Benefits

Member: $100,000
Spouse: $30,000
Dependent Child: $4,000
Age Limitation: Up to age 70

Member / Spouse / Eligible Dependents

Injury/loss to natural teeth completed within 12 months

Members / Spouse / Dependent Child

$85 per visit up to an overall combined paramedical therapy
Maximum of $2,000 per calendar year

Members / Spouse / Dependent Child

Covered after OHIP excluding air and rail

Members / Spouse / Dependent Child

Covered

Members / Spouse / Dependent Child

Covered including replacement

Members / Spouse / Dependent Child

$85 per visit up to an overall combined paramedical therapy
Maximum of $2,000 per calendar year

Members / Spouse / Dependent Child

One (1) external breast to a max of $500 per breast once every 24 months

Members / Spouse / Dependent Child

Specializing in Cancer Care Assistance / Navigation

Members / Spouse / Dependent Child

Covered

Members / Spouse / Dependent Child

Benefit: Provide protection if child develops a severe illness, disability or injury
Conditions: Genetic conditions -Cystic Fibrosis, Down and Rett syndromes, Autism, Cerebral Palsy, Muscular Dystrophy and many more rare diseases

Dependent Child

$100 1st visit / $85 subsequent visits (chiropractor services only)
Maximum of $2,000 per calendar year

Members / Spouse / Dependent Child

$105 per visit up to an overall combined behavioral therapy
Maximum of $2,000 per calendar year

Members / Spouse / Dependent Child

Up to $4,000 per year (Sensor/Transmitter/Receiver)

Members / Spouse / Dependent Child

Member: $20,000
Spouse: $5,000
Child: $2,500
Age Limitation: Up to age 70
Survival Period: None

Member / Spouse / Eligible Dependents

Calendar Year Maximum: $3,000 (per family member)
Reimbursement: 2025 O.D.A. Fee Guide
Member Advantage Card: Dental Reimbursement

See booklet for specific coverage details.

Members / Eligible Dependents

Covered

Members / Spouse / Dependent Child

WSIB / STD Integration

Members only

Age Limitation: Under the age of 99
Coverage: 24 Hours
Maximum Per Trip Benefit: $5,000,000 / up to age 80
$2,500,000 / age 80 – up to age 99 (180 day pre-existing stability clause)
Period of Coverage: Maximum of 90 consecutive days per trip

Members / Spouse / Dependent Child

Diagnostics Healthcare Services
MRI / CT Scans / Ultrasound / Endoscopy / Colonoscopy

Specialists Healthcare Services
Dermatologist, Endocrinologist, Gynecologist, Podiatrist, Respirologist, Cardiology, Gastroenterology, General Surgery, Neurosurgery, Ear, nose & throat, Orthopedics, Ophthalmology, Rheumatology, Urology, Neurology

Surgeries Healthcare Services (MEMBER ONLY)
Orthopedic Surgery – ACL, Elbow, Foot, Ankle, Toe, Hand, Wrist, Hip, Knee & Shoulder
General Surgery – Cataract, Ear, Nose & Throat, Gallbladder & Hernia Joint Replacement Surgeries – Hip, Knee, Shoulder, Elbow, Ankle & Wrist

Members / Spouse / Dependent Child

Orthopedic Surgery – ACL, Elbow, Foot, Ankle, Toe, Hand, Wrist, Hip, Knee & Shoulder
General Surgery – Cataract, Ear, Nose & Throat, Gallbladder & Hernia

Members Only

Once a lifetime / Maximum $1,500

Members / Spouse / Dependent Child

Access to tools / information to assist in educating and providing guidance for financial goals and assist in alleviating stress from financial uncertainty

Members / Spouse / Dependent Child

Must be insulin dependent/Monitor reimbursement $75.00
Sensors thru Drug Card

Members / Spouse / Dependent Child

Wills, Power of Attorney, Real Estate, Separation Agreements, Divorce, Cohabitation Agreement Benefit, Highway Traffic Act

*Subject to the limitations as set out under the Pre-Paid Legal Benefit Trust

Member / Spouse

Confidential one-on-one coaching support around diabetes & heart health

Members / Spouse / Dependent Child

Navigation of Healthcare System

Members / Spouse / Dependent Child

One set /$3,500 maximum every 36 months
(including replacement, repair, batteries)

Members / Spouse / Dependent Child

$10,000 for member and spouse

Member / Spouse

Age Limitation: Up to age 75
Daily Maximum Benefit: $225 (50% after Age 70)
Benefit Duration: Maximum of 120 consecutive days
Waiting Period: 3 consecutive days commencing upon arrival
Waiting Period for Birth: 24 Hours

Members / Spouse / Dependent Child

Covered

Members / Spouse / Dependent Child

Iron Drug Injectables

Members / Spouse / Dependent Child

Benefit
$200 per day

Duration
Maximum of 100 days

Members only

Member: $100,000 – Principal Sum
Interment Benefit (Self Insured): $10,000 within 48 hours
Terminal Illness Advance (24 months life expectancy): 50% of the principal sum up to a maximum of $50,000
Age Limitation: Up to age 75

Member

Age Limitation: Over the age of 18
Maximum Indemnity Benefit: $50 per day for Long Term Care Services
Daily Reimbursement Benefit: $100 per day for eligible Long Term Care Expenses
Hospice Care (In-Home): $10,000
Lifetime Maximum per person: $100,000

Member / Spouse

Virtual / Phone Counselling Services

Members / Spouse / Dependent Child

In-house destination for support on matters relating to disability, workers compensation, and other medical benefits and services.

