identification Number (DIN), are dispensed by a licensed pharmacist and are listed in our approved drug formulary. ‍ Some drugs require pre-approval through our review process before reimbursement. ‍ Pre-existing conditions do not guarantee coverage, and only drugs listed in our formulary are eligible. Brand name medications will only be covered if no generic option exists. ‍ We do not cover prescription drugs used for lifestyle purposes, including but not limited to: • Erectile dysfunction • Infertility • Medicinal marijuana • Quitting smoking • Weight loss
Pre-existing medication use	Includes any pre-existing medication you take based on medical needs if they are listed in our approved drug formulary and meet coverage criteria
Coordination with RAMQ	If you are a Quebec resident, your prescription drug claims must first be submitted to RAMQ. Any remaining, unpaid portion that is eligible under this policy can then be submitted to us for reimbursement. The coinsurance and deductible that you must pay under their plan with RAMQ are eligible under this policy. Some prescription drugs require pre-approval first from RAMQ. You must submit your pre-approval from RAMQ first before submitting the claim to us for any remaining balance.

Vision Benefits

Prescription Drugs benefits
Eye examination	$100   every 2 benefit years
Eyewear	$400 every 2 benefit years
List of items covered	• Prescription eyeglasses, including lenses and frames • Prescription contact lenses • Laser eye surgery

Extended Health Benefits

Prescription Drugs benefits
Professional services	‍
Annual combined maximum for all professional services	$1,000 per anniversary year Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	80%
List of covered licensed and registered practitioners	• Acupuncturist • Chiropodist • Chiropractor • Dietitian • Massage therapist • Naturopath • Osteopath • Physiotherapist • Podiatrist
Mental health services	‍
Annual combined maximum for mental health services	$1,300 per anniversary year ‍ Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	$100 per session
List of covered licensed and registered mental health practitioners	• Clinical counselor • Professional with a Master of Social Work • Registered psychologist • Registered psychotherapist • Registered social worker
Speech therapist	‍
Maximums	$500 per anniversary year
Reimbursement rate	70%
Accidental dental benefits	‍
Maximums	$10,000   per anniversary year
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
In-province emergency ambulance transportation benefits	‍
Maximums	Covers the difference between the amount allowed under the provincial government health insurance plan and the reasonable and customary limit
Medical services Diagnostic services benefits (Quebec only) services like diagnostic tests, x-rays, ultrasounds and laboratory tests	‍
Maximums	$1,000 per anniversary year
Home support service, medical items and medical equipment	‍
Annual combined maximum for homecare and nursing, prosthetic appliances and durable medical equipment	Per anniversary year – ‍ Year 1 $1000 ‍ Year 2 $2,000 ‍ Year 3+ $4,000
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
Waiting period (if applicable)	3 month waiting period applies (except diabetic supplies)
Home support service	‍
List of covered professionals	• Registered Nurse (R.N.) • Registered Practical Nurse (R.P.N.) • Licensed Practical Nurse (L.P.N) • Personal Support Worker (PSW) • Occupational Therapist
Additional details	• Pre-authorization form must be submitted and approved before any reimbursement* • Services must be done in the home (per visit) to be eligible and virtual home services is not covered
CPAP, BIPAP and APAP	‍
Maximums	Combined device and supply maximum per anniversary year – ‍ Year 1 $250 ‍ Year 2 $250 ‍ Year 3+ Included as part of overall maximum for home support service, medical items and medical equipment ‍ Reimbursement is provided up to the reasonable and customary limit
Compression stockings	‍
Maximums	2 pairs every 2 benefit years
Custom-made orthotics	‍
Maximums	$225 every 2 benefit years
‍Custom-made footwear	‍
Maximums	$500 every 2 benefit years
‍Diabetic, blood glucose meter, glucose monitoring system and supplies	‍
Maximums	$500 per benefit year
‍Hearing aids	‍
Maximums	$400 every 4 benefit years
‍Mobility aids ‍ canes, crutches, walkers and wheelchairs (including wheelchair batteries)	‍
Maximums	• Subject to $2,500 lifetime maximum • Included within the annual combined maximum for home support service, medical items and medical equipment

In-Province Hospital Accommodation Benefits

Prescription Drugs benefits
Room coverage in a public hospital	Semi-private hospital room covered at 100% for first 60 days (up to $200 every day) and 50% for next 90 days (up to $100 every day)

Additional Mental Health Support

Prescription Drugs benefits
Available services	Confidential online peer support and self-guided mental wellness resources available 24/7 via TogetherAll
Plan member access	Available to all household members aged 16 and older, including spouses, children and extended family

Benefit year: Each successive 12-month period following the date a claim for a specified benefit is first incurred under the policy.

Anniversary year: Each successive 12-month period following the effective date of the policy.

Choose your plan (0):

Here’s how much value you get for your monthly premium

Economic Plan - Guaranteed Issue

Based on public rates for a 32-year-old person from Ontario.

Compare PolicyMe with other insurance providers
Covered Benefit	Value Per Person
Dental (first year)	$500
Prescription drugs	$500
Vision (per two benefit years)	$260
Professional services/registered therapists	$600
Mental health services	$500
Speech therapist	–
Accidental dental	$10,000
Homecare, nursing & equipment (first year)	–
Total benefits	$12,360
Your total monthly premium:	$134/_month

What’s covered in this plan

Each covered person on this plan will receive the following benefits:

Dental Benefits

Prescription Drugs benefits
Annual maximum for all dental benefits combined	$500 every anniversary year
Basic preventative and restorative services ‍cleanings, basic services, oral exams and basic oral surgery	‍
Reimbursement rate	70%
Additional parameters	‍
Complete oral examinations Emergency and specific oral examinations Full-series X-rays and panoramic X-rays	1 every 3 anniversary years
Bitewing X-rays	1 every anniversary year
Recall examinations	1 every 9 months
Preventative teeth cleaning	1 every 9 months (up to 1 unit of polishing and up to 1 unit of scaling at recall exam)
Topical application of fluoride	1 every 9 months (for age 19 and under only)
Comprehensive services ‍endodontic, periodontal treatment and denture services	Not included in this plan
Major services ‍crowns, bridges, dentures on natural teeth	Not included in this plan
Orthodontics treatments to correct the bite	Not included in this plan

