Retirees

 

Benefit summary


This is only a summary of your PSGIP benefits. It does not describe all the details, such as applicable maximums and exclusions. Certain limitations and conditions apply.

Health benefits

Dental benefits

Travel benefits
Death benefits

You may also want to consult the retiree checklist for an overview of benefit-related considerations and action items before you retire.

Note: If you are a retiree of CUPE Local 1145, 1770, 1775 or 3260, the City of Charlottetown, PEI Business Development, WCB of PEI, or Island Waste Management, this site applies to you for health, dental and travel benefits only.

Health benefits
Option 1
All eligible expenses, except semiprivate hospital room

Option 2

Same as option 1, except each policy year (April 1 to March 31), you must pay the first $200 (single coverage) or $400 (family coverage) of eligible prescription drugs before drug coverage begins
Option 3
Same as option 1, except once you pay up to $50 per eligible drug appearing on your prescription, the plan covers the remainder of the drug cost at 100%
Option 4
All eligible expenses, including semiprivate hospital room, but excluding drug coverage
Examples of eligible expenses
Ambulance
100% of the first $50 of eligible expenses per person, per calendar year, and 80% of any excess
Drugs
Option 1: 80% of the first $150 of eligible expenses per drug requiring a prescription; 100% of the excess
Option 2: Same as option 1 after you have paid the first $200 or $400 each policy year
Option 3: 100% after you have paid up to $50 per eligible drug appearing on your prescription
Hospital
100% of the difference between ward and semiprivate room
80% of the difference between semiprivate room and private room
Medical services/ equipment,
paramedical services,
private nursing care
80%
Vision care
Eye exams: 80%, subject to a maximum reimbursement of $80 once every 2 calendar years (every calendar year for persons under 18)
Eyeglasses or contact lenses: 80%, subject to a maximum reimbursement of $80 every 2 calendar years (every calendar year for persons under 18)

Additional benefits may be payable in the event of accidental injury. Also, certain health care expenses are not covered.

Dental benefits
Option 1
80% for basic services only
Option 2
80% for basic services
50% for major services (max. $500 per calendar year)
Examples of eligible expenses
Basic services Major services
Routine check-ups
Fillings
Teeth polishing/cleaning
Root canal therapy
Dentures
Crowns
Bridges
Inlays/onlays

Travel benefits

Coverage during the first 180 days of a trip, up to $1 million per emergency above what your provincial plan pays.

Examples of eligible expenses and services
Reimbursement
at 100%
Reimbursement at the
same level as in Canada
Hospitalization
Physician services
Referrals
Return home airfare
Return of vehicle
Living expenses for companion travelling with patient
Arrangements for direct payment for physicians’ services, hospitalization,
and other insured services
Prescription drugs
Wheelchairs
Crutches
Other eligible expenses under the plan’s health coverage

Death benefits
  Natural death Accidental death
Your death
$5,000 (or your basic life insurance in effect prior to your retirement, if you retired from the Civil Service before June 1, 1997, with a pension from the Pension Plan, and you pass away before age 65 )
PLUS
If you are under age 65, optional life insurance coverage chosen before retirement (up to $300,000)
Same amounts as for natural death
PLUS
The following amounts, if applicable:
Basic accidental death benefits of $5,000, if you retired from the Civil Service on or after June 1, 1997
Basic accidental death benefits of 2 x your earnings, up to age 65 ($5,000 afterward), if you retired from the Civil Service before June 1, 1997
If you are under age 65, optional accidental death coverage chosen before retirement (up to $300,000)
Spouse's death
$4,000* ($3,500 if you were a permanent, full-time UPSE employee who transferred from the Civil Service to the Health Sector on August 1, 1995, and remained an UPSE employee)
PLUS
If you are under age 65, optional life insurance coverage chosen before retirement (up to $300,000)
Same amounts as for natural death
PLUS
If you are under age 65, Optional accidental death coverage equal to 50% of your optional accidental death coverage (60% if you have no dependent children)
Dependent child's
death
$3,500*
PLUS
If you are under age 65, $10,000 of optional life insurance coverage
Same amounts as for natural death
PLUS
If you are under age 65, Optional accidental death coverage equal to 15% of your optional accidental death coverage if you have a spouse (20% otherwise; maximum $20,000 per child)
* If you retired from the Health Sector, this basic coverage will end on the first day of the month following your 65th birthday. If you retired from the Civil Service, it will continue for life.

May 2011