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Personal Health Coverage Brochure – Ontario Residents

Includes the Ontario rate schedule and side-by-side comparison of plan benefits.

Effective June 1, 2018

Simplified Chinese Personal Health Coverage Brochure – Ontario Residents

Includes the Ontario rate schedule and side-by-side comparison of plan benefits.

Effective June 1, 2018

Punjabi Personal Health Coverage Brochure – Ontario Residents

Includes the Ontario rate schedule and side-by-side comparison of plan benefits.

Effective June 1, 2018

Additional Coverage

Basic Prescription Drug

Covers the cost of prescription drugs listed under your provincial drug formulary† (as detailed under your province’s drug or pharmacare plan/program) up to $3,500 per person, per year. Pay only $4 for each eligible prescription. Use our convenient pay-direct card and reduce your out-of-pocket expenses. Prescriptions for pre-existing medical conditions are not eligible for coverage.

* Coverage excludes contraceptives, fertility drugs, drugs intended to treat sexual dysfunction, lifestyle drugs, diet drugs, drugs for cosmetic purposes, over-the-counter drugs, drugs used to stop smoking, and experimental and non-formulary drugs.

Please refer to the policy document for full details.

Enhanced Prescription Drug

Covers the cost of prescription formulary† drugs and oral contraceptives up to $5,000 per person, per year. Includes coverage up to $800 per person, per year for prescription drugs for pre-existing medical conditions and legal prescriptions for drugs not listed under your provincial drug formulary. Pay only $4 for each eligible prescription. Use our convenient pay-direct card.

* Coverage excludes fertility drugs, drugs intended to treat sexual dysfunction, lifestyle drugs, diet drugs, drugs for cosmetic purposes, over-the-counter drugs, drugs used to stop smoking, and experimental drugs.

To determine if a prescription drug is listed under your province’s drug formulary, contact your provincial health department or ministry, or consult with your physician.

Please refer to the policy document for full details.

† a list of government-approved prescription drugs that are covered by a provincial health care plan

Dental Care

Basic services include oral exams, scaling, polishing, fillings, uncomplicated extractions, endodontics, periodontics, oral surgery, and repairs to dental appliances. Major services include crowns, bridges, dentures, gold inlays and onlays.

  • 1st year: 75% Basic services to a maximum of $500 per person
  • 2nd year: 80% Basic services and 50% Major services to a combined maximum of $750 per person
  • 3rd year and up: 80% Basic services and 50% Major services to a combined maximum of $1,000 per person

Please refer to the policy document for full details.

Hospital Cash

GMS will pay $100 per day, to a maximum of $3,000 per policy year if you are hospitalized. Coverage commences on the 4th day of hospitalization in the case of an accident or illness, or on the 7th day of a maternity stay. This cash can be used for any expenses, such as food, parking and television or telephone rental.

Please refer to the policy document for full details.

Annual Travel

(Available to BC, AB, MB, ON, NS, NL, PE, YU, NWT and NU residents only. For SK residents, travel medical emergency coverage is included in ExtendaPlan® and OmniPlan®.)

Travel coverage includes the following benefits in the event of a medical emergency:

  • In-Hospital Care
  • Physicians Services
  • Diagnostic Services
  • Out-Patient Medical Treatment
  • Prescription Drugs – maximum 30 day prescription
  • Rental of Essential Medical Appliances
  • Emergency Dental Services – $2,000 for accidents and $500 for dental pain
  • Private Duty Nursing – $5,000
  • Health Practitioners- $300
  • Road and Air Ambulance
  • Remote Evacuation- up to a maximum of $20,000
  • Repatriation
  • Special Attendant – if returned to Canada by air
  • Return of Family Member – $1,000
  • Return & Escort of a Dependant Child/GrandChild – one way economy airfare
  • Family/Friend to Bedside – $3,000 for airfare and $750 for out-of-pocket expenses
  • In Event of Death- $2,000 maximum
  • Return of Remains – $7,000
  • Return of Vehicle – $2,000
  • Return of Cat or Dog – $300
  • Child Care – $500
  • Out-of-pocket Expenses – $1,000

Take as many trips as you like:

  • In Canada: $2 million coverage, 180 days per trip, available to all age groups
  • Outside Canada: $2 million coverage; 15, 30, or 48 days per trip; available to people under 80 years of age

GMS Travel Assistance must be contacted within 24 hours of an emergency or accidental injury if outside of Canada. Failure to notify shall limit payment to 70%, up to a maximum of $50,000.

Please refer to the policy document for full details.