Dental, Optical and Hearing Aid

(These pages are being re-written and will be updated shortly. Until updated, the text may not be accurate)

The CMAW Benefit Plan offers you and your dependents coverage for dental care, eye care and hearing aids. In each case, we will reimburse 80 per cent of your costs, up to an annual maximum.

What we cover …

Unlike many group plans, we cover all normal dental services, up to the annual maximum (see the maximum benefit you can receive below).

We cover the purchase of prescription eyeglasses (frames and lenses), contact lenses and repairs. As of May 1 2010, you and each eligible dependent can receive a benefit of up to 80 per cent of $600 (i.e. $480) once a rolling calendar year. (The one-year period begins with the date of purchase.)

As of May 1 2010, we cover 80% of one eye examination per year (a rolling period, counted from the date of the last eye exam benefit claimed) to a maximum of $75 for each eligible dependent up to age 16 and 80% up to a maximum of $125 per 24 months for adults.

We cover the cost of hearing aids, including repairs and batteries at 80% of $1,000 as of May 1 2010.

The maximum benefit you can receive …

… for dental for you and your family in a single calendar year is 85% of $6,000, i.e. $4,800.

For hearing aids, as of May 1 2010 the most you can receive is 80% of $1,000, i.e. $800  per eligible family member, every five years. (The five-year period begins with the date of purchase.)

There are some limitations …

For example, the plan does not cover hearing aid claims covered by the Medical Services Act or the Extended Health Care Plan, or claims for which a third party is liable.

Other restrictions are outlined on the Green Shield Claim Form found on our Benefit Forms page. Please be sure to read it thoroughly and send all the information asked for in with your claim, or your claim will be rejected.

If you joined the Plan part-way through the year …

… then your benefits will be pro-rated for the remainder of your first year in the Plan. If you joined the Plan on July 1, for example, your maximum dental claim up to the end of the year will be 85% of $3,000.

If your coverage lapses part-way through the year and you rejoin the plan …

… then your benefits will be pro-rated accordingly.

If you need care outside the province …

… not to worry. The Plan covers 80% of your out-of-province expenses for required care, subject to your annual maximum.

When coverage terminates

The Plan’s dental coverage ends if your full coverage ends, when you reach the age of 65, or begin receiving retirement benefits with one exception. As long as you have enough employer-contributed hours in your Hour Bank to cover the monthly charge, your dental coverage will continue past the age of 65.