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In general, the PSHCP supplements the coverage provided under the provincial/territorial plan in the member's province/territory of residence. This coverage consists of the Extended Health Provision (80%) reimbursement except for:</p> <ol style="list-style-type: lower-alpha;"> <li>Emergency Benefit While Travelling and the Emergency Travel Assistance Services which are reimbursed at 100%;</li> <li>Catastrophic drug coverage which provides 100% reimbursement for eligible drug expenses in excess of $3,500 out-of-pocket cap;</li> <li>Hospital Provision (100% reimbursement).</li> </ol> <h2 id="s822-tc-tm_2">4.2 Comprehensive Coverage</h2> <p>4.2.1 This coverage is intended for members and their eligible dependants who are residing with the member outside Canada and who are not covered under a provincial/territorial health insurance plan or in a non-government hospital insurance plan. A person covered under Comprehensive coverage will continue to be covered under this benefit after their return to Canada until such time as they become eligible to be insured under a provincial/territorial health insurance plan. This coverage consists of the:</p> <ol style="list-style-type: lower-alpha;"> <li>Extended Health Provision (80% reimbursement) except for: <ol style="list-style-type: lower-roman;"> <li>Catastrophic drug coverage which provides 100% reimbursement for eligible drug expenses in excess of $3,500 out-of-pocket cap;</li> <li>Hospital Provision (100% reimbursement);</li> <li>Out-of-Province Benefit is not available under Comprehensive coverage.</li> </ol> </li> <li>Basic Health Care Provision (100% reimbursement);</li> <li>Hospital Expense (Outside Canada) Provision (100% reimbursement). This provision does not apply to pensioners.</li> </ol> <h2 id="s822-tc-tm_3">4.3 Eligibility for Provisions</h2> <h3 id="s822-tc-tm_3_1"><strong>Employees, Dependants of Members of the CAF and of the RCMP</strong></h3> <table border="1" cellspacing="0" cellpadding="3"> <tbody> <tr> <td> <p><strong>Residency</strong></p> </td> <td style="text-align: center;"> <p><strong>Extended Health Provision and Hospital Level I</strong></p> </td> <td style="text-align: center;"> <p><strong>Hospital Provision Level II and III</strong></p> </td> <td style="text-align: center;"> <p><strong>Basic Health Care</strong></p> </td> <td style="text-align: center;"> <p><strong>Hospital Expense (Outside Canada)</strong></p> </td> </tr> <tr> <td> <p>In Canada and covered under a provincial/ territorial health insurance plan</p> </td> <td style="text-align: center; font-size: x-large;"><strong>✓</strong></td> <td style="text-align: center; font-size: x-large;"><strong>✓</strong></td> <td style="text-align: center;"> <p>No</p> </td> <td style="text-align: center;"> <p>No</p> </td> </tr> <tr> <td> <p>Posted outside Canada</p> </td> <td style="text-align: center;"> <p>compulsory<sup>3</sup></p> </td> <td style="text-align: center; font-size: x-large;"><strong>✓</strong></td> <td style="text-align: center;"> <p>compulsory</p> </td> <td style="text-align: center;"> <p>compulsory</p> </td> </tr> <tr> <td> <p>On loan to serve with an international organization<sup>1</sup></p> </td> <td style="text-align: center; font-size: x-large;"> <p><strong><span style="font-size: x-large;">✓</span></strong><span style="font-size: 20px;"><sup>3</sup></span></p> </td> <td style="text-align: center; font-size: x-large;"><strong>✓</strong></td> <td style="text-align: center; font-size: x-large;"><strong>✓</strong></td> <td style="text-align: center; font-size: x-large;"><strong>✓</strong></td> </tr> <tr> <td> <p>On educational LWOP<sup>4</sup> outside Canada<sup>1</sup></p> </td> <td style="text-align: center;"> <p><strong><span style="font-size: x-large;">✓</span></strong><span style="font-size: 20px;"><sup>3</sup></span></p> </td> <td style="text-align: center; font-size: x-large;"><strong>✓</strong></td> <td style="text-align: center; font-size: x-large;"><strong>✓</strong></td> <td style="text-align: center; font-size: x-large;"><strong>✓</strong></td> </tr> <tr> <td> <p>On LWOP<sup>4</sup> and outside Canada</p> </td> <td style="text-align: center; font-size: x-large;"> <p><strong><span style="font-size: x-large;">✓</span></strong><span style="font-size: 20px;"><sup>2</sup></span></p> </td> <td style="text-align: center; font-size: x-large;"> <p><strong><span style="font-size: x-large;">✓</span></strong><span style="font-size: 20px;"><sup>2</sup></span></p> </td> <td style="text-align: center;"> <p>No</p> </td> <td style="text-align: center;"> <p>No</p> </td> </tr> </tbody> </table> <h3 id="s822-tc-tm_3_2"> Pensioners</h3> <table border="1" cellspacing="0" cellpadding="3"> <tbody> <tr> <td> <p><strong>Residency</strong></p> </td> <td