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Group Medical Services (GMS)
Health Insurance

 

GMS offers two options to meet your health insurance needs.

 

   Personal Health Coverage Replacement Health Plans  

Personal Health insurance plans cover a wide variety of services, and you can choose basic coverage for medical emergencies and everyday health needs, or extensive benefit coverage.

 

Replacement Health benefit plans are available when you’re leaving your employer’s benefit plan. These plans are guaranteed issue and there are no medical questions, if you apply within 60 days after your group insurance expires.

     

 

 

Get Your Quote or Buy ONLINE

 

 


 

Personal Health Coverage

The company offers three Extended Health Plans: BasicPlan, ExtendaPlan, OmniPlan.

You can add to each of these plans one or more Optional benefits:

 

Basic Benefits:

Extended Health Plans

Optional Benefits:

Prescription Drugs

Prescription Drugs Enhanced

Dental care

Hospital Cash

Travel 


Extended Health (Basic benefits)

Benefits

BasicPlan

ExtendaPlan

OmniPlan

Notes

Health Practitioners

N/A

 Maximum of $250 (for all health practitioners combined), per person, per policy year

Maximum of $300 per specialty, per person, per policy year

Acupuncturist, chiropractor, chiropodist/podiatrist, clinical psychologist, massage therapist, naturopath, speech therapist and physiotherapist.

Ambulance

$2,000 / person / year

Unlimited 

Unlimited 

100% emergency transport to hospital; 50% return of bedridden patients.

Air Ambulance

Unlimited 

Unlimited 

Unlimited 

Transport within your province of residence.

Preferred Hospital Rooms

$500 / person / year

$1,000 / person / year

45 days up to $3,500 / person / year

Private or semi-private hospital room costs

Cast and Crutches

Unlimited

Unlimited

Unlimited

Fibreglass casts and the purchase or rental of crutches.

In-Hospital Prescription Drugs

$1,000 / person / year

$1,000 / person / year

$2,000 / person / year

Prescription drugs, which are not covered by your provincial prescription drug service plan.

Private Duty Nursing 

80% to $1,500 per person per year (in-hospital only)

80% to $3,000 per person per year

80% to $5,000 per person per year

Includes in-hospital and in-home care

Wheelchairs, Motorized Scooters & Adjustable Beds

Purchase or rental to a maximum of $500 / 5 years

Purchase or rental to a maximum of $750 / 5 years

Purchase or rental to a maximum of $1000 / 5 years

These benefits have a one year waiting period and require a Physician's written order.

Patient Walker

80% of purchase or rental to a max. of $300 / 5 years

80% of purchase or rental to a max. of $300 / 5 years

80% of purchase or rental to a max. of $300 / 5 years

Must be prescribed by a Physician.

Mobility Aids

N/A

$300 / policy / year

$300 / policy / year

Canes, reaching aids, raised toilet seats, grab bars, bathtub/toilet safety rails, and bathtub/transfer benches.

Diabetic Supplies & Equipment

N/A

$300/person/year

$300/person/year

Diabetic supplies and equipment, including insulin pumps and testing devices, when prescribed by a physician for personal use in the home. Does not cover insulin and other prescription drugs.

Ostomy Supplies

N/A

$300 / person / year

$300 / person / year

 

Oxygen Equipment

N/A

$500 / person / year
to a lifetime maximum of $1,500

$500 / person / year to a lifetime maximum of $2,500

Does not cover the cost of oxygen.

Blood Pressure Monitors

N/A

1 in a 5 year period

1 in a 5 year period

Require Physician's written order.

Hearing Aids

N/A

$500 / 5 years

$800 / 5 years

One year waiting period.

Breast Prosthesis

$175 / 2 yrs lateral
$350 / 2 yrs bilateral

$325 / 2 yrs lateral
$650 / 2 yrs bilateral

$325 / 2 yrs lateral
$650 / 2 yrs bilateral

Excludes surgical brassieres.

