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Please include all immediate family members who would be covered under this plan. All members must be registered with Manitoba Health and Seniors Care in order to be eligible for our personal health plans. All fields are required.

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By selecting Yes you will be quoted one of our retiree plans. If you would prefer to be quoted for one of our individual plans select No.

Your quote

Please note that rates are subject to change based on additional information that may be provided during the application process.

Date requested: April 16, 2021

Effective date: May 1, 2021

Family member
Birth date
Blue choice A
A comprehensive plan including coverage for ambulance, dental, prescription drugs and some practitioner services
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More info
Blue choice B
The gold standard for complete health and dental coverage that includes everything in plan A, plus higher coverage maximums and additional coverage such as massage therapy, vision and hospital care.
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More info
Blue choice C
The most robust option that includes everything in plan B with even higher coverage maximums. Plan C also offers coverage for popular benefits like massage therapy, osteopathy, clinical psychology and orthodontic services.
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More info
Accident
The most robust option that includes everything in plan B with even higher coverage maximums. Plan C also offers coverage for popular benefits like massage therapy, osteopathy, clinical psychology and orthodontic services.
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More info
Retiree Basic
A comprehensive plan including coverage for ambulance, dental, prescription drugs and some practitioner services (e.g. physiotherapy, podiatry, chiropractic services). Travel coverage within Canada is included.
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More info
Retiree Standard
Our most robust retiree plan that includes international travel, plus everything in Retiree Basic with the added advantage of higher coverage maximums and additional coverage such as massage therapy, vision and hospital care.
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More info
John Smith
Apr 04 1950
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Request more information

If you would like to be contacted by a Manitoba Blue Cross advisor to discuss these recommendations or to learn about additional options that may be available to you, please provide your contact information. All fields are required.

Date requested: April 16, 2021

Effective date: May 1, 2021

Family member
Birth date
Blue choice A
A comprehensive plan including coverage for ambulance, dental, prescription drugs and some practitioner services
open_in_new
More info
Blue choice B
The gold standard for complete health and dental coverage that includes everything in plan A, plus higher coverage maximums and additional coverage such as massage therapy, vision and hospital care.
open_in_new
More info
Blue choice C
The most robust option that includes everything in plan B with even higher coverage maximums. Plan C also offers coverage for popular benefits like massage therapy, osteopathy, clinical psychology and orthodontic services.
open_in_new
More info
Accident
The most robust option that includes everything in plan B with even higher coverage maximums. Plan C also offers coverage for popular benefits like massage therapy, osteopathy, clinical psychology and orthodontic services.
open_in_new
More info
Retiree Basic
A comprehensive plan including coverage for ambulance, dental, prescription drugs and some practitioner services (e.g. physiotherapy, podiatry, chiropractic services). Travel coverage within Canada is included.
open_in_new
More info
Retiree Standard
Our most robust retiree plan that includes international travel, plus everything in Retiree Basic with the added advantage of higher coverage maximums and additional coverage such as massage therapy, vision and hospital care.
open_in_new
More info
John Smith
Apr 04 1950
--
--
--
--
--
--
Total monthly rate
--
--
--
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Contact information

We respect your privacy and will ensure discretion when communicating with you.

I understand that the personal information and personal health information provided herein as well as any other personal information and personal health information currently held or collected in the future by Manitoba Blue Cross and/or Blue Cross Life Insurance Company of Canada (collectively referred to as "Blue Cross") may be collected, used, or disclosed to administer the terms of the policy of which I am an eligible member, to develop and recommend suitable products and services to me, and to manage the company's business.

Depending on the type of coverage I carry, limited personal information or personal health information may be collected from and/or released to a third party. These include other Blue Cross organizations, licensed physicians and/or any other healthcare professionals or institutions, health and life insurers, government and regulatory authorities, and other third parties when required to administer the benefits outlined in the policy of which I am an eligible member. I understand that Blue Cross may retain service providers inside and outside of Canada to assist them in their business and further understand that my personal information may be subject to disclosure to law enforcement and other authorities, where required by law, both inside and outside of Canada, when such information is in the possession of Blue Cross or one of its authorized service providers.

I understand that I have provided my consent for Blue Cross to collect, use and disclose my personal information as outlined in the Blue Cross Privacy Code. I understand that I may revoke my consent at any time; however, if consent is withheld or revoked, the coverage may be denied or rescinded. I understand why my personal information and personal health information is needed and am aware of the risks and benefits of consenting or refusing to consent to its disclosure. For additional information regarding Blue Cross's privacy policies as to the collection, use, or disclosure of my information, I may contact Blue Cross at 204.775.0151 or 1.800.873.2583 or mb.bluecross.ca.

I authorize Blue Cross to collect, use and disclose my personal information and personal health information as described above.

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