Maximum Eligible Expenses

Extended Health Provision

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Drug Benefit

Benefit item Maximum Eligible Expense PSHCP pays

Eligible drugs

Reasonable and customary charges

80%

Erectile dysfunction drugs

$500 every calendar year on a combined basis

80%

Smoking cessation aids

?$1,000 in a lifetime

80%

Catastrophic drug coverage

Eligible drug expenses in excess of $3,000 out-of-pocket drug expense incurred in a given calendar year payable at 100%

100%

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Vision Care Benefit

Benefit item Maximum Eligible Expense PSHCP pays

Eyeglasses/contact lenses (purchase and repairs)

$275 every two calendar years commencing every odd year

No limit if required as a result of surgery or accident and purchased within six months of the event

80%

Eye examinations

One examination every two calendar years commencing every odd year

80%

Laser eye surgery

$1,000 per lifetime

Surgery must be performed on or after October 1, 2014 to be eligible

80%

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Medical Practitioners Benefit

Practitioner Maximum Eligible Expense PSHCP pays

Physiotherapist

Up to $500 and over $1,000 in a calendar year

80%

Psychologist, or social worker (when no psychologist practices in that isolated post)

$2,000 in a calendar year

In 2014:

$1,000 for expenses incurred between January 1 and September 30

$1,000 for expenses incurred between October 1 and December 31

80%

Massage Therapist

$300 in a calendar year

80%

Osteopath

$300 in a calendar year

80%

Naturopath

$300 in a calendar year

80%

Podiatrist or chiropodist

$300 in a calendar year

80%

Chiropractor

$500 in a calendar year

80%

Speech language pathologist

$500 in a calendar year

80%

Electrologist (or electrology treatment performed by a physician)

$20 per visit

80%

Nurse (nursing services)

$15,000 in a calendar year

80%

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Miscellaneous Expense Benefit

Benefit item Maximum Eligible Expense PSHCP pays
Orthopaedic shoes $150 in a calendar year 80%
Servicing fees, repairs and replacement parts for CPAP and BiPAP machines

$300 per calendar year

Does not include expenses for cleaning supplies or warranties

Purchases must be made on or after October 1, 2014, to be eligible.

80%

Hearing aids (purchase/repairs)

$1,000 less any eligible hearing aid expenses claimed during the previous 60 months

No limit if required as a result of surgery or accident and purchased within 6 months of the event

80%

Orthopaedic brassieres

$200 in a calendar year

80%
Wigs $1,000 in a 60-month period 80%
Insulin jet injector device $760 during a 36-month period 80%

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Out-of-Province Benefit

Benefit item Maximum Eligible Expense PSHCP pays

Emergency benefit while travelling / Emergency travel assistance services

$500,000 per period of travel (not exceeding 40 consecutive days)

100%
Referral benefit

$25,000 per illness or injury

80%

?

Hospital Provision

Level of coverage Maximum Eligible Expense PSHCP pays
Level I ?$60 per day 100%
Level II ?$140 per day 100%
Level III ?$220 per day 100%

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Basic Health Care Provision

Maximum Eligible Expense PSHCP pays

Three times (3x) the amount otherwise payable under the current fee schedule of the Health Insurance Act 1972 of Ontario

100%

Impacts of the Covid-19 pandemic on the PSHCP - Member Satisfaction Survey??

In response to the COVID-19 pandemic, the Government of Canada implemented temporary changes to the Public Service Health Care Plan (PSHCP), effective March 24, 2020. These changes were designed to help PSHCP members and eligible dependants continue to have access to their health care benefits amid the social distancing restrictions. If you are a member of the PSHCP, please share your level of satisfaction with the information you received about these changes by completing the survey below.

The survey is conducted by SimpleSurvey and will take approximately three minutes to complete. All results are strictly confidential. All data will be stored in Canada on Canadian servers. See our?Privacy Policy?for more information on the collection and retention of data.

Please take a few minutes to share your views with us!

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