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Frequently Asked Questions
What is the cost of the MediDirect® Health, Dental and Wellness Benefit Program?
- There is a one time Company set-up fee of $250.00 plus applicable taxes. Each employee added to the plan is $25.00 plus taxes. Following that, there are no monthly premiums. The company pays only for the medical, dental and wellness expenses incurred by the business owner, employees and their families. If there are no expenses, there is no cost.
- A 10% tax deductible administration fee is applied to each claim processed plus applicable taxes. Taxes are not applied to the medical claim amount except in the case of Ontario employers.
- All fees are tax deductible to the business.
What expenses are deductible? Can I expense Provincial Health Care Premiums through my MediDirect® program?
- All expenses which normally qualify as a medical expense under the relevant provisions of the Canadian Income Tax Act, which encompasses a very broad range of services, are deductible. A more complete list is contained under our page on coverage.
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Provincial Health Care premiums CANNOT be expensed through your MediDirect® program. However, premiums that an employee or their spouse pay towards private, extended health and dental plans can be reimbursed through the MediDirect® program.
As an employee of a business utilizing a MediDirect® program, is there a way to further tax effectively reduce my medical expenses?
What is the maximum annual benefit limit?
- Incorporated companies and organizations are permitted to set their own reasonable maximum annual limits. Sole Proprietorships have an imposed maximum annual limit. Refer to our website’s page on Eligibility, or call the MediDirect® offices for details.
Can I qualify if my health is poor?
- Unlike many insurance based programs, the MediDirect® programs do not have health qualifications. In fact, people who have a pre-existing condition or those who require greater amounts of medical services and supplies may benefit the most from a MediDirect® program. There are no exclusions due to pre-existing conditions, no deductibles to consider, and the employee is free to seek alternative treatments that are not normally covered under an insurance based program.
Can my dependents be included on my MediDirect® program?
- The spouse and dependent children of the business owner and the employees may all be included. A dependent child is defined as: (a) an unmarried child under age 21; (b) an unmarried child under age 25 if attending a post-secondary institution on a full-time basis; or (c) an unmarried child who is incapable of supporting himself because of a mental or physical handicap.
As a smaller business, can I still have benefits normally associated with large business through this plan?
- Yes. Any MediDirect® program is effectively a reimbursement service for the employer no matter how large or small your business may be.
- Incorporated companies and organizations are permitted to set their own reasonable maximum annual limits. Sole Proprietorships have an imposed maximum annual limit. Refer to our website’s page on Eligibility, or call the MediDirect® offices for details.
What about my employees’ privacy?
- Employees submit their claim forms and receipts directly to the MediDirect® offices to ensure their privacy. Personal information will not be provided to any third party. Access to personal information is restricted to only those employees of MediDirect® who are responsible for administration, the Privacy Officer of MediDirect®, or any other person(s) whom you authorize.
My spouse already has a plan, do I need one myself?
- Many people may be covered by a spousal plan. However, such plans often prohibit therapeutic, wellness or complementary medical services or only pay a small portion of the total expense. Now there is a way to avoid additional billing that you currently pay with after tax dollars.
After the MediDirect® offices have received my claim, how soon can I expect reimbursement?
- MediDirect® issues the reimbursement to the Employee within 5 business days upon receipt of the claim and payment by their Employer.
What is the time limit to file a claim?
- Employees should submit claims within three months of the business year end.
What is an Administrative Services Only (ASO)?
- An ASO is similar to a Health Spending Account in that it is a Private Health Services Plan (a self-insured, or self-funded plan) set up by the employer and administered by MediDirect®. The difference is that an ASO gives the employer the ability to manage benefit costs by specifying certain restrictions and limitations on coverages. Effectively, it provides coverage similar to insurance company plans, but at a much lower cost for the same coverage and allows the employer to change coverage at anytime.
Can I claim my health club membership or expensive running shoes through my MediDirect® program?
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A popular new option within a MediDirect® health, dental and wellness program is a combined HSA and Wellness Account. One portion of the HSA is allotted to medical, dental or wellness expenses which are reimbursed as non-taxable benefits. The other portion is paid on a "wellness account", which is intended for expenses such as fitness club memberships, golf memberships or athletic footwear. These expenses are reimbursed to the employee but are a taxable benefit.
MediDirect® provides administration and adjudication of claims, determines whether the expense are non-taxable or taxable, and provides full accounting to the corporation at year-end.
What happens if one of my family members is diagnosed with a terminal illness or is in a serious accident, how much coverage do I have?
My current group benefit plan provides for disability insurance, critical illness insurance and travel coverage. Are these part of the MediDirect® program?
- Yes, we can customize a benefits program for each corporation or each employee to their desired coverages. Please refer to our Insurance Options page for more information on optional insurances.
I’ve noticed that MediDirect® is referred to as a “program” and not a “plan”. What is the difference?
- A "plan" is generally used to describe an insurance based benefit plan, which is sold with pre-determined, fixed coverage parameters. If the corporation desires different features, there are a set number of options to choose from, like a cafeteria menu.
MediDirect® chose the word "program" to describe what we offer because of the flexibility inherent in our offerings. The program can be anything you want it to be because we provide a single source for an extensive menu of customizable services that you can pick and choose from. You aren’t forced to choose from a pre-set list of options.
At a basic level the corporation or sole proprietor can change from insurance-based health coverage or no coverage at all, to a self-funded health, dental and wellness program with all of the benefits that entails. Or they can choose to add one or more components such as a MediDirect® Flex Benefit Program or optional insurance tailored to meet the needs of the business or the individual.
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