(Div. of Paloma Ventures Ltd.)

Cost Efficient Benefit Plan (a div. of Paloma Ventures Ltd.) is based in Calgary, AB. We service all of Canada as a third party administrator for the Private Health Services Plan (PHSP)     Home   WHAT IS COVERED?   Below is a comprehesive (though not complete) list of all health and dental related expenses that can be paid for through your company, with the Private health Services Plan (PHSP). If you have any questions or concerns please feel free to call us at: 403-282-3776 or Toll Free: 1-800-651-3776   In general, any service by a qualified practitioner is an eligible expenditure. To be a qualified medical practitioner, the person must be authorized to practice in accordance with the laws of the province and certified according to the practitioner's governing body.                         Eligible Expenditures Which Qualify For The "Cost Plus" Benefit Plan                       Premiums for Health Care                   Professional Services               Dental Services               Laboratory Examinations and tests               Hospital Services                 Prescribed Medical Treatments                 Medicines                 Other Materials and Apparatus Which Don't Require a Prescription                   Other Expenditures                       Materials and Apparatus Which are Prescribed By A Recognized Medical Practitioner                     What's not covered                       Premiums for Health Care Plans Premiums paid to any non-government medical or hospital care plan. e.g. Blue Cross, London Life, etc.                         Back to top                     Professional Services Any service performed by a qualified medical practitioner, including but not limited to the following:                     Acupuncturist (qualified) Gynecologist Orthodontist Practical Nurse (for medical service) Chiropodist Massage Therapist Osteopath Psychiatrist Chiropractor Naturopath Orthopedist Psychoanalyst Christian Science Practitioner Neurologist Pediatrician Psychologist (if licensed) Dental Hygienist Obstetrician Pharmacist Registered Nurse Dental Mechanic Occupational Therapist Physician Speech-language pathologist or speech-language audiologist (treatment for pathological or audiological impediments) Dentist Ophthalmologist Physiotherapist Surgeon Dermatologist Optician Plastic Surgeon Therapeutist or Therapist Dietician Optometrist Podiatrist Note: A qualified medical practitioner means a person who is authorized to practice in accordance to the laws of the province and certified according to the practitioner's governing body.                                               Back to top                     Dental Services                           Dental X-Rays Extracting Teeth Oral Surgery Dental Repair and Replacement Filling Teeth Straightening Teeth Examinations Gum Treatment                                 Back to top                     Laboratory Examinations and Tests                       Blood Tests Metabolism Tests Stool Examination X-Ray Examination Cardiographs Spinal Fluid Tests Urine Analyses                         Back to top                     Hospital Services                         Anesthetist Oxygen Masks, Tent Vaccines Hospital Bills Use of Operating Room X-Ray Technician                       Back to top                     Prescribed Medical Treatments                         Blood Transfusion Healing Services Nursing (by Registered Nurse) Speech Pathology or Audiology Bone Marrow or Organ Transplant Hydrotherapy Pre-Natal, Post Natal Treatments Ultra-violet Ray Treatments Diathermy Injections Psychotherapy Whirlpool Baths Electric Shock Treatments Insulin Treatments Radium Therapy  X-Ray Treatments                       Back to top                       Medicines                            Any non-prescription medicines (over the counter), prescribed by a qualified medical practitioner and recorded by a licensed  pharmacist  All Prescription Drugs Liver Extract - injectable for pernicious anemia Tapes or Tablets-for sugar content tests by diabetics, if prescribed Insulin or Substitutes Oxygen Vitamin B12 - for pernicious anemia                       Back to top                     Materials and Apparatus Which are Prescribed By A Recognized Medical Practitioner                     An external breast prosthesis Inductive coupling osteogenesis stimulator Any device designed to assist walking where the individual has a mobility impairment Infusion pumps for diabetics, including peripherals Contact lenses Monitors attached to babies identified as being prone to sudden infant death syndrome Devices designed to assist a person to use bathtubs, showers, or toilets Optical scanners or similar devices for a blind individual to enable him/her to read print Devices designed to enable individuals with a mobility impairment to operate a vehicle Orthopedic shoes or boots Devices used by individuals suffering from a chronic respiratory aliment or a severe chronic immune system disregulation Oxygen tent Electronic or computerized environmental control systems for individuals with severe and prolonged mobility restrictions Power operated guided chair installation for stairways Electronic speech synthesizers for mute individuals Power operated guided lifts and transportation equipment designed to allow access to buildings, vehicles, or to allow wheelchair access to a vehicle Equipment that enable deaf or mute persons to make and receive telephone calls including visual ringing indicators, acoustic coupler, teletyping, which makes telephone communication possible with other persons swelling Syringes Extremity pumps or elastic support hose to reduce lymph edema swelling Synthetic speech systems, Braille printers, and large print-on-screen devices that enable blind persons to utilize computers Eye Glasses Television closed captioning decoders Heat monitors or pace makers wigs if required as a result of disease, accident, or medical treatment Hospital beds, if required in home                       Back to top                     Other Expenditures                           Ambulance Charges Specially trained animals to assist blind, deaf, or severely impaired persons, including the cost of its care and maintenance Canadian Red Cross Home Maker Service Transportation costs-to hospital, clinic or doctor's office to obtain services not otherwise available Prescription Birth Control Pills Victorian Order of Nurses - Home Care Rehabilitative therapy, Lip reading and sign language training                       Back to top                     Other Materials and Apparatus Which Don't Require a Prescription                     Any device to aid the hearing of a deaf person including bone conduction telephone receivers, extra loud audible signals and devices to permit volume adjustment of telephone equipment above normal levels Crutches Artificial eye Hernia truss Artificial kidney machine, including installation, operating costs Illestomy pads Artificial limb Iron lung Blood sugar level measuring devices for diabetics Laryngeal speaking aid Brace for a limb Spinal Brace Catheters, catheter trays, tubing, diapers, disposable briefs required by incontinent persons Wheelchair Colostomy pads                       Back to top                     What's not covered                           Air conditioners, humidifiers, dehumidifiers, or air cleaners Medical expenses for which you are reimbursed or are entitled to be reimbursed from other plans Antiseptic diaper service Over-the-counter products (contacts lens solutions, vitamins, supplements, aspirin, bandages, etc) Birth control devices (Non prescription) Payments to a municipality where the municipality employed a doctor to provide medical services to the residents of the municipality Cost of missed appointments Purely cosmetic procedures. Expenses must be for diagnostic, therapeutic or rehabilitative services. Some cosmetic procedures qualify if required for medical or reconstructive purposes and must be so stated in writing by your medical practitioner. Expenses incurred for purely cosmetic procedures are not eligible medical expenses; for example, teeth whitening, liposuction, hair replacement procedures, botulinum toxin (Botox) injections, face lifts and breast augmentation. These and any related devices and services were disallowed under new regulations effective March 4, 2010. Gym memberships Reiki Practitioner Health programs offered by resort hotels, health clubs Rolf therapy (unless paid to a physician) Homeopathic medicaments and herbal supplements Scales for weighing food Hospital parking (unless it can be included in long distance travel) Toothpaste Illegal operations, treatment or drugs Umbilical cord blood extraction and storage Maternity clothes   IMPORTANT - Provincial Health Care Premiums ARE NOT eligible expenditures.                           CONTACT US AT (403) 282-3776 or E-MAIL: info@costplus.ca             Toll Free: 1-800-651-3776                   Back to top Cost Plus home | Private Health Services Plan