Prescription Drug Benefits

Prescription Drugs benefits
Annual maximum	$500 per anniversary year
Reimbursement rate	Covers 70% of the cost of eligible prescription drugs
Eligible prescription drugs	Non-Québec residents: Provincial formulary Québec residents: Covers generic name drugs
Dispensing fee	Covers $10 per perscription
Medications covered	This plan uses the Essentials Formulary. The Essentials Formulary covers drugs based on your provincial/territorial pharmacare formulary (excluding Quebec) and are within our managed formulary. It is meant for those who are not already covered by provincial drug plans. ‍ Quebec residents will have full coverage of generic prescriptions that have a Drug Identification Number (DIN) within our managed formulary. ‍ We do not cover prescription drugs used for lifestyle purposes, including but not limited to: • Erectile dysfunction • Infertility • Medicinal marijuana • Quitting smoking • Weight loss
Pre-existing medication use	Includes any pre-existing medication you take based on medical needs if they are listed in our approved drug formulary and meet coverage criteria
Coordination with RAMQ	For Quebec residents to be eligible for prescription drug coverage under this policy, you must be registered under the RAMQ Public Prescription Drug Insurance Plan

Vision Benefits

Prescription Drugs benefits
Eye examination	$60 every 2 benefit years
Eyewear	$200 every 2 benefit years
List of items covered	• Prescription eyeglasses, including lenses and frames • Prescription contact lenses • Laser eye surgery

Extended Health Benefits

Prescription Drugs benefits
Professional services	‍
Annual combined maximum for all professional services	$600 per anniversary year Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	50%
List of covered licensed and registered practitioners	• Acupuncturist • Chiropodist • Chiropractor • Dietitian • Massage therapist • Naturopath • Osteopath • Physiotherapist • Podiatrist
Mental health services	‍
Annual combined maximum for mental health services	$500 per anniversary year ‍ Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	$75 per session
List of covered licensed and registered mental health practitioners	• Clinical counselor • Professional with a Master of Social Work • Registered psychologist • Registered psychotherapist • Registered social worker
Speech therapist	Not included in this plan
Accidental dental benefits	‍
Maximums	$10,000   per anniversary year
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
In-province emergency ambulance transportation benefits	‍
Maximums	Covers the difference between the amount allowed under the provincial government health insurance plan and the reasonable and customary limit
Medical services Diagnostic services benefits (Quebec only) services like diagnostic tests, x-rays, ultrasounds and laboratory tests	Not included in this plan
Home support service, medical items and medical equipment	Not included in this plan
Home support service	Not included in this plan
CPAP, BIPAP and APAP	Not included in this plan
Compression stockings	Not included in this plan
Custom-made orthotics	Not included in this plan
‍Custom-made footwear	Not included in this plan
‍Diabetic, blood glucose meter, glucose monitoring system and supplies	Not included in this plan
‍Hearing aids	Not included in this plan
‍Mobility aids ‍ canes, crutches, walkers and wheelchairs (including wheelchair batteries)	Not included in this plan

In-Province Hospital Accommodation Benefits

Prescription Drugs benefits
Room coverage in a public hospital	Not included in this plan

Additional Mental Health Support

Prescription Drugs benefits
Available services	Confidential online peer support and self-guided mental wellness resources available 24/7 via TogetherAll
Plan member access	Available to all household members aged 16 and older, including spouses, children and extended family

Benefit year: Each successive 12-month period following the date a claim for a specified benefit is first incurred under the policy.

Anniversary year: Each successive 12-month period following the effective date of the policy.

Here’s how much value you get for your monthly premium

Classic Plan - Guaranteed Issue

Based on public rates for a 32-year-old person from Ontario.

Compare PolicyMe with other insurance providers
Covered Benefit	Value Per Person
Dental (first year)	$750
Prescription drugs	$600
Vision (per two benefit years)	$310
Professional services/registered therapists	$750
Mental health services	$800
Speech therapist	$500
Accidental dental	$10,000
Homecare, nursing & equipment (first year)	$500
Total benefits	$14,210
Your total monthly premium:	$162/_month

What’s covered in this plan

Each covered person on this plan will receive the following benefits:

Dental Benefits

Prescription Drugs benefits
Annual maximum for all dental benefits combined	Per anniversary year – ‍ Year 1 $750 ‍ Year 2+ $900
Basic preventative and restorative services cleanings, basic services, oral exams and basic oral surgery	‍
Reimbursement rate‍	80%
Additional parameters	‍
Complete oral examinations Emergency and specific oral examinations Full-series X-rays and panoramic X-rays	1 every 3 anniversary years
Bitewing X-rays	1 every anniversary year
Recall examinations	1 every 9 months
Preventative teeth cleaning	1 every 6 months (up to 1 unit of polishing and up to 1 unit of scaling at recall exam)
Topical application of fluoride	1 every 9 months (for age 19 and under only)
Comprehensive services ‍endodontic, periodontal treatment and denture services	‍
Reimbursement rate	60%
Additional parameters	‍
Periodontal scaling and/or root planing Occlusal equilibration	6 units every anniversary year
Standard relining or rebasing of dentures	1 every 3 anniversary year
Major services crowns, bridges, dentures on natural teeth	‍
Reimbursement rate	Year 3+ 50%
Additional parameters	‍
Denture cleaning	1 every anniversary year
Additional details	An estimate completed by a legally qualified Dental Practitioner must be submitted for assessment and pre-approval
Orthodontics treatments to correct the bite	Not included in this plan

