|Artificial Limbs, temporary and permanent (to replace temporary)|
Including replacement of existing prosthesis, no earlier than:
- 60 months after the last purchase for patients over age 21, or
- 12 months after the last purchase for spouse, or child age 21 or less.
Earlier replacement may be approved if medically proven that growth or shrinkage of surrounding tissue requires replacement at an earlier date.
|Bandages and Surgical Dressings||Required for the treatment of an open wound or ulcer.|
|Braces that contain either metal or hard plastic||Not including dental braces or braces used primarily for athletic use.|
|Breast (mammary) prosthesis following mastectomy||One replacement for each prosthesis in any 24-month period.|
|Colostomy, ileostomy and tracheostomy supplies, catheters and drainage bags for incontinent, paraplegic or quadriplegic patients|
|Doctor's services, when such services would be eligible for reimbursement under one or more provincial health plans||Claims for such services, following cessation of provincial coverage, will be held by Sun Life pending the decision of the Board of Trustees. |
|Durable equipment manufactured specifically for medical use, required for temporary and therapeutic use in the patient's private residence - rental, or purchase at Sun Life's option - including walkers, hospital beds, apnea monitors and alarm systems for eneuretic patients||Reimbursement limited to the cost of non-motorized equipment, unless medically proven that motorized is required.|
|Elasticised support stockings and elasticised apparel for burn victims||Manufactured to individual patient specifications, or with a minimum compression of 30 millimetres.|
|Glucometers||Glucometers, and their repair and replacement, for insulin-dependent diabetics and for legally blind or colour blind non-insulin-dependent diabetics.
No earlier than 60 months following the date of purchase of the monitor.|
|Insulin jet-injector device for insulin-dependent diabetics||Maximum reimbursable expense of $7601 for each covered person every 36 months.|
|Insulin pumps and associated equipment for insulin-dependent diabetics, including repair or replacement at least 60 months following the date of purchase||Maximum reimbursable expense of $100 for each covered person in any one calendar year.|
|Orthopaedic brassieres||Maximum reimbursable expense of $100 for each
covered person in any one calendar year.|
|Orthopaedic shoes that are an integral part of a brace or are specifically constructed for the patient, including modifications to such shoes, prescribed by a physician, chiropodist or podiatrist|
Maximum reimbursable expense for each covered person in any one calendar year of:
- total charges, less the average cost of regular footwear, as determined by Sun Life, or
whichever is less.
|Orthotic inserts for shoes||Orthotics Maximum reimbursable expense of $3001 for each covered person in any one calendar year.|
|Oxygen and its administration|
|Private duty nurse|
Maximum reimbursable expense of $15,0001 for each covered person in any one calendar year:
- Prescribed by a physician and medically necessary.
(A private duty nurse is a registered nurse, or nursing assistant, licensed, registered or certified through the respective provincial licensing body or professional organization as the case may be. In the absence of such a registry, this will include a nurse with comparable qualifications as determined by Sun Life.)
|Trusses, crutches, splints, cast and cervical collars in metal or hard plastic|
|Wheelchair required for therapeutic use in the patient's private residence - rental, or purchase at Sun Life's option - including repairs and replacement||Reimbursement limited to the cost of non-motorized equipment, unless medically proven that motorized is required (no earlier than 60 months after the last purchase).|
|Wigs following total hair loss as the result of an illness. ||Lifetime maximum reimbursable expense of $5001.|