Health, Dental & Prestige Travel Insurance

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MARGE offers a variety of Health, Dental and Travel/Trip Cancellation insurance coverage options

Our Health coverage is very affordable considering the benefits…

  • Coverage limits and reimbursement levels are flexible to assist you in budgeting your monthly costs.  
  • We offer both a Basic and Enhanced Plan for health and dental.
  • Your premiums are tax deductible.

With great features…

  • No age limit.
  • Direct-to-pharmacy reimbursement to assist you in keeping your monthly costs within your budget. All members will be supplied with a health card which allows healthcare providers to submit electronic claims on your behalf. Present your card to participating pharmacists, dentists, chiropractors, physiotherapists, opticians, optometrists, massage therapists, acupuncturists and other healthcare providers who can submit claims electronically. 

Please note: For complete coverage information, go to the bottom of this page and click on the applicable Certificates of Insurance for Health, Dental and Prestige Travel/Trip Cancellation Plans.

 

Extended Health Care (EHC) Plan Options

There are two Extended Health Care Plan Options -- both available with or without the Prestige Travel/Trip Cancellation option*:

  1. BASIC EHC Plan
  2. ENHANCED EHC Plan
1. BASIC Extended Health Care (EHC) Coverage

You get 80% coverage for the following eligible expenses (individual limits apply).

Basic Prescription Drug Coverage:

Pay direct drug card to reimburse provincial formulary drugs at 80% to a maximum of $1,750 per family per drug plan year (April 1-March 31).

  • Subject to mandatory generic substitution pricing
  • $10 dispensing fee cap and 8% mark-up limit

Basic Non-Drug Coverage:

  • Accidental Dental ($1,000 per calendar year)
  • Ambulance Service (100%)
  • Diagnostic Services
  • Hearing Aids ($1,000 once every 5 calendar years)
  • Home Care ($50/day, up to 10 days after minimum of 12 hour hospital stay)
  • Medical Aids and Appliances (individual limits apply)
  • Foot Orthotics/Orthopedic Shoes ($500 every 2 calendar years when medically required)
  • 13 Paramedical services ($75 maximum per visit, up to $750 per calendar year for all 13 paramedical treatments combined -- with Massage, Physiotherapy, Chiropractic treatment limited to a maximum of $500 combined, as part of total paramedical coverage)
  • Prescribed Health Education Programs for cardiac, diabetic conditions etc. ($300 lifetime max. per individual)
  • Private Duty Nursing ($5,000 per calendar year)
  • Semi-private Hospital Room (100%)
2. ENHANCED Extended Health Care (EHC) Coverage

All the benefits of the Basic Extended Health Care Plan with additional enhancements and 80% coverage for the following eligible expenses (individual limits apply).

Enhanced Prescription Drug Coverage:

Pay direct drug card to reimburse prescription drugs at 85% for provincial formulary and lowest cost alterative drugs -- or 75% for all non-formulary prescribed drugs up to $2,000 per family per policy year (April 1-March 31).

  • Subject to mandatory generic substitution.
  • $12.50 dispensing fee cap & 8% mark-up limit.

Enhanced Non-Drug Coverage:

The same benefits as the BASIC plan with the following increases/additions in coverage.

  • Hearing Aids ($1,500 per 5 calendar years)
  • 13 Paramedical services ($75 maximum per visit, up to $1,200 per calendar year for all 13 paramedical treatments combined -- with Massage, Physiotherapy, Chiropractic treatment limited to a maximum of $750 combined, as part of total paramedical coverage)
  • Private Hospital Room (100%)
  • Private Duty Nursing ($10,000 per calendar year)
  • Vision Care

Dental Care Options**

There are two Dental Care plans available:

  1. BASIC
  2. ENHANCED
1. BASIC Dental Care Coverage
  • $1,000 annual maximum per insured person combined for Basic/Minor Restorative Services.
  • 80% Basic / Preventative Services, includes:
    • Denture repairs, fillings, 2 oral exam per calendar year, 8 units of scaling and/or root planing per year, and 4 units of dental facility fees for surgical removal of teeth.
  • 80% Minor Restorative, includes:
    • Endodontics / Periodontics
2. ENHANCED Dental Care Coverage
  • $1,000 annual maximum per insured person combined for Basic/Minor Restorative Services
  • 85% Basic / Preventative Services, includes:
    • Denture repairs, fillings, 2 oral exam per calendar year, 8 units of scaling and/or root planing per year, and 4 units of dental facility fees for surgical removal of teeth
  • 85% Minor Restorative, includes:
    • Endodontics / Periodontics
  • PLUS 60% Major Restorative procedures 
    • Additional $1,000 annual maximum per insured person for Major Restorative Services, such as Crowns / Posts / Inlays / Onlays / Bridges / Dentures / Implants

Prestige Travel Option*

Out-of-Province/Country Insurance with Trip Cancellation 100% Emergency Travel Insurance per insured person can be included with the Extended Health Care plan:

  • Premium rates for Prestige Travel are flat and not based on age or health condition
  • Lifetime maximum of $2,000,000 for sudden and unforeseen eligible emergency travel expenses
  • Multiple trips up to 62 days duration per trip
  • Trip Cancellation / Interruption ($8,000 per trip)
  • Hospital Accommodations and Physician Services
  • Private Duty Nursing ($5,000 per calendar year)
  • Drugs / Diagnostic Services / Aids and Appliances
  • Emergency Dental ($1,000 per incident)
  • Paramedical Services ($225 per speciality/ year)
  • Emergency Transportation (ground, air)
  • Vehicle Return / Return of Dependent Children
  • Repatriation or burial of Deceased Member

Additional Information on Plans, Application Form and Insurance Certificates

Health Plan Brochure

Application Form for Extended Health Care & Dental Plans

Certificate of Insurance for Extended Health

Certificate of Insurance for Dental

Certificate of Insurance for Prestige Travel

Prestige Travel Guidelines 

Plan FAQ

Claims Submission FAQ 

 

* Prestige Travel/Trip Cancellation option ONLY available with Basic or Enhanced EHC.
** Dental Care ONLY with Basic or Enhanced EHC with or without Travel.

 

Johnson Inc. (Johnson) is a licensed insurance intermediary. Johnson provides administrative, consulting and/or claims administration/payment services. Insurance products are underwritten by various insurance providers. *Certain conditions, limitations, eligibility may apply. Policy wordings prevail.

Johnson Inc. is proud to offer 50 scholarships, valued at $1000 each, to students completing high school in 2018 and starting post-secondary education in the fall.

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