Prescription Drug Benefits

Prescription Drugs benefits
Annual maximum	$600 per anniversary year
Reimbursement rate	Covers 70% of the cost of eligible prescription drugs
Eligible prescription drugs	Covers generic name drugs
Dispensing fee	Reimbursement is provided up to the reasonable and customary limit.
Medications covered	We fully cover birth control and any generic prescriptions that have a Drug Identification Number (DIN), are dispensed by a licensed pharmacist and are listed in our approved drug formulary. ‍ Some drugs require pre-approval through our review process before reimbursement. ‍ Pre-existing conditions do not guarantee coverage, and only drugs listed in our formulary are eligible. Brand name medications will only be covered if no generic option exists. ‍ We do not cover prescription drugs used for lifestyle purposes, including but not limited to: • Erectile dysfunction • Infertility • Medicinal marijuana • Quitting smoking • Weight loss
Pre-existing medication use	Includes any pre-existing medication you take based on medical needs if they are listed in our approved drug formulary and meet coverage criteria
Coordination with RAMQ	For Quebec residents to be eligible for prescription drug coverage under this policy, you must be registered under the RAMQ Public Prescription Drug Insurance Plan

Vision Benefits

Prescription Drugs benefits
Eye examination	$60 every 2 benefit years
Eyewear	$250 every 2 benefit years
List of items covered	• Prescription eyeglasses, including lenses and frames • Prescription contact lenses • Laser eye surgery

Extended Health Benefits

Prescription Drugs benefits
Professional services	‍
Annual combined maximum for all professional services	$750 per anniversary year Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	80%
List of covered licensed and registered practitioners	• Acupuncturist • Chiropodist • Chiropractor • Dietitian • Massage therapist • Naturopath • Osteopath • Physiotherapist • Podiatrist
Mental health services	‍
Annual combined maximum for mental health services	$800 per anniversary year ‍ Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	$100 per session
List of covered licensed and registered mental health practitioners	• Clinical counselor • Professional with a Master of Social Work • Registered psychologist • Registered psychotherapist • Registered social worker
Speech therapist	‍
Maximums	$500 per anniversary year
Reimbursement rate	70%
Accidental dental benefits	‍
Maximums	$10,000   per anniversary year
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
In-province emergency ambulance transportation benefits	‍
Maximums	Covers the difference between the amount allowed under the provincial government health insurance plan and the reasonable and customary limit
Medical services Diagnostic services benefits (Quebec only) services like diagnostic tests, x-rays, ultrasounds and laboratory tests	‍
Maximums	$1,000 per anniversary year
Home support service, medical items and medical equipment	‍
Annual combined maximum for homecare and nursing, prosthetic appliances and durable medical equipment	Per anniversary year – ‍ Year 1 $500 ‍ Year 2 $1,000 ‍ Year 3+ $2,000
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
Waiting period (if applicable)	3 month waiting period applies (except diabetic supplies)
Home support service	‍
List of covered professionals	• Registered Nurse (R.N.) • Registered Practical Nurse (R.P.N.) • Licensed Practical Nurse (L.P.N) • Personal Support Worker (PSW) • Occupational Therapist
Additional details	• Pre-authorization form must be submitted and approved before any reimbursement* • Services must be done in the home (per visit) to be eligible and virtual home services is not covered
CPAP, BIPAP and APAP	‍
Maximums	Combined device and supply maximum per anniversary year – ‍ Year 1 $250 ‍ Year 2 $250 ‍ Year 3+ Included as part of overall maximum for home support service, medical items and medical equipment ‍ Reimbursement is provided up to the reasonable and customary limit
Compression stockings	‍
Maximums	2 pairs every 2 benefit years
Custom-made orthotics	‍
Maximums	$225 every 2 benefit years
‍Custom-made footwear	‍
Maximums	$500 every 2 benefit years
‍Diabetic, blood glucose meter, glucose monitoring system and supplies	‍
Maximums	$500 per benefit year
‍Hearing aids	‍
Maximums	$400 every 4 benefit years
‍Mobility aids ‍ canes, crutches, walkers and wheelchairs (including wheelchair batteries)	‍
Maximums	• Subject to $2,500 lifetime maximum • Included within the annual combined maximum for home support service, medical items and medical equipment

In-Province Hospital Accommodation Benefits

Prescription Drugs benefits
Room coverage in a public hospital	Not included in this plan

Additional Mental Health Support

Prescription Drugs benefits
Available services	Confidential online peer support and self-guided mental wellness resources available 24/7 via TogetherAll
Plan member access	Available to all household members aged 16 and older, including spouses, children and extended family

Benefit year: Each successive 12-month period following the date a claim for a specified benefit is first incurred under the policy.

Anniversary year: Each successive 12-month period following the effective date of the policy.

Here’s how much value you get for your monthly premium

Dental Care Plan - Guaranteed Issue

Based on public rates for a 32-year-old person from Ontario.

Compare PolicyMe with other insurance providers
Covered Benefit	Value Per Person
Dental (first year)	$750
Prescription drugs	-
Vision (per two benefit years)	$250
Professional services/registered therapists	$750
Mental health services	$800
Speech therapist	$500
Accidental dental	$10,000
Homecare, nursing & equipment (first year)	$500
Total benefits	$13,550
Your total monthly premium:	$135/_month

What’s covered in this plan

Each covered person on this plan will receive the following benefits:

