Health
Health
You have a choice of three health plan options — Basic, Standard and Premium.
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Overview
GreenShield Canada is the carrier for all three plans. When comparing options, consider your health needs:
What were your health expenses last year?
Do you have any injuries or chronic conditions that require frequent treatment?
Does your spouse/partner have a health plan? Can you coordinate your benefits to provide 100% reimbursement?
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Coverage details
All three health plans cover the services in the tables below, including prescription drugs. The tables show what each plan pays for care. Costs shown are in Canadian dollars or the percentage of coinsurance the Plan pays. (Coinsurance is a portion of the cost of health care services; you and the Plan share the cost of services.) Maximums noted are per covered person per calendar year, unless stated otherwise.
Basic Standard Premium Prescription Drugs (mandatory generic substitution 70% until you have $2,000 in drug claims paid from the plan, and then 80% after 90% 100% Deductible $0 $0 $0 Dispensing Fee Cap* $7 per prescription $7 per prescription $7 per prescription Fertility Drugs Not covered $15,000 lifetime maximum $25,000 lifetime maximum Smoking Cessation Not covered $500 lifetime maximum $1,000 lifetime maximum Anti-Obesity Not covered $2,500 Unlimited *The dispensing fee cap does not apply in Quebec.
Health Services
Basic Standard Premium Paramedical Services** (see below for all included services) Not covered 80%
$400 per practitioner maximum
$750 combined practitioner maximum100%
$500 per practitioner maximum
$1,250 combined practitioner maximumMental Health Services*** (see below for all included services) 50%
$500 maximum combined for all mental health practitioners80%
$500 maximum combined for all mental health practitioners100%
$500 maximum combined for all mental health practitionersVision Services (includes contact lenses, glasses or laser eye correction) Not covered 80%
$300 every 24 months from date of purchase100%
$350 every 24 months from date of purchaseHospital Accommodations Not covered 80%
Semi-private100%
Private or semi-privateConvalescent Hospital Not covered $20 per day,
to a maximum of 180 days$20 per day,
to a maximum of 180 daysOut-of-Canada Emergency Services, with Travel Assistance Not covered 100%
$1,000,000 lifetime maximum first 60 days of trip100%
$1,000,000 lifetime maximum first 60 days of tripMedical Supplies and Services 50% of the cost up to the annual maximum 80% of the cost up to the annual maximum 100% of the cost up to the annual maximum Private Duty Nursing $15,000 $15,000 $25,000 Orthopedic Shoes 1 pair 1 pair 1 pair Prefabricated Orthopedic Shoes $150 $150 $150 Custom Orthotics $500 $500 $500 Hearing Aids $500 every 5 years $500 every 5 years $500 every 5 years Glucometers $700 lifetime maximum $700 lifetime maximum $700 lifetime maximum **Includes: Acupuncturist, audiologist, chiropractor (maximum one X-ray), dietician, massage therapist, naturopath, occupational therapist, osteopath, physiotherapist, podiatrist/chiropodist, speech therapist.
***Includes: Psychologist, counsellor, social worker, master of social work, psychotherapist and behavioural therapist.Women's Health
For additional support for women’s health, click here. You’ll find relevant articles related to Mind, Body, Work and Relationships.
Are You a New Hire?
If you don’t enroll within 30 days of your hire date, you’ll default to the Basic Health option and the Preventive Dental option for Employee Only coverage. You won’t be able to change your elections until the next Open Enrollment unless you have a qualifying life event.
More Support from Change4Life
Need help with health issues like a chronic condition or weight management? Find out how Change4Life can help.
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Prescription drugs
Prior Authorization
Certain drugs require prior authorization, or pre-approval, before they will be covered by your health plan, due to cost and the potential to be misused. To find out if your prescription requires prior authorization, ask your doctor what drug is being prescribed and then:
Search for the drug on the GreenShield Canada website or via the GSC on the Go® mobile app,
Call Green Shield Canada at 888.711.1119 or
Ask your pharmacist to submit the drug claim electronically using your GSC ID card.
If your prescription requires prior authorization, you can apply for it or fill the prescription and submit a claim for payment to GreenShield Canada.
For more information, click here or call Green Shield Canada at 888.711.1119.17
Specialty Medications
Available across Canada,* GreenShield Canada’s Preferred Pharmacy Network (PPN) helps you get the best price on specialty medications. A specialty medication is a high-cost medication used to treat complex, chronic conditions such as cancer, rheumatoid arthritis, HIV and hepatitis C. The PPN includes many chain pharmacies — such as Shoppers Drug Mart, Loblaws, Safeway and Lawton Drugs — as well as independent pharmacies in remote or rural areas. All pharmacies in the network offer home delivery.
If a drug you’re prescribed is approved in the PPN, you’ll be automatically enrolled in the program and a care coordinator will help you find participating pharmacies. To find out if your prescription is in the PPN, you can:
Use the online drug search tool on the GreenShield Canada website,
Use the Drugs on the Go® feature on the GSC on the Go® mobile app or
Contact GreenShield Canada at 888.711.1119.
*Not available in Quebec or Alberta.
Compound Medications
Compound medications are medications that are not commercially available and must be prepared by a pharmacist. Per GreenShield Canada’s Compound Policy, a compound medication must contain certain eligible ingredients to be covered by your health plan.
Learn more about this policy.
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Finding a health provider
The GreenShield Canada (GSC) Find a Health Provider tool can help you find reliable providers who don’t bill you for unnecessary services or charge excessive fees.
You can use the tool to find providers close by who:
Have a valid Canadian address
Are in good standing with their applicable professional college or provincial association
Are registered with and monitored by GSC to ensure they don’t have a history of fraud (e.g., over-billing)
Bill GSC directly,* so you don’t have out-of-pocket expenses
*Excludes dental providers; they do not need to bill directly to be included in the tool.
Get Started
Access the Find a Health Provider tool.
From the GSC website:
1. Go to the GreenShield Canada website.
2. Click “Login” to log in to your account or to register for an account.
3. Once registered, select “Find a Health Provider” from the homepage.
4. Complete the form and click “Submit.”
5. The results of your search will display.
From the GSC on the Go® app:
1. Select “Find a health provider” from the menu.
2. Select the type of provider and follow the prompts to enter your search criteria (e.g., search from your current location). Click “Search.”
3. The results of your search will display.
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Costs
Here’s what you pay per paycheck (in Canadian dollars) to have health coverage.*
Coverage Basic Standard Premium Employee $5.30 $9.87 $15.25 Employee + 1 $9.68 $18.05 $27.86 Employee + Family $16.15 $30.12 $46.49 *Plus retail sales tax, if applicable.
What Happens if You Leave Iron Mountain
If you voluntarily leave Iron Mountain, your health coverage will end on your last day of employment.
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Contacts
GreenShield Canada
Health and dental
Health and dental policy number: IMCC