The Extended Health Provision is part of both Supplementary and Comprehensive Coverage, and therefore applies to all employees, pensioners and their dependants who are participants in the PSHCP.
Members with Comprehensive coverage are not eligible for the Out-of-Province Benefit.
The provision is intended to provide coverage based on the reasonable and customary charges for specific services and products not usually insured under a provincial/territorial health insurance plan (or under the Basic Health Provision, for members living outside Canada).
The products and services that are eligible under the Extended Health Provision are subject to maximum expense limits.
You are reimbursed 80% of the reasonable and customary charges for eligible expenses. The remaining 20% of your expenses is referred to as your “co-payment”.
If you have coordinated your benefits with your spouse and you have Family coverage, the remaining 20% of your expenses can be claimed on your spouse’s plan.
The maximum eligible expenses are identified for each benefit category of the Extended Health Provision.