Dental Benefits

Prescription Drugs benefits
Annual maximum for all dental benefits combined	Per anniversary year – ‍ Year 1 $750 ‍ Year 2+ $900
Basic preventative and restorative services cleanings, basic services, oral exams and basic oral surgery	‍
Reimbursement rate‍	80%
Additional parameters	‍
Complete oral examinations Emergency and specific oral examinations Full-series X-rays and panoramic X-rays	1 every 3 anniversary years
Bitewing X-rays	1 every anniversary year
Recall examinations	1 every 9 months
Preventative teeth cleaning	1 every 6 months (up to 1 unit of polishing and up to 1 unit of scaling at recall exam)
Topical application of fluoride	1 every 9 months (for age 19 and under only)
Comprehensive services ‍endodontic, periodontal treatment and denture services	‍
Reimbursement rate	60%
Additional parameters	‍
Periodontal scaling and/or root planing Occlusal equilibration	6 units every anniversary year
Standard relining or rebasing of dentures	1 every 3 anniversary year
Major services crowns, bridges, dentures on natural teeth	‍
Reimbursement rate	Year 3+ 50%
Additional parameters	‍
Denture cleaning	1 every anniversary year
Additional details	An estimate completed by a legally qualified Dental Practitioner must be submitted for assessment and pre-approval
Orthodontics treatments to correct the bite	Not included in this plan

Prescription Drug Benefits

Prescription Drugs benefits
Not included in this plan	‍

Vision Benefits

Prescription Drugs benefits
Eye examination	$60 every 2 benefit years
Eyewear	$250 every 2 benefit years
List of items covered	• Prescription eyeglasses, including lenses and frames • Prescription contact lenses • Laser eye surgery

Extended Health Benefits

Prescription Drugs benefits
Professional services	‍
Annual combined maximum for all professional services	$750 per anniversary year Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	80%
List of covered licensed and registered practitioners	• Acupuncturist • Chiropodist • Chiropractor • Dietitian • Massage therapist • Naturopath • Osteopath • Physiotherapist • Podiatrist
Mental health services	‍
Annual combined maximum for mental health services	$800 per anniversary year ‍ Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	$100 per session
List of covered licensed and registered mental health practitioners	• Clinical counselor • Professional with a Master of Social Work • Registered psychologist • Registered psychotherapist • Registered social worker
Speech therapist	‍
Maximums	$500 per anniversary year
Reimbursement rate	70%
Accidental dental benefits	‍
Maximums	$10,000   per anniversary year
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
In-province emergency ambulance transportation benefits	‍
Maximums	Covers the difference between the amount allowed under the provincial government health insurance plan and the reasonable and customary limit
Medical services Diagnostic services benefits (Quebec only) services like diagnostic tests, x-rays, ultrasounds and laboratory tests	‍
Maximums	$1,000 per anniversary year
Home support service, medical items and medical equipment	‍
Annual combined maximum for homecare and nursing, prosthetic appliances and durable medical equipment	Per anniversary year – ‍ Year 1 $500 ‍ Year 2 $1,000 ‍ Year 3+ $2,000
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
Waiting period (if applicable)	3 month waiting period applies (except diabetic supplies)
Home support service	‍
List of covered professionals	• Registered Nurse (R.N.) • Registered Practical Nurse (R.P.N.) • Licensed Practical Nurse (L.P.N) • Personal Support Worker (PSW) • Occupational Therapist
Additional details	• Pre-authorization form must be submitted and approved before any reimbursement* • Services must be done in the home (per visit) to be eligible and virtual home services is not covered
CPAP, BIPAP and APAP	‍
Maximums	Combined device and supply maximum per anniversary year – ‍ Year 1 $250 ‍ Year 2 $250 ‍ Year 3+ Included as part of overall maximum for home support service, medical items and medical equipment ‍ Reimbursement is provided up to the reasonable and customary limit
Compression stockings	‍
Maximums	2 pairs every 2 benefit years
Custom-made orthotics	‍
Maximums	$225 every 2 benefit years
‍Custom-made footwear	‍
Maximums	$500 every 2 benefit years
‍Diabetic, blood glucose meter, glucose monitoring system and supplies	‍
Maximums	$500 per benefit year
‍Hearing aids	‍
Maximums	$400 every 4 benefit years
‍Mobility aids ‍ canes, crutches, walkers and wheelchairs (including wheelchair batteries)	‍
Maximums	• Subject to $2,500 lifetime maximum • Included within the annual combined maximum for home support service, medical items and medical equipment

In-Province Hospital Accommodation Benefits

Prescription Drugs benefits
Room coverage in a public hospital	Not included in this plan

Additional Mental Health Support

Prescription Drugs benefits
Available services	Confidential online peer support and self-guided mental wellness resources available 24/7 via TogetherAll
Plan member access	Available to all household members aged 16 and older, including spouses, children and extended family

Benefit year: Each successive 12-month period following the date a claim for a specified benefit is first incurred under the policy.

Anniversary year: Each successive 12-month period following the effective date of the policy.

Here’s how much value you get for your monthly premium

Advanced Plan - Guaranteed Issue

Based on public rates for a 32-year-old person from Ontario.

Compare PolicyMe with other insurance providers
Covered Benefit	Value Per Person
Dental (first year)	$800
Prescription drugs	$700
Vision (per two benefit years)	$500
Professional services/registered therapists	$1,000
Mental health services	$1,300
Speech therapist	$500
Accidental dental	$10,000
Homecare, nursing & equipment (first year)	$1,000
Total benefits	$15,700
Your total monthly premium:	$221/_month

What’s covered in this plan

Each covered person on this plan will receive the following benefits:

