Guaranteed Acceptance Plan – Sonata Health

If you’re looking for a plan that provides well-rounded coverage for all of your essential needs, or if your health prevents you from qualifying for Sonata Health’s Scales 1 to 4, our Guaranteed Acceptance Plan (GAP) may be right for you.

Because acceptance is guaranteed with GAP, you’re eligible even if your health situation prevents you from qualifying for more enhanced coverage. And you don’t need to have had any prior coverage.

Note: The ability to customize your coverage with optional benefits is not available with this plan. Instead, some of the additional benefits we offer are already included as standard coverage under the GAP plan.

GAP provides coverage for the following benefits and benefit levels.

Prescription drugs

Drugs that require a prescription by law are covered at:

• 70% reimbursement¹ for both generic and brand name prescriptions²
• $300 per person annual maximum
• $5 maximum dispensing fee per prescription

If you live in Quebec, read the Information for Quebec Residents.

Ambulance services – 100% reimbursement¹ for ground or air transport.

Paramedical services – 70% reimbursement¹ to a $300 annual maximum for all practitioners combined.

In-home nursing benefits

• 80% reimbursement¹ to a $2,500 maximum every 36 months
• Home care is not included

Medical supplies – 100% reimbursement¹ for selected medical supplies.

Dentalcare

• Waiting period: 3-month no-claims waiting period³
• Deductible of $50 per person to a maximum of $400 per family per calendar year
• 70% reimbursement¹ for selected routine services (for example, cleanings, scalings, fillings and examinations) to a $300 per person annual maximum
• 100% reimbursement¹ for accidental injury to natural teeth

Additional Coverage

With Sonata Health’s GAP, you also have coverage for benefits that are only available as optional add-ons under our other Sonata Health plans:

• Emergency travel medical – coverage for trips outside Canada up to 9 days
• Hospital accommodation – coverage for a maximum of $175 per day up to 30 days each year
• Accidental death and dismemberment – coverage for you and your dependents in case of accidental death or injury, up to $25,000 for the policyowner, $12,500 for your spouse and $2,500 for children

PVS – discount on prescription eyewear and hearing aids at participating outlets.

Best Doctors® - consultation services that put you in touch with the world’s best medical specialists to help with diagnosis and treatment planning.

Sonata Health also features several included services as part of each plan.

To learn more

• Compare all 5 Sonata Health plans
• Talk to your financial security advisor, or contact us and we’ll put you in touch with a financial security advisor in your area.

¹Reimbursement: refers to reimbursement for eligible expenses.

²Generic and brand name prescriptions: the plan pays for the lower cost alternative drug, unless the physician has directed that a particular brand name prescription drug not be interchanged.

³Waiting period: A 3-month waiting period applies to dentalcare services and supplies. This means no benefits are payable for dentalcare services and supplies expenses incurred during the period starting on your policy's effective date and ending on the last day of the third month following your policy's effective date. However, if you had prior dentalcare coverage, and apply for Sonata Health within 60 days of losing your coverage, the 3-month waiting period will be waived for routine dental services only. The waiting period will still apply to endodontic services, periodontal services, oral surgery and denture maintenance, as well as major dental. If you had no prior coverage, the waiting period will apply for all dentalcare services.

Benefits payable for certain health and dental services and supplies are subject to a limitation. A limitation may apply to a dollar amount which is payable under the policy or the frequency for which benefits will be payable.