Supplementary Coverage
This coverage is intended for eligible participants who are covered under a provincial/territorial health insurance plan. In general, the PSHCP supplements the coverage provided under the provincial/territorial plan in the member's province/territory of residence. This coverage consists of the:
- Extended Health Provision (80% reimbursement/deductible except for:
- Emergency Benefit While Travelling and the Emergency Travel Assistance Services which are reimbursed at 100% and no deductible applies;
- Catastrophic Drug Coverage which provides 100% reimbursement for eligible drug expenses in excess of $3,000 out-of-pocket cap, exclusive of the deductible);
- Hospital Provision (100% reimbursement/no deductible).
Comprehensive Coverage
This coverage is intended for members and their eligible dependants who are residing with the member outside Canada and who are not covered under a provincial/territorial health insurance plan or in a non-government hospital insurance plan. A person covered under Comprehensive Coverage will continue to be covered under this benefit after their return to Canada until such time as they become eligible to be insured under a provincial/territorial health insurance plan. This coverage consists of the:
- Extended Health Provision (80% reimbursement/deductible) except for:
- Catastrophic Drug Coverage which provides 100% reimbursement for eligible drug expenses in excess of $3,000 out-of-pocket cap, exclusive of the deductible;
- Hospital Provision (100% reimbursement/no deductible);
- Out-of-Province Benefit is not available under Comprehensive Coverage.
- Basic Health Care Provision (100% reimbursement/no deductible);
- Hospital Expense (Outside Canada) Provision (100% reimbursement/no deductible). This provision does not apply to pensioners.
Eligibility for Provisions
Employees, Dependants of Members of the CF and of the RCMP
| Residency | Extended Health Provision and Hospital Level I | Hospital Provision Level II and III | Basic Health Care | Hospital Expense (Outside Canada) |
|---|---|---|---|---|
| In Canada and covered under a provincial/territorial health insurance plan | √ | √ | No | No |
| Posted outside Canada | compulsory 3 | √ | compulsory | compulsory |
| On Loan to serve with an International organisation1 | √ 3 | √ | √ | √ |
| On Educational LWOP4 outside Canada1 | √ 3 | √ | √ | √ |
|
On LWOP4 and outside Canada |
√ 2 | √ 2 | No | No |
| Residency | Extended Health Provision and Hospital Level I | Hospital Provision Level II and III | Basic Health Care | Hospital Expense (Outside Canada) |
|---|---|---|---|---|
| In Canada and covered under a provincial/territorial health insurance plan | √ | √ | No | No |
| Residing Outside Canada | √ 3 | √ | √ | No |
√ means eligible for coverage under this provision
1 Departmental approval required.
2 Provided that the member is insured under a provincial/territorial health insurance plan's "out-of-country" coverage.
3 Members with Comprehensive Coverage and, therefore without provincial/territorial health insurance, are not eligible for the out-of-province benefit.
4 LWOP means leave without pay.