Know Your Plan: Comprehensive Coverage

3 April 2018
This article was published before the transition to the new Plan Administrator, Canada Life. If you have any questions, contact the PSHCP Member Contact Centre at 1-855-415-4414 (toll-free anywhere in North America) or 1-431-489-4064 (call collect if you are outside North America).

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.

Comprehensive coverage is:

  1. Mandatory for employees and members of the Canadian Forces and the Royal Canadian Mounted Police on assignment residing outside of Canada, and their eligible dependants;
  2. Optional for pensioners and their dependants residing outside of Canada;
  3. Optional for employees on leave without pay outside of Canada, and their dependants.

The following benefits are available to all PSHCP members with comprehensive coverage:

  • Basic Health Care Provision
  • Extended Health Provision
    • Drug Benefit
    • Vision Care Benefit
    • Medical Practitioners Benefit
    • Miscellaneous Expense Benefit
    • Dental Benefit
  • Hospital Provision (Level I, II, or III)
  • Hospital (Outside Canada) Provision. This provision does not apply to pensioners.

The Hospital (Outside Canada) Provision provides hospital coverage protection equivalent, as far as possible, to that available to individuals residing in Canada and covered under a provincial/territorial health insurance plan. This provision may provide reimbursement for reasonable and customary charges for expenses incurred while hospitalized such as drugs, laboratory services, and services of hospital staff. For a complete list of the eligible expenses, click here.

Pensioners living abroad are not eligible under the Hospital (Outside Canada) Provision. Should they be hospitalized, pensioners will only receive reimbursement as per the coverage they have chosen under the Hospital Provision (Level I, II or III). Therefore, pensioners are encouraged to obtain hospital coverage through another source.