Dental Benefits

Prescription Drugs benefits
Annual maximum for all dental benefits combined	Per anniversary year – ‍ Year 1 $800 ‍ Year 2+ $1,200
Basic preventative and restorative services cleanings, basic services, oral exams and basic oral surgery	‍
Reimbursement rate‍	90%
Additional parameters	‍
Complete oral examinations Emergency and specific oral examinations Full-series X-rays and panoramic X-rays	1 every 3 anniversary years
Bitewing X-rays	1 every anniversary year
Recall examinations	1 every 6 months
Preventative teeth cleaning	1 every 6 months (up to 1 unit of polishing and up to 1 unit of scaling at recall exam)
Topical application of fluoride	1 every 6 months (for age 19 and under only)
Comprehensive services ‍endodontic, periodontal treatment and denture services	‍
Reimbursement rate	80%
Additional parameters	‍
Periodontal scaling and/or root planing Occlusal equilibration	6 units every anniversary year
Standard relining or rebasing of dentures	1 every 3 anniversary year
Major services crowns, bridges, dentures on natural teeth	‍
Reimbursement rate	Year 2+ 60%
Additional parameters	‍
Denture cleaning	1 every anniversary year
Additional details	An estimate completed by a legally qualified Dental Practitioner must be submitted for assessment and pre-approval
Orthodontics treatments to correct the bite	‍
Reimbursement rate	Year 2+ 60% ‍ Subject to $2,500 lifetime orthodontics maximum
Additional details	Pre-authorization form must be submitted and approved before any orthodontic treatment begins*

Prescription Drug Benefits

Prescription Drugs benefits
Annual maximum	$700 per anniversary year
Reimbursement rate	Covers 70% of the cost of eligible prescription drugs
Eligible prescription drugs	Covers generic name drugs
Dispensing fee	Covers $10 per perscription
Medications covered	We fully cover birth control and any generic prescriptions that have a Drug Identification Number (DIN), are dispensed by a licensed pharmacist and are listed in our approved drug formulary. ‍ Some drugs require pre-approval through our review process before reimbursement. ‍ Pre-existing conditions do not guarantee coverage, and only drugs listed in our formulary are eligible. Brand name medications will only be covered if no generic option exists. ‍ We do not cover prescription drugs used for lifestyle purposes, including but not limited to: • Erectile dysfunction • Infertility • Medicinal marijuana • Quitting smoking • Weight loss
Pre-existing medication use	Includes any pre-existing medication you take based on medical needs if they are listed in our approved drug formulary and meet coverage criteria
Coordination with RAMQ	For Quebec residents to be eligible for prescription drug coverage under this policy, you must be registered under the RAMQ Public Prescription Drug Insurance Plan

Vision Benefits

Prescription Drugs benefits
Eye examination	$100 every 2 benefit years
Eyewear	$400 every 2 benefit years
List of items covered	• Prescription eyeglasses, including lenses and frames • Prescription contact lenses • Laser eye surgery

Extended Health Benefits

Prescription Drugs benefits
Professional services	‍
Annual combined maximum for all professional services	$1,000 per anniversary year Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	80%
List of covered licensed and registered practitioners	• Acupuncturist • Chiropodist • Chiropractor • Dietitian • Massage therapist • Naturopath • Osteopath • Physiotherapist • Podiatrist
Mental health services	‍
Annual combined maximum for mental health services	$1,300 per anniversary year ‍ Reimbursement is provided up to the reasonable and customary limit
Reimbursement rate	$100 per session
List of covered licensed and registered mental health practitioners	• Clinical counselor • Professional with a Master of Social Work • Registered psychologist • Registered psychotherapist • Registered social worker
Speech therapist	‍
Maximums	$500 per anniversary year
Reimbursement rate	70%
Accidental dental benefits	‍
Maximums	$10,000   per anniversary year
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
In-province emergency ambulance transportation benefits	‍
Maximums	Covers the difference between the amount allowed under the provincial government health insurance plan and the reasonable and customary limit
Medical services Diagnostic services benefits (Quebec only) services like diagnostic tests, x-rays, ultrasounds and laboratory tests	‍
Maximums	$1,000 per anniversary year
Home support service, medical items and medical equipment	‍
Annual combined maximum for homecare and nursing, prosthetic appliances and durable medical equipment	Per anniversary year – ‍ Year 1 $1,000 ‍ Year 2 $2,000 ‍ Year 3+ $4,000
Additional details	Pre-authorization form must be submitted and approved before any reimbursement
Waiting period (if applicable)	3 month waiting period applies (except diabetic supplies)
Home support service	‍
List of covered professionals	• Registered Nurse (R.N.) • Registered Practical Nurse (R.P.N.) • Licensed Practical Nurse (L.P.N) • Personal Support Worker (PSW) • Occupational Therapist
Additional details	• Pre-authorization form must be submitted and approved before any reimbursement* • Services must be done in the home (per visit) to be eligible and virtual home services is not covered
CPAP, BIPAP and APAP	‍
Maximums	Combined device and supply maximum per anniversary year – ‍ Year 1 $250 ‍ Year 2 $250 ‍ Year 3+ Included as part of overall maximum for home support service, medical items and medical equipment ‍ Reimbursement is provided up to the reasonable and customary limit
Compression stockings	‍
Maximums	2 pairs every 2 benefit years
Custom-made orthotics	‍
Maximums	$225 every 2 benefit years
‍Custom-made footwear	‍
Maximums	$500 every 2 benefit years
‍Diabetic, blood glucose meter, glucose monitoring system and supplies	‍
Maximums	$500 per benefit year
‍Hearing aids	‍
Maximums	$400 every 4 benefit years
‍Mobility aids ‍ canes, crutches, walkers and wheelchairs (including wheelchair batteries)	‍
Maximums	• Subject to $2,500 lifetime maximum • Included within the annual combined maximum for home support service, medical items and medical equipment

In-Province Hospital Accommodation Benefits

Prescription Drugs benefits
Room coverage in a public hospital	Not included in this plan

Additional Mental Health Support

Prescription Drugs benefits
Available services	Confidential online peer support and self-guided mental wellness resources available 24/7 via TogetherAll
Plan member access	Available to all household members aged 16 and older, including spouses, children and extended family

Benefit year: Each successive 12-month period following the date a claim for a specified benefit is first incurred under the policy.

Anniversary year: Each successive 12-month period following the effective date of the policy.