style="text-align: center;"> <p><strong>Extended Health Provision and Hospital Level I</strong></p> </td> <td style="text-align: center;"> <p><strong>Hospital Provision Level II and III</strong></p> </td> <td style="text-align: center;"> <p><strong>Basic Health Care</strong></p> </td> <td style="text-align: center;"> <p><strong>Hospital Expense (Outside Canada)</strong></p> </td> </tr> <tr> <td> <p>In Canada and covered under a provincial/ territorial health insurance plan</p> </td> <td style="text-align: center; font-size: x-large;"><strong>✓</strong></td> <td style="text-align: center; font-size: x-large;"><strong>✓</strong></td> <td style="text-align: center;"> <p>No</p> </td> <td style="text-align: center;"> <p>No</p> </td> </tr> <tr> <td> <p>Residing outside Canada</p> </td> <td style="text-align: center; font-size: x-large;"> <p><strong><span style="font-size: x-large;">✓</span></strong><span style="font-size: 20px;"><sup>3</sup></span></p> </td> <td style="text-align: center; font-size: x-large;"><strong>✓</strong></td> <td style="text-align: center; font-size: x-large;"><strong><span class="ui-provider hc b c d e f g h i j k l m n o p q r s t u v w x y z ab ac ae af ag ah ai aj ak">✓</span></strong></td> <td style="text-align: center;"> <p>No</p> </td> </tr> </tbody> </table> <p><strong>✓ </strong>means eligible for coverage under this provision</p> <p><sup>1</sup> Departmental approval required.</p> <p><sup>2</sup> Provided that the member is insured under a provincial/territorial health insurance plan's "out-of-country" coverage.</p> <p><sup>3</sup> Members with Comprehensive coverage and therefore without provincial/territorial health insurance, are not eligible for the out-of-province benefit.</p> <p><sup>4</sup> LWOP means leave without pay.</p><div class="page-navigation text-center margin-bottom-20"><a href="/directive/d9/v283/s821/en" title="3 Contributions" class="btn btn-primary directive-section-nav prev"><span>Previous</span></a> <a href="/directive/d9/v283/en" class="btn btn-primary directive-section-nav"><span>Index</span></a> <a href="/directive/d9/v283/s818/en" title="5 Plan Provisions" class="btn btn-primary directive-section-nav next"><span>Next</span></a></div></div></div> </div> <div class="col-12 col-xl-3 hidden-print"> <nav class="inpage-menu"> <div class="card"> <h5 class="card-header bg-light">Related Links</h5> <div class="card-body"> <a href="/directive/d9/v283/en?print" class="list-group-item">Print Full Directive</a><a href="/directive/d9/v283/en?definitions" class="list-group-item">Definitions</a><a href="/directive/d9/v283/s823/en" class="list-group-item">Schedule I – Participating Employers</a><a href="/directive/d9/v283/s824/en" class="list-group-item">Schedule II – Employers Withdrawn from the PSHCP</a><a href="/directive/d9/v283/s825/en" class="list-group-item">Schedule III - Designated Persons, Boards and Agencies</a><a href="/directive/d9/v283/s826/en" class="list-group-item">Schedule IV - Recognized Ongoing Pension Benefits</a><a href="/directive/d9/v283/s827/en" class="list-group-item">Schedule V - Monthly Contribution Rates</a><a href="/directive/d9/v283/s828/en" class="list-group-item">Schedule VI - Full Employer-Paid Coverage</a><a href="/directive/d9/v283/s829/en" class="list-group-item">Schedule VII - Life-Sustaining Drugs</a> </div> </div> </nav> </div> </div> </div> <div class="container-fluid site-footer"> <div class="container"> <div class="row"> <div class="col-md-4 text-center"> © 2024 National Joint Council </div> <div class="col-md-4 text-center"> <a href="/d65/en">Important Notices</a> | <a href="https://www.canada.ca">Canada.ca</a> </div> <div class="col-md-4 text-center"> <a href="/s19/en">Contact Us</a> | <a href="/en">Home</a> </div> </div> </div> </div> <script src="/theme/njc/bootstrap-5/js/bootstrap.bundle.min.js?_nocache=1633790663" ></script><script src="/theme/njc/js/jquery-3.6.0.min.js?_nocache=1644962952" ></script><script src="/theme/njc/js/moment.js?_nocache=1457634357" ></script><script src="/theme/njc/js/bootstrap-datetimepicker.min.js?_nocache=1648748775" ></script><script src="/theme/njc/js/font-spy.js?_nocache=1487693893" ></script><script src="/theme/njc/js/smartmenus/jquery.smartmenus.min.js?_nocache=1595527398" ></script><script src="/theme/njc/js/smartmenus/addons/bootstrap-4/jquery.smartmenus.bootstrap-4.js?_nocache=1645136528" ></script><script src="/theme/njc/js/njc.theme.js?_nocache=1715023601" ></script><script src="https://cdn.datatables.net/v/bs5/dt-2.0.3/fc-5.0.0/fh-4.0.1/r-3.0.1/sc-2.4.1/datatables.min.js"></script> <script> jQuery('.make-datatable').each(function(){ let $t = jQuery(this); 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