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Toll Free: 1-877-838-0020
Toll Free: 1-877-838-0020
Health PEI is responsible for the delivery of publicly funded health services in Prince Edward Island. The organization operates hospitals, health centres, public long-term care nursing facilities, and community-based programs and services.
DENTAL
- What is covered: Dental Public Health provides preventative and treatment services to children 3-17 years of age. Special program for children born with a cleft palate. Long-term care dental treatment is provided to residents in long-term care facilities. Certain oral surgery procedures performed by an oral surgeon when it is medically necessary that they be performed in a hospital.
- What is NOT covered: Routine dental services such as examinations, fillings, cleanings, and extractions (unless medically necessary and done in hospital).
DRUGS
- What is covered: Coverage under the Seniors Drug Cost Assistance program for residents aged 65 and over. Seniors must pay the first $8.25 of the medication cost plus the pharmacy fee for each prescription. Coverage under the Family Health Benefits program for low-income families. Coverage for eligible residents under specific programs such as the Diabetes Control Program, Multiple Sclerosis Drug Program. Catastrophic Drug program: Effective October 1, 2013, the government pays all eligible residents’ prescription fees above the set percentage of the family’s income.
TRAVEL INSURANCE
- What is covered: Health PEI covers emergency or sudden illness will be provided at P.E.I. rates in Canadian currency.
- What is NOT covered: The cost for medical services outside Canada may be considerably higher and you will be required to pay the medical costs upfront. You will be reimbursed at PEI rates in Canadian currency; however, you will be responsible to pay the difference between the amount charged and the amount paid by PEI Medicare.
VISION
- What is covered: ‘Eye See… Eye Learn Program’ covers eye exams and glasses for the children who entered grade 1 or 2 and without private insurance.
- What is NOT covered: Prince Eduard Island Health Insurance does NOT cover eye care services, eyeglasses, and lenses.
PARAMEDICAL
- What is covered: Health PEI covers physiotherapy when performed in a hospital.
- What is NOT covered: No coverage for acupuncturists, acupressurists, audiologists, chiropodists, chiropractors, dieticians, homeopaths, naturopaths, optometrists, physiotherapists, podiatrists, osteopaths, and services done by a dentist.
HOSPITAL ROOM
- What is covered: Coverage for standard ward rooms only. The following hospital services are insured (some are available on an out-patient basis): Meals and accommodations at the standard ward rates (semi-private and private rooms are covered at the standard ward rate). Nursing services that are medically necessary. Laboratory, x-rays, and diagnostic procedures. Radiotherapy and physiotherapy. Operating room, routine surgical supplies, and anesthetic facilities. Drugs that are prescribed by a doctor and administered in a hospital. Surgical supplies.
- What is NOT covered: Health PEI does NOT cover semi-private and private rooms.
PRIVATE DUTY NURSING AND MEDICAL EQUIPMENT
- What is covered: Provincial Insulin Pump Program may provide up to 90% coverage for the cost of the pump and monthly supply for children under the age of 19. Coverage varies based on household income and private health insurance. Some coverage for prosthetics and supplies through various provincial programs. Based on assessed needs, home care and support services are provided through the Home Care Program.
- What is NOT covered: Health PEI does NOT cover medical appliances such as hearing aids and artificial limbs.
HEARING AIDS
- What is covered: No coverage
- What is NOT covered: Health PEI does NOT cover medical appliances such as hearing aids and artificial limbs.
AMBULANCE
- What is covered: Residents pay a flat fee of $150 for a ground ambulance. There is no charge for emergency air ambulance when the patient is transported from P.E.I. to a referred hospital out of province. Seniors age 65 and over are exempted from paying user fees.
Helpful links:
Visit www.ExtendedHealth.ca or call toll free 1-877-838-0020 to get a quote or apply for Extended Health care insurance.
IMPORTANT NOTE: The information on this web page is for illustration purposes only. Every effort has been made to ensure the accuracy of the information. Coverage details are subject to change. For complete benefits, terms, conditions, limitations, and exclusions, please contact the Prince Edward Island Department of Health.
Last revised in September 2020.