Product Highlights

Skip the doctor's visit: No physical exams, no medical tests or questionaries. PolicyMe Health & Dental plans offer instant, hassle-free approval with coverage starting as soon as the next day. And yes, all your pre-existing conditions will be covered!*

‍Low-stress digital sign-up: Your application is fully online and takes less than 20 minutes for most people.

*Some services, like major dental, orthodontics and medical equipment are subject for pre-approval

No blanket exclusions: Once you're approved, your pre-existing conditions are covered under your plan. Simple as that.

Prescription drugs for pre-existing conditions are covered as long as they’re included in your plan’s drug list. We recommend doing a DIN lookup in your account or speaking with a licensed advisor to confirm.
A few things need approval first: Just so we can make sure everything's in order, you’ll need to submit paperwork if you’re in need of the following:
Major dental work: Your dentist will need to submit an estimate for us to review and pre-approve before starting treatment.
Orthodontics: Submit a pre-authorization form and get the green light before beginning any braces or orthodontic work.
Home support, medical items and equipment: Send us a pre-authorization form before purchase so we can approve it for reimbursement.

Important. Some claims may be subject to a waiting period. Please refer to your plan’s Schedule of Benefits to confirm if a waiting period applies to your coverage.

‍

Get covered fast: With PolicyMe, your primary coverage kicks in at 12:01 a.m. on whichever date comes later:

The effective date shown on your “Getting Started” document, or
The date we email you to confirm your coverage is active after receiving your first premium payment

You pick the date: You'll get to pick your coverage start date when you're checking out during the online application.

Important. Most benefits are available right away, but a few have waiting periods that apply even if your primary coverage has already started. Major dental work, orthodontics, home support, and medical equipment all have waiting periods of between 3 months and 3 years, depending on the plan you select. Check out the waiting periods section for each benefit category for the full details.

If you're self-employed and earn most of your income from your business, your PolicyMe Health & Dental premiums may be tax-deductible as a business expense under Canada's Private Health Services Plan (PHSP) rules. This can cover premiums for you, your spouse, and anyone in your household.

Quick eligibility check:
You may be able to deduct your premiums from your taxable income if:

You earn over 50% of your income from self-employment, or
Your non-self-employed income is $10,000 or less

How it works: Deduct eligible premiums on your business tax return (lines 9270, 9804, or business expenses) to lower your taxable income. Any amounts you can't deduct as a business expense can still be claimed as medical expenses on your personal return for a tax credit.

What you need: Download your annual premium statement from your PolicyMe account and keep it with your tax records in case the CRA asks for verification.

Important: We're not tax advisors, so this info is just intended to help you start the process of claiming a deduction. For detailed guidance, check out the official CRA page or chat with your tax professional to see what applies to your specific situation.

Direct billing (most common): In most cases, your provider can bill us directly. You'll only pay your co-pay portion out of pocket, and we handle the rest with your provider automatically.

No direct billing? If your provider doesn't have direct billing set up with us, you'll need to pay upfront and submit a claim through your PolicyMe account to get reimbursed.

How to submit a claim:

Keep and submit all itemized paid receipts (not just credit card slips)
Enter your Member ID from your benefits card
File within 12 months of receiving the service

Important: Some benefits, such as major dental work, require pre-authorization before you can claim them. Check your policy details to see if you need pre-authorization for specific medical services.

Getting reimbursed: We'll send your reimbursement via direct deposit or cheque after your provincial health plan pays their portion. Reimbursement is based on when you received the service, not when you paid for it.

Speak to a healthcare professional anytime: Get advice, assessments, and prescriptions without leaving your home.
Included in all eligible plans: No need for add-ons! Telehealth is part of your coverage automatically, with no extra fees.
Great for families: Access care quickly for kids or loved ones when you can’t make it to a clinic.
Perfect for busy schedules: Save time and skip the commute for common health issues.
Automatically renews
- Auto-renew on a yearly basis (unless you tell us you want to cancel!).
- You can cancel at any time, without fees or penalties.

