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Supplemental Health Benefits

Supplemental health benefits are employer-funded additions to the basic health plans available to all Canadians. Through a Private Health Services Plan, employers can provide these benefits as a tax deduction, while employees are granted a tax-free benefit.

Supplemental health benefits may incorporate any of the following health services; however, an employer or association may elect to decline specific coverage or apply limits to others. In addition to the expenses listed below, all items outlined under IT 519 of the Income Tax Act are also available to be included in a PHSP.

Non-Qualifying Expenses

In accordance with the Canada Health Act, the following cannot be covered with a Supplemental Health Benefits Plan:

  • Supplements / Vitamins
  • Cosmetic Surgery
  • Amounts that the employee is entitled to be reimbursed by another plan
  • Amounts not supported by acceptable documentation
  • Amounts not covered by the current Income Tax Act

Pacific Rim Administration Services will advise the employer of any changes in any act that will affect alteration in their plan.

Basic Coverage

The following are medical expenses generally not covered, or not covered in their entirety, by provincial or territory medical programs that may be covered through a supplemental health benefits plan:

  • Private nursing home care
  • Hearing aids
  • Eyeglasses and contact lenses
  • Prescription drugs
  • Medical devices
  • Speech therapy
  • Registered massage therapy
  • Chiropractor
  • Naturopath
  • Osteopath
  • Podiatrist
  • Acupuncture
  • Psychologist
  • Psychiatrist
  • Orthotics diagnosis and material
  • Orthopaedics services and medical needs
  • Physiotherapist
  • Laser eye surgery

Hospital Services:

  • Semi-private or private hospital room
  • Any hospital expense not covered by your provincial plan

Medicines:

  • Any prescription medications not covered by your provincial plan
  • All drugs must be dispensed by a pharmacist and have a DIN

Apparatus and Materials:

  • Artificial eye
  • Artificial limb
  • Brace for a limb
  • Artificial kidney machine, including reasonable installation, home alteration and operating costs
  • Blood sugar level measuring devices for diabetes
  • Catheters, catheter trays, tubing, disposable briefs or other products required by persons who are incontinent by virtue of illness, injury, or affliction
  • Colostomy pads
  • Crutches
  • Reasonable expenses for altering a driveway to facilitate bus access by a mobility-impaired person
  • Devices designed to assist entrance or leave into a bathtub, shower, or toilet
  • A hospital bed, including any prescribed attachment
  • Any device designed to assist a mobility-impaired individual
  • Exclusive devices enabling a mobility-impaired individual to operate a vehicle
  • A defined sum toward the cost of a van adapted to transport a patient in wheelchair
  • External breast prosthesis following mastectomy
  • All hearing aid devices and television closed caption decoders for the deaf
  • Sign language interpretation services
  • Any equipment enabling a deaf or mute person to make and receive telephone calls
  • Electronic speech synthesizers for mute individuals
  • Optical scanner or similar device to aid a blind individual in reading print
  • Synthetic speech systems, Braille printers and large print-on-screen devices
  • Electronic or computerized environmental control systems designed for individuals with severe and prolonged mobility restrictions
  • Extremity pumps or elastic support hose designed to treat lymphoedema
  • Inductive coupling ontogenesis stimulator for treating fractures or aiding bone fusion
  • Repairs and replacement batteries for any relevant apparatus

Note: all items indicated above must be prescribed by a medical practitioner.

Prescribed Medical Treatments

  • Any treatment not covered by your provincial plan

To ascertain the specific coverage your plan offers, you may review your documents or contact us directly with any questions.