Prince Edward Island

PROVINCIAL/ TERRITORIAL HEALTH PROGRAMS

Medical Insurance

Medical Services Plan

Hospital Insurance

PEI Hospital Insurance Plan

Prescription Drug Insurance

Drug Cost Assistance Plan (ODB)

HEALTH PREMIUMS/TAXES

Health Insurance Premiums/Employer Tax

No premiums or employer tax

Additional Premiums

Not applicable

WHEN COVERAGE BEGINS

If move is from within Canada

Coverage on the first day of the third month after arrival in PEI

If move is from outside Canada

Coverage on the date of arrival in PEI

HOW LONG COVERAGE CONTINUES

Moving within Canada

Balance of the month in which you leave the province plus two consecutive months

Moving Outside Canada

Date of departure

Short Absences

Coverage is maintained during an absence of up to 183 days in any 12 month period if PEI remains the permanent and principal home

OUT OF PROVINCE / COUNTRY COVERAGE

Out-of-province

Medical and hospital services obtained within Canada as a result of an emergency or sudden illness. Any related non-emergency or elective service is not covered unless prior approval is received; Claims paid at the standard rates of the province/territory where services were obtained.

Cost of emergency in-patient / out-patient hospital while outside of Canada

Emergency health services;
Payment at PEI rates in Canadian currency.

WHAT IS COVERED

Physician Services

Medically required services associated with physician and diagnostic services and hospital in-and-out patient care, such as:

• Medically necessary surgical services, including the services of anaesthetists and surgical assistants where necessary
• Obstetrical services, including pre-natal and post-natal care, new-born care or any complications of pregnancy such as miscarriage or caesarean section
• Certain medically required oral surgery procedures performed by an oral surgeon when performed in a hospital
• Sterilization procedures, both female and male
• Treatment of fractures and dislocations
• Certain insured specialist services, when properly referred by an attending physician

Eye Examinations

Not covered

Dental

Certain medically necessary surgical-dental procedures performed in hospital by a dentist or oral surgeon

Hospital

Standard ward hospitalization in an approved hospital and in-patient services such as:

• Necessary nursing services
• Laboratory, radiological and other diagnostic procedures
• Formulary drugs prescribed by an attending physician and administered in the hospital
• Operating room, case room and anaesthetic facilities
• Routine surgical supplies
• Radiotherapy
• Physiotherapy received in hospital
• Services rendered by persons who receive remuneration from the hospital

PARAMEDICAL SERVICES

Physiotherapy Services

Physiotherapy services provided at a hospital, on an inpatient or outpatient basis within Canada

Chiropractic Care

Not covered

Osteopath

Not covered

Chiropodist/podiatrist

Not covered

Drug

A Drug Cost Assistance Plan for seniors is open to residents age 65 and over on application. The Seniors Program pays the full cost for eligible prescriptions minus a $11 co-payment and the senior must also pay the dispensing fee.
The Family Health Benefit program assists lower income families with the cost of prescription drugs. Families with at least one child under age 18 with a total annual income less than $22,000 are eligible to participate.

Ambulance

Not covered

• Fees capped at $150 per day