Documentation & Important Information

Product Summary

Sample Policy

Important Product Information

Prescription Drugs benefits
Official Product Name:	PolicyMe Health and Dental Insurance
Insurer	Securian Canada 1400-25 Sheppard Avenue West Toronto, ON, Canada, M2N 6S6 ‍ Email: service@canadianpremier.ca ‍Phone (Toll-free): 1-855-883-6176 Website: https://securiancanada.ca/ ‍ ‍AMF Client Number: 2000829775A MF Website: http://lautorite.qc.ca/en
Distributor:	PolicyMe Corp 1300-60 Adelaide St E Toronto, ON, Canada, M5C 3E4 AMF Client Number: 3002916818 ‍ General Inquiries: info@policyme.com ‍ Phone: 1-866-999-7457 Website: www.policyme.com
Plans	PolicyMe Health and Dental Insurance - Guaranteed Issue Economic Plan PolicyMe Health and Dental Insurance - Guaranteed Issue Classic Plan PolicyMe Health and Dental Insurance - Guaranteed Issue Advanced Plan PolicyMe Health and Dental Insurance - Guaranteed Issue Dental Care Plan PolicyMe Health and Dental Insurance - Guaranteed Issue No Dental Advanced Plan PolicyMe Health and Dental Insurance - Guaranteed Issue Drug Care Plan PolicyMe Protect Health and Dental Insurance - Economic Plan PolicyMe Protect Health and Dental Insurance - Classic Plan PolicyMe Protect Health and Dental Insurance - Advanced Plan PolicyMe Protect Health and Dental Insurance - No Dental Advanced Plan Your premium will remain the same for the duration of your 1-year policy term, except under the following circumstances: the Government Health Insurance Plan changes; our practices change; you move to a different age band; you move to a new province/territory; or you change the number of people covered by this policy (e.g., family, couple/two person, single). If any of the above situations arise, we may make changes to your premiums or benefits by giving you at least 30-days notice in writing (email) of any change we make. We reserve the right to make other changes that do not appear in the list above, as long as we give you 30 days of notice in writing. Your policy will automatically renew on a yearly basis as long as premiums continue to be paid, unless you choose to cancel. You can cancel at any time without fees or penalties.
Premiums	Your premium will remain the same for the duration of your 1-year policy term, except under the following circumstances: the Government Health Insurance Plan changes our practices change you move to a different age band you move to a new province/territory you change the number of people covered by this policy (e.g., family, couple/two person, single) If any of the above situations arise, we may make changes to your premiums or benefits by giving you at least 30-days notice in writing (email) of any change we make. We reserve the right to make other changes that do not appear in the list above, as long as we give you 30 days of notice in writing.    ‍ Your policy will automatically renew on a yearly basis as long as premiums continue to be paid, unless you choose to cancel. You can cancel at any time without fees or penalties.
Lives Insured	Individuals or families (up to 11 members in total)
Issue Ages	18-99
Wait period	Only applicable for certain services
Who can be covered	To be eligible and remain eligible for coverage under this policy, a person must be: a resident of Canada; covered under a provincial/territorial Government Health Insurance Plan; and not enrolled in the Canadian Dental Care Plan (CDCP) if the plan you have selected currently offers dental benefits. You and your eligible Dependents, who are listed on your Getting Started document, are covered under this policy. Each person covered may be referred to as a Covered Person and everyone, collectively, as Covered Persons. To be eligible for coverage, your Dependents must be your Spouse or Dependent Children. Some important information about your Dependents: You can include only one person at a time as your Spouse. When your Dependent Child covered under this policy turns age 21, we will notify you on your next anniversary date of their removal from the policy. We will then adjust your premiums, if needed, on the contract anniversary date stated in your Getting Started document. When a Dependent Child turns 21, we will give them the opportunity to transfer to a separate PolicyMe health and dental plan. If you purchased a PolicyMe Protect plan, you or your Spouse must have been covered under a group health insurance plan within no more than 90 days before the day you submitted your Application in order to be eligible for coverage. You are responsible for telling us when a Covered Person no longer meets the eligibility requirements stated above. You can only be covered under one of our health and dental plans at any given time. For Québec residents only ‍ Québec residents must be registered under the public prescription drug insurance plan of the Régie de l’assurance-maladie du Québec (RAMQ), which provides basic coverage for prescription drug costs. Your policy will provide coverage that supplements RAMQ’s basic coverage. This supplementary coverage does not replace RAMQ’s basic coverage; it adds to it by covering, for example, drugs that are not reimbursed by the public plan or the portion of drug costs not reimbursed by the public plan. ‍
Coordination of Benefits (COB)	If you are covered for health and dental benefits under another plan in addition to this plan, and both plans permit a Coordination of Benefits (COB), your benefits under this plan will be coordinated with the other plan following industry standard guidelines developed by the Canadian Life and Health Insurance Association: the total amount payable cannot be greater than 100% of the eligible expense incurred.  ‍ Applying COB allows all benefit carriers to identify which plan is the primary payor and which is the secondary payor. We work together with other carriers or benefit plans to make sure you receive the maximum dollar value from all plans that you and your family are entitled to. ‍ If your Spouse is covered under another plan, they must submit claims to that benefit plan first and then submit any remaining balances to this plan. Coverage under this plan will be secondary. ‍ When your Dependent Children are covered under both your benefit plan and your Spouse’s benefit plan, you should first submit claims under the plan for the parent whose birth month and day fall earlier in the Calendar Year.
Cancellations	If you cancel within 30 days of the Effective Date, you will receive a full refund of any premiums you have paid minus any claims that have been paid or are payable to you. If the claims that we have paid are greater than the premiums paid, you must pay us the difference right away. ‍ You will not be charged any cancellation fees or penalties. ‍ You may request to cancel your policy by sending an email to advisor@policyme.com with your policy number.
Renewals	PolicyMe Health and Dental Insurance is a renewable product. This policy will auto-renew on a yearly basis, unless you tell us you wish to cancel. You can cancel at any time, without fees or penalties.
Exclusions	Standard Exclusions ‍ PolicyMe Health and Dental Insurance has the industry-standard exclusions where the insurer will not pay out any benefit related in any way to any of the following: expenses that are excluded from the Covered Person’s coverage because of an individual exclusion as stated in the Getting Started document, if applicable, an act or accident of war (declared or undeclared), due to any type of military conflict, act of terrorism, or while serving in the armed forces of any country, the commission or attempted commission of a criminal offence or illegal act, failing to keep a scheduled appointment with a legally qualified Health Practitioner or Dental Practitioner, charges for translating or completing any claims forms, insurance reports, or medical reports for any reason, a sickness, injury, or other loss suffered where payment under this policy is not permissible by law, expenses for which a non-profit association, insurance carrier, third-party administrator, or someone other than us makes a payment on your behalf, services provided by a Health Practitioner whose license has been suspended or revoked by the relevant regulatory or professional association, expenses that are solely for recreational or sporting activities that are not Medically Necessary for regular activities, expenses that are primarily for cosmetic or aesthetic purposes, or to correct congenital malformations, expenses incurred from services or supplies that are provided by an immediate family member who is related to you by birth, adoption, or marriage, or by a practitioner who normally lives in your home, or are provided in a facility that you own or are employed through, delivery and transportation charges, charges that are provided for free from any government agency by complying with government laws or regulations or would normally have been paid through a government health insurance plan, Workplace Safety and Insurance Board or tribunal, the Assistive Devices Program, or any other government agency if you made a proper application for coverage and proper and timely claims submission, regardless of any waiting list, expenses incurred outside Canada and/or your province or territory of residence, expenses from a Health Practitioner who has opted out of a provincial or territorial Government Health Insurance Plan that would have otherwise been paid, administrative services or other fees charged by a Service Provider other than those directly related to the delivery of the service or supply, expenses that occur prior to the effective date of this Policy, charges, services, supplies, or treatment that are not generally recognized by the medical profession in Canada as appropriate, effective, or required for the treatment of an accident, injury, or illness in accordance with Canadian medical standards. ‍
Misstatements	If any Covered Persons’ date of birth or province has been misstated, your premiums will be adjusted to the amount that would have been charged based on their correct age or province. If you would have been ineligible for coverage had the correct information been provided at the time coverage became effective, this policy is void and we will return all of the premiums paid. ‍ If you, intentionally or unintentionally, misrepresent, hide or fail to give us information when you are making a claim, we can choose to not pay the claim. If we have already paid it, you must pay us back any amounts we have paid to you. Under certain circumstances, we may terminate your policy and you will have to pay us back. If we investigate you for fraud, you must provide (at your own cost) all information that we need to investigate your claim. ‍ We may need to conduct a claims assessment, which may require you to complete a medical questionnaire or provide us with additional medical information. You are responsible for the costs you incur for collecting this information. ‍ If you applied for a fully underwritten policy and failed to disclose a Material Fact that may have resulted in an individual exclusion being applied to your policy at the time of issuance, we may update your benefits to apply the appropriate individual exclusions to this policy. ‍ You must provide us with satisfactory proof of identity, age or other eligibility-related information for any Covered Person on this policy if we ask you.