Accidental Injury to Natural Teeth

$500 / injury

$2,000 / injury

$5,000 / injury

Services over $300 must be pre-approved. 

Artificial Limbs, Eyes & Larynx

$5000 / person / year

$5000 / person / year

$5000 / person / year

Therapeutic Shoes

N/A

$200 / person / year

$200 / person / year

Require a Physician's written prescription.

Out of Province Referral

N/A

$50,000 / lifetime

$50,000 / lifetime

Requires prior written approval from GMS.

Custom Foot Orthotics

N/A

80% - 1 per 5 years per adult and 1 per year for children under 16

80% - 1 per 3 years per adult and 1 per year for children under 16

Other Health Benefits

N/A

$500 / person / year

$500 / person / year

See policy wording for a complete list of eligible items. Requires a Physician's written prescription.

Funeral Expenses

N/A

N/A

$4,000 in the case of accidental death

Eye Exam

N/A

$120 / 2 years

$90 / 2 years

Eye Glasses, Contacts, or Laser Eye Surgery

N/A

Included in Eye Exam limit

$200 / 2 years


Optional Benefits (can be purchased with any Extended Health plan)

Prescription Drugs 
(optional)

Up to $3,500 maximum.

Pay only $4 per eligible prescription.

Coverage for drugs on your provincial drug services formulary plan.

Current medications are excluded from coverage.

Prescription Drugs - Enhanced
(optional)

Up to $5,000 maximum.

Pay only $4 per eligible prescription.

Coverage for prescription formulary, non-formulary and special status drugs.

Includes $800 coverage for medications associated with pre-existing conditions.

Dental
(optional)

Diagnostic services, Preventive services, Basic Restorations Periodontal treatment, Endodontic treatment including root canal therapy, Basic Surgical Services, Standards Denture Services, Major Services

1st policy year - 75% of the charges for eligible Basic Dental Services, to a maximum of $500 per person per policy year. (Waiting period applies.)
 

2nd policy year - 80% of the charges for eligible Basic Dental Services and 50% of the charges for eligible Major Dental Services, to a combined maximum of $750 per person per policy year.
 

3rd policy year - 80% of the charges for eligible Basic Dental Services and 50% of the charges for eligible Major Dental Services, to a combined maximum of $1,000 per person per policy year.

A three month waiting period applies to all dental services.

Services over $500 must be pre-approved by GMS.

Hospital Cash (optional)

$100 / day, up to 30 consecutive days.

Begins on the 4th day of hospitalization and on the 7th day if hospitalization is due to maternity.

30 day waiting period.

Travel
(ВС, АВ, MB, ON, NS, PE, NL residents)

$2 Million coverage
3 options:

15 days per trip
30 days per trip
48 days per trip

Subject to exclusions for pre-existing conditions.  Applicants aged 80 + are covered for in-Canada travel only. Travel benefits are included in OmniPlan and ExtendaPlan for Saskatchewan residents.

Refer to the policy wording for complete details.

NOTE: The product-related information is for illustration purposes only. For complete benefits, terms, conditions, limitations and exclusions, please refer to the Policy wording (BC, AB, MB, ON, NS, PE, NL) and Policy Wording (SK)

 

All plans are medically underwritten, which means you will have to answer a number of medical questions when applying for this insurance. Your application has to be approved by the insurance company.

 


 

Replacement Health Plans

You can also consider Guaranteed Acceptance Health & Dental plans with GMS: GMS Replacement Health & Dental Plans. If you apply within 60 days of your loss of group benefits, your application is automatically accepted.

 

If you have questions or need more information please call at 416-493-0101, 1-877-443-0101 or

 click here to ask your question Online.

 


Other insurance products from GMS:

Travel Insurance for Canadians

Visitors to Canada Insurance

Group Benefits for Small businesses

  

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Revised: August 18, 2020.