Better by design
We’ve taken a different approach when it comes to plan design, with a commitment to give you the most cover combined with the best value. This is achieved by asking you to take some of the responsibility of your health care costs. Such items are deductibles, co-insurance or what is referred to as out-of-pocket expenses (these terms are explained below).
By asking you to take partial responsibility for these costs we can offer a plan that does not have specific limits on important elements such as specialists fees, out-patient visits, physician office visits, prescription drugs, or chronic conditions. It all adds up to more protection for you.
A deductible is the amount you pay towards covered medical expenses before Personal Health pays for your treatment. Once you have met your individual deductible, Personal Health pays for your covered medical expenses as per your Schedule of Benefits.
Co-insurance is the amount you are responsible for paying under your schedule of benefits. In most cases, Personal Health pays 100% or 90% outside North America4, and generally 90% inside North America.
Your costs are capped with an out-of-pocket (OOP) limit. This limit caps your responsibility of co-insurance. The maximum individual out-of-pocket you have to pay in any one policy year is $1,000. After your OOP limit has been met, your covered medical expenses are paid at 100%.
Thanks to the design of your plan you can be assured of quality, accessible care - and the best value.
Notes:
4 North America for the purposes of Personal Health is defined as USA and its territories, plus Canada.