The goal of ARTA's Group Benefits Program is to provide the best benefits at an affordable price to meet the needs of the majority of retired teachers, regardless of age. ARTA's Health and Dental Plans compare favourably with other plans and ARTA's Travel Emergency Medical coverage (included with ARTA's Extended Health Care with Travel Plan) offers the best value for the retiree age group. Below are the highlights of a recent comparison with Blue Cross Plan, a private individual insurance plan offered by Blue Cross to Alberta Seniors over age 65.

Options for all ages: ARTA members can choose Health (with or without travel) or Dental coverage at any age. The plans are separate. Blue Cross Plus combines Health and Dental into one plan and is available only at ages 65 and older. The plans are combined.

60-day window without medical evidence: ARTA's Health and Dental Plan is available without medical evidence for members applying within 60 days of losing prior group coverage. Because Blue Cross Plus is an individual plan, it does not qualify as prior group coverage. ARTA members transferring from Blue Cross Plan would be required to submit medical evidence and may be denied coverage.

Travel with pre-existing conditions covered: ARTA's Health Plan reimburses 100% of elig-ible out-of-province/out-of-country emergency medical expenses for an unlimited number of trips up to 60 days in duration. The lifetime maximum is $1,000,000. There are no age limits, no pre-existing condition limitations. Blue Cross Plus excludes travel out-of-country (but air ambulance out-of-province is covered). For an additional premium, Blue Cross offers per trip coverage up to age 80, but is subject to medical evidence.

Drugs over and above Alberta's Seniors Formulary: ARTA's Health Plan reimburses 80% of prescribed drugs not covered by Alberta's Seniors Drug Plan formulary plus 80% of Alberta's

(next column >>>)

ARTA © 2005

 

Seniors Drug Plan deductible. Diabetic supplies are also covered. Blue Cross Plus excludes drugs.

Hospital, Home Care and more:
Other Health coverage includes Hospital, Acute Home Care (after a hospital stay of 24 hours), Nursing, Air Ambulance, Paramedical, Vision Care, Hearing Aids, Medical Aids and Orthopaedic Shoes. In general, ARTA's list of eligible expenses is longer and internal limits are higher than the Blue Cross Plus Plan. However, ARTA limits in-province medical expenses to $10,000 per year. Accidental Death and Dismemberment (AD&D) is covered by Blue Cross, but not included in ARTA's Health Plan. However, ARTA's separate life insurance plans do include AD&D.

Reasonable and customary dental fee schedule:
ARTA's Dental Plan reimburses 80% of Basic and Preventative treatment, 80% of Minor treatment (periodontics, endodontics and eight (8) 15-minute units of scaling) and 50% of Major treatment (crowns, bridges and, after one year, dentures). Limits apply to Minor and Major treatment only. Basic and Preventative is unlimited. The insurer, Manulife, updates the fee schedule on a reasonable and customary basis. Blue Cross Plus Plan C limits the reimbursement to $500 in year one and $2000 in year two and to a more conservative fee guide - Alberta Blue Cross' Dental Schedule.