Comprehensive coverage is available to Plan members and their eligible dependants who live outside of Canada and who are not covered under a provincial or territorial health insurance plan.
Pensioners living outside of Canada are eligible for Comprehensive coverage but are not covered by the Hospital (Outside Canada) Provision.
If you have Comprehensive coverage, you are covered for the following benefits:
- Basic Health Care Provision
- Extended Health Provision (not including the Out-of-Province Benefit)
- Drug Benefit
- Vision Care Benefit
- Medical Practitioners Benefit
- Miscellaneous Expense Benefit
- Dental Benefit
- Hospital Provision (Level I, II, or III)
- Hospital (Outside Canada) Provision (not available to pensioners)
If you are an employee who works in Canada but you live outside of Canada (i.e. across the US border), you are not eligible to receive Comprehensive coverage.
If you choose to go on Leave Without Pay (LWOP), you may be eligible for Comprehensive coverage if your LWOP has been approved for educational leave that is of benefit to your department or agency, or your LWOP is so you may serve with an international organization at the request of the Government of Canada.
Comprehensive coverage exclusions
No benefit is payable for:
- Expenses identified in the General Exclusions and Limitations of the Plan.
- Physician services rendered by a salaried employee of a hospital (if you are an employee posted outside Canada, you may be reimbursed for these expenses under the Hospital (outside Canada) Provision).
- Co-insurance charges or similar charges for hospital care in excess of charges payable by a provincial/territorial government health or hospital insurance plan and which are not charges for semi-private or private accommodation.
- Charges incurred by a person who is insured under a non-government group insurance plan in a foreign country when that plan provides hospital expense benefits similar to those provided under the Health Insurance Act, 1972 of Ontario, as amended from time to time.