Member Health Management Services
T: 416-240-2104 / 1-866-315-6011
F: 416-240-7047
200 Labourers Way, Suite 5400
Vaughan, ON, L4H 5H9

memberhealthservices@liunacare183.com

Members / Spouse / Dependent Child

Benefit
Assist with mild to moderate mental health symptoms, including mood and anxiety disorders, depression, or bipolar disorders

Duration
Eight (8) week (9 hours per week) intensive outpatient program,followed by 10 weeks of aftercare

Members / Spouse / Dependent Child

Benefit
Online portal to assist with mental health issues with convenience and privacy of at-home support

Duration
Six (6) sessions to address most prominent mental health issues

Members / Spouse / Dependent Child

Confidential Counselling for Mental Wellness
Anxiety, Addiction, Depression, Stress & Substance Abuse

Members / Spouse / Dependent Child

$85 per visit up to an overall combined paramedical therapy
Maximum of $2,000 per calendar year

Members / Spouse / Dependent Child

Up to $2,000 every 36 months (not eligible for cosmetic purposes)

Members / Spouse / Dependent Child
M.D. Referral Required

Assistance with workplace accidents and illnesses (WSIB) claims.

Member Health Management Services
T: 416-240-2104 / 1-866-315-6011
F: 416-240-7047
200 Labourers Way, Suite 5400
Vaughan, ON, L4H 5H9

memberhealthservices@liunacare183.com

Members Only

Member: $100,000
Age Limitation: Up to age 70

Member

$85 per visit up to an overall combined paramedical therapy
Maximum of $2,000 per calendar year

Members / Spouse / Dependent Child

Outpatient Treatment Service for confidential opioid therapy and treatment

Members / Spouse / Dependent Child

Custom made orthopedic shoes
1 pair every 24 months / Maximum $500

Members / Spouse / Dependent Child

Custom made orthotics
50% / Maximum $250 per calendar year

Members / Spouse / Dependent Child

$85 per visit up to an overall combined paramedical therapy
Maximum of $2,000 per calendar year

Members / Spouse / Dependent Child

Benefit
$300 per day

Duration
Maximum of 3 days immediately following the birth of a newborn

Members only

Provide supportive services (telephone or video conference) for the caregiving needs of the elderly no matter age, stage, crisis or concern

Member

Member: $100,000
Age Limitation: Up to age 70

Member

Physiotherapist (M.D. Referral)

$100 1st visit / $90 subsequent visits up to an overall combined paramedical therapy
Maximum of $2,000 per calendar year

Members / Spouse / Dependent Child

$85 per visit up to an overall combined paramedical therapy
Maximum of $2,000 per calendar year

Members / Spouse / Dependent Child

100% (Rx drugs prescribed by a Physician and dispensed by a Pharmacist)
$50,000 Lifetime Maximum on Opioids

Members / Spouse / Dependent Child

$5,000 Lifetime Maximum

Members / Spouse / Dependent Child

$500 for each child/grandchild born on or after January 1, 2017

$100 for each child/grandchild born on or after January 1, 2000

Members only

Rental of Durable Medical Equipment

Members / Spouse / Dependent Child

$20 per visit / $2,500 Calendar Year Maximum

Members / Spouse / Dependent Child

Second Medical Opinion Benefit

Members / Spouse / Dependent Child

Online training platform for Smoking Cessation / Weight Loss / Alcohol / Stress / Diabetes / Sleep etc.

Members / Spouse / Dependent Child

Age Limitation: Up to age 65
Benefits Payable: 1st day Accident
Total Period of Coverage: Maximum of 38 weeks
Integrated: EI Sickness Benefits (maximum 26 weeks)
Maximum Weekly Benefit: Weekly Benefit is $300
Approved Claims Only: $100 initial claim form completion fee

Member (Full Time)

Online Substance Management & Recovery Program

Members / Spouse / Dependent Child

One (1) course treatment up to a maximum of $350 per lifetime

Members / Spouse / Dependent Child

Age Limitation: Up to age 70
Benefit: $25,000 per occurrence
Lifetime Maximum: $250,000 per individual
Coverage: Hospital, Surgeon, Physician Fees

Members / Spouse / Dependent Child

Member: $100,000
Age Limitation: Up to age 75

Member

Speech Therapist (M.D. or N.P. Referral) (Dependent Child Only)

Lifetime maximum of $10,000 per dependent child only
$200 per visit maximum

Dependent Child

Intensive outpatient mental health program offered virtually or in-person to address substance use and addiction.

Members Only

Residential inpatient program for substance use disorders and addiction.

Members Only

Two pairs per calendar year

Members / Spouse / Dependent Child

Two pairs per calendar year

Members / Spouse / Dependent Child

Maximum of $500 per calendar year

Members / Spouse / Dependent Child

Online platform for Non-Emergency Medical Support

Members / Spouse / Dependent Child

Home delivery for prescription medications

Members / Spouse / Dependent Child

Vision Care: One set (lenses & frames) / $450 maximum every 24 months
Replacement Lenses (Rx Change/Damaged): $100 maximum within the same 24 month period
Contact Lenses: In lieu of glasses / $450 maximum every 24 months
Eye Exams – Under 65 years of age (Member & Dependents): Included once (with vision care coverage)
within the same 24 month period
Eye Exams – Over 65 years of age (Member & Dependents): OHIP Covered
Eye Exams – Dependents under 65 years of age / Member is over 65 years of age: Included once (with vision care coverage) within the same 24 month period (Dependents only)
Laser Eye Surgery: $2,000 Lifetime Maximum
Intra-ocular lens (IOL) Prep Exam – Prior cataract surgery: Maximum $450 per eye, per lifetime
Intra-ocular lens (IOL) – Post cataract surgery: Single-focal – max $250 per eye per lifetime / Multi-focal – max $600 per eye per lifetime

Members / Spouse / Dependent Child

$500 Lifetime Maximum

Members / Spouse / Dependent Child