Frequently Asked Questions

We're big believers in keeping things simple, so ask us anything and we'll answer honestly and without the jargon.

What is PolicyMe’s Health and Dental Insurance?

PolicyMe’s Health & Dental Insurance provides comprehensive coverage for medical and dental expenses that might be not covered by your provincial plan. Coverage includes prescription drugs (depending on plan), dental, vision, mental health services, registered therapists, accidental dental, and more.

Are pre-existing conditions covered?

Yes. Once your policy is approved, pre-existing conditions are covered—there are no blanket exclusions. Please note that prescription drugs for pre-existing conditions are covered if they’re included in your plan’s drug list. It’s best to confirm a specific medication using the DIN lookup in your account or by speaking with a licensed advisor.

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Note: Certain services require pre-authorization and may be subject to waiting periods. Check your plan’s Schedule of Benefits for details.

Are there waiting periods?

Yes, for certain benefits. Major dental work, orthodontics, home support, and medical equipment can have waiting periods between 3 months and 3 years, depending on the plan. Refer to the waiting period section in each benefit category of your Schedule of Benefits.

Does the plan auto‑renew? Can I cancel?

Plans auto‑renew yearly. You can cancel anytime with no fees or penalties.

How long will it take for a claim to be paid?

If you're submitting a claim online, it will be processed in real time and you'll typically receive your reimbursement the following day through direct deposit. In some cases, a claim might trigger an audit at which point you may be asked to submit additional documentation within a certain timeframe.

From the time we receive your documents, it could take up to a week for us to review your claim and process your reimbursement.

If your medical provider will be submitting the claim on your behalf, it will be processed in real time.

Who will pay my claim?

Securian Canada will be responsible for handling all the paperwork and paying out valid claims.

How will my reimbursement be paid?

If you're submitting a claim online yourself, it will be reimbursed through direct deposit. In the event that a reimbursement can't be made via direct deposit (e.g. if the banking details haven't yet been added to the portal or are incorrect), then you'll receive a cheque by mail.

How long should I hold onto my receipts?

We recommend that our customers keep the receipts of any submitted claims for at least 12 months.

What is health and dental insurance?

Health and dental insurance provides coverage for a range of medical and dental expenses that aren’t covered by provincial healthcare plans in Canada. This type of insurance helps reduce out-of-pocket costs for services like prescription drugs, dental check-ups, orthodontics, physiotherapy, and mental health services.

Depending on the plan, coverage can vary widely, including everything from basic preventative care to more extensive treatments and specialized care. It can be an essential tool for managing unexpected health expenses and ensuring that routine care is accessible and affordable.

Vous avez des questions?

Appelez +1-866-999-7457 de 9h à 17h HNE du lundi au vendredi ou envoyez-nous un courriel. Notre équipe de conseillers agréés sera heureuse de vous aider!

About PolicyMe’sHealth and Dental Insurance

Choose a health and dental insurance plan to learn more:

Here’s how much value you get for your monthly premium

$500

Basic preventative and restorative services

70%

Comprehensive services

Major services

Orthodontics

$1,000

80%

$10

$60

$200

Professional services

$600

50%

Mental health services

$500

$75

Speech therapist

Accidental dental benefits

$10,000

In-province emergency ambulance transportation benefits

Medical services

Home support service, medical items and medical equipment

Here’s how much value you get for your monthly premium

$750

$900

Basic preventative and restorative services

80%

Comprehensive services

60%

Major services

50%

Orthodontics

$1,600

$60

$250

Professional services

$750

80%

Mental health services

$800

$100

Speech therapist

$500

70%

Accidental dental benefits

$10,000

In-province emergency ambulance transportation benefits

Medical services

$1,000

Home support service, medical items and medical equipment

$500‍

$1,000‍

$2,000

$250‍

$250‍

2 pairs

$225

$500

$500

$400

Here’s how much value you get for your monthly premium

$750

$900

Basic preventative and restorative services

80%

Comprehensive services

60%

Major services

50%

Orthodontics

$60

$250

Professional services

$750

80%

Mental health services

About PolicyMe’s
Health and Dental Insurance

$1,000  

$10,000  

$500
‍

$1,000
‍

$250
‍

$250
‍

$10,000  

$500
‍

$1,000
‍

$250
‍

$250
‍

$2,800  

$100  

$10,000  

$1000
‍

$2,000
‍

$250
‍

$250
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