• Québec, Montréal - Association de massothérapeutes - massothérapie

Health, Drugs and Dental coverage,
for AQTN members


Note: Just like our liability policies, the contract is between you and the insurance company. AQTN is not part of the contract and receives no commission. Unlike liability insurance, you are not required to take health and dental coverage.

Three key advantages of the Health and Dental insurance program available to AQTN members:

  • Cut out the middle man - deal with the insurance company directly and save money.
  • Deal with a dedicated representative and speak to the same person each call.
  • Find the most appropriate plan for your needs.

Note: This coverage does not replace an existing group benefits plan, you must be registered with either RAMQ or have equivalent coverage (for drugs) under a group plan.



Small sample of available coverage:

Prescription Drugs

  • Covers expenses not covered by your provincial prescription drug insurance plan, including annual deductible and co-payment up to the stated maximum
  • Name brand or generic drugs, including birth control and fertility drugs
  • Full coverage of reasonable and customary dispensing fees
  • 100% of eligible prescription costs not covered by your provincial prescription drug insurance plan, to a maximum per person per calendar year equal to the current RAMQ deductible.

Exclusions - smoking cessation drugs, over-the-counter drugs, and drugs not requiring a prescription  

 

Dental

  • Dental coverage is for fillings, cleanings, scalings, examinations, polishing and certain extractions
  • Recall visits every 6 months, per person

Percentage PaidTo a maximum of
(per anniversary year)
On your first $500 of eligible services 100%$500
On your next $700 of eligible services 60% $420
Total benefits payable per person per anniversary year $920

The following 6 dental services have a combined first anniversary year maximum of $400, and a combined 3 consecutive years maximum of $1,250 per person. For orthodontics, crowns, bridges and dentures, no benefit is available until Year 3. The payment percentage increases from the effective date of the contract as follows:

Anniversary Year 1
Anniversary Year 2
Anniversary Year 3 & beyond
Oral Surgery 60% 60% 80%
Periodontics 60% 60% 80%
Endodontics (Root Canal) 60% 60% 80%
Orthodontics 0% 0% 60%
Crowns, Bridges 0% 0% 60%
Dentures 0% 0% 60%

Coverages are designed to coincide with your current provincial Dental Association Fee Guide for General Practitioners. The Dental coverage will be adjusted to match any increases in the fee guide.

The following Core benefits are also included with Enhanced coverage:

 
 

Vision (Basic)

  • $250 maximum per person per 2 consecutive benefit years to cover the costs towards prescription lenses, frames, contact lenses and laser eye surgery
  • $50 maximum for Optometrist fees per person per 2 consecutive benefit years (payable only after Government Health Insurance Plan maximum has been reached, if applicable)
  • Eyeglasses are covered against breakage and scratches by a repair guarantee for a period of 2 benefit years. This warranty applies to lenses and frames purchased with the Vision benefit.

No deductible is charged to you if your eyeglasses can be repaired. If beyond repair, your eyeglasses will be replaced and a $50 deductible charged for eyeglasses originally purchased for up to $250; a $75 deductible, if the original purchase price was $251 to $300; and a $100 deductible, if your eyeglasses originally cost $301, or more.

 
 

Extended Health Care (Starter)

  • Lifetime Maximum . $250,000 per person
  • Health Service Navigator® - With Health Service Navigator, you and your eligible family members can quickly and easily get answers to your questions and access to support services. Easily accessible on the web or with a simple call to a dedicated toll-free line, you will be connected to Health Service Navigator where you can receive information, medical coordination services and resources on how to navigate the Canadian health care system. And, if you want a second opinion from a world-class hospital, Health Service Navigator will help you get it.
  • Chiropractor, Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist . $20 maximum per visit, 20 visit maximum per person per discipline per anniversary year
  • Chiropractic X-ray . $35 maximum per person per anniversary year
  • Psychologist . $80 maximum first visit, $65 maximum subsequent visits, 10 visit maximum per person per anniversary year
  • Physiotherapist . $250 maximum per person per anniversary year
  • Homecare and Nursing, Prosthetic Appliances, Durable Medical Equipment . $3,000 maximum per person per anniversary year, for each of these 3 categories of benefits separately
  • Custom-made Orthotics . $225 maximum per person per anniversary year
  • Speech Pathologist/Therapist . $65 maximum first visit, $45 maximum subsequent visits, 10 visit maximum per person per anniversary year
  • Lifeline ® Personal Response Service . lifetime maximum of 3 months of service per person, not including installation fee
  • Accidental Dental . $2,000 maximum per person per anniversary year
  • Ambulance . unlimited ground transportation to hospital and $4,000 maximum for air ambulance transportation per person per anniversary year
  • Hearing Aid . $400 maximum per person per 4 consecutive benefit years.
  • CAT Scans . $200 maximum per person per anniversary year
  • Ultrasound Scans . $50 maximum per person per anniversary year
  • Audiologist . $500 maximum per person per anniversary year
  • Magnetic Resonance Imaging . $500 maximum per person per anniversary year
  • Laboratory tests . $100 maximum per person per anniversary year towards the cost of blood tests, urine tests and throat cultures which result from an accident, or for the diagnosis or treatment of an illness
  • Prostate Specific Antigen (PSA) . $75 maximum per person per anniversary year towards the cost of testing required for the diagnosis or treatment of an illness, when prescribed or requested by the attending physician.
  • CA 125 Test . $75 maximum per person per anniversary year towards the cost of testing required for the diagnosis or treatment of an illness, when prescribed or requested by the attending physician

Extended Health Care benefits are payable only after Government Health Insurance Plan maximums have been reached, as applicable.

 
 

Travel

  • $5,000,000 emergency health coverage per person for trips lasting a maximum of 9 days. (A $100 deductible applies per claim.)
  • Additional coverage for either 8 or 21 days can be purchased as an Add-On.

Note: Coverage may be limited or excluded for any illness or condition which first manifested itself within the 9 month period preceding the effective date of departure. Not available to persons age 65 and over.

 

Accidental Death & Dismemberment (Basic)

  • Up to $25,000 upon the Accidental Death or Dismemberment of an adult under 65; up to $10,000 upon the Accidental Death or Dismemberment of an adult 65 and over, or a child.
  • Additional coverage can be purchased as an Add-On.
 
 

Survivor Benefit

  • Provides for coverage to be continued for 1 year, following the death of an adult policyholder.