OPIP HEALTH & HEALTH PLUS Plan Details and Cost Comparisons

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1 & HEALTH PLUS Plan Details and Cost Comparisons With the OMA Priority Insurance Program (OPIP), you have the opportunity to enhance your existing government subsidized OPIP Health Plan with optional self-funded benefits. Features PLAN DETAILS: PLUS Plan Year January 1 to December 31 January 1 to December 31 Plan Maximums (Lifetime Reimbursement) Lifetime limits on expenses per insured person for: emergency out-of-province/country travel medical $2,000,000 prescription drugs - $1,000,000 fertility drugs - $2,400 wheel chairs - $5,000 hospital beds - $5,000 wigs following chemotherapy - $500 accidental dental - $10,000 Co-insurance 50% of your eligible expenses reimbursed upfront, followed by 100% reimbursement after you have claimed $1,000 for yourself and, 50% of your spouse s and children s eligible expenses upfront, followed by 100% reimbursement (Applies to prescription drugs, in-province hospital and convalescent hospital expenses, ambulance, nursing, medical equipment and services, paramedical services and hearing aids) Paramedical Services $350 per plan year, per practitioner, per insured person can include: licensed psychologist and registered massage therapist: physician s prescription required chiropractor, osteopath, acupuncturist, podiatrists, naturopaths, chiropodist, speech therapist, kinesiologist: physician s prescription not required Lifetime limits on expenses per insured person for: wheel chairs - $5,000 every 5 Plan years accidental dental - $10,000 for any one dental accident 90% of your eligible expenses upfront, followed by 100% reimbursement after you have claimed $1,000 for yourself and, 90% of your spouse s and children s eligible expenses upfront, followed by 100% reimbursement (Applies only to prescription drugs, paramedical services excluding physiotherapists, ambulance and nursing) $500 per plan year, per practitioner, per insured person can include: licensed psychologist, massage therapist: physician s prescription required chiropractor, osteopath, podiatrist, licensed naturopath, chiropodist, acupuncturist, audiologist, occupational therapist, dietician, speech therapist, or kinesiologist: physician s prescription not required one diagnostic x-ray examination in each plan year per practitioner per insured person physiotherapist: physician s prescription not required, no annual maximum applies Page 1 of 6

2 Features Medical Equipment $5,000 maximum per plan year for purchase of braces, crutches, canes, walkers, and artificial limbs or eyes required as a result of illness or injury wheelchairs - $5,000 lifetime maximum hospital beds - $5,000 lifetime maximum Accidental Dental expenses incurred within 3 plan years of accident, $10,000 lifetime maximum Orthopaedic Shoes & Supplies orthopaedic shoes and orthopaedic modifications, and orthotics, maximum $400 per covered person in 2 plan years and requires a doctor s prescription PLAN DETAILS: PLUS $5,000 maximum per plan year for purchase of braces, crutches, casts, splints, trusses and artificial limbs or eyes required as a result of illness or injury wheelchairs - $5,000 every 5 plan years, and expenses are limited to the use of a manual wheelchair except if the insured s medical condition warrants use of an electric wheelchair expenses incurred within 3 plan years, $10,000 for any one dental accident custom made orthotic inserts for shoes or custom made orthopaedic shoes or modification to orthopaedic shoes up to a combined maximum of $300 per plan year and requires a doctor s prescription Ambulance unlimited ground and air ambulance Vision Not Included $300 per covered person (a) under age 18 in a 12 month period or (b) for any other covered person in any 2 calendar years can include: $50 maximum per insured per 2 calendar years for ophthalmologist or licensed optometrist services contact lenses, eyeglasses or laser eye correction surgery requires prescription by an ophthalmologist or licensed optometrist laser eye correction surgery must be performed by an ophthalmologist contact lenses or intraocular lenses following cataract surgery limited to a lifetime maximum of one lens per eye Page 2 of 6

3 Features Prescription Drugs generic drugs (or brand name drugs when no generic equivalent is available) listed in federal or provincial drug schedules that have a DIN number and require a prescription $1,000,000 lifetime maximum per insured, once lifetime maximum is reached, annual $25,000 maximum reinstated injectable drugs, vitamins and allergy serums insulin and diabetic supplies vaccines, whether or not they require a prescription fertility drugs up to $2,400 lifetime maximum Pay-Direct Drug card can easily be downloaded from: Private Duty Nursing Prosthetic Appliances & Other Medical Services Licensed, certified or registered nurse or nursing assistant who is not a relative of the patient or a resident in the insured s home: prescribed by a physician and rendered outside the hospital $25,000 every 3 plan years, if age 65 or under $5,000 per plan year over age 65 laboratory tests, ultrasounds, magnetic resonance imaging, computed tomography scans and other medical imaging services, blood oxygen, colostomy and ileostomy supplies, artificial limbs and eyes, radiotherapy, diabetic supplies and cosmetic surgery necessary to repair disfigurement due to an accident sustained while insured, up to $5,000 per plan year (some restrictions apply please contact the Customer Care Department at ) mammary prosthesis, $200 maximum per plan year, per insured mastectomy brassieres, 2 per plan year, per insured surgical stockings, 2 pairs per plan year, per insured amputation socks, 5 pairs per plan year, per insured wigs following chemotherapy, $500 lifetime maximum, per insured blood glucose monitors, $250 every 5 plan years, per insured PLAN DETAILS: PLUS Hearing Aids $500 every 4 plan years $1000 every 4 plan years Emergency Out-of- Province/ Country Travel Medical lifetime maximum of $2,000,000 per insured person coverage for the first 90 days of travel if under age 70 coverage for the first 30 days of travel age 70 or over Page 3 of 6

4 PLAN DETAILS: Features Continuation of Coverage (Portability) Coverage Ends if a member no longer meets the plan s eligibility requirements, he/she may continue coverage with full premium (certain restrictions may apply please contact the Plan Administrator at ) Member coverage automatically ends: when insured fails to pay premium, subject to the grace period of 31 days upon death, subject to the survivor benefit if OMA terminates the group policy if insured ceases to reside in Canada if insured sends a written request to cancel coverage if insured is no longer covered by a provincial or territorial government health plan if you are no longer eligible for funding, unless you choose to continue your coverage PLUS Member coverage automatically ends: Insured dependent coverage automatically ends: when he/she is no longer an eligible dependent when he/she ceases to reside in Canada if he/she is no longer covered by a provincial or territorial government health plan when insured physician coverage ends the date the group policy no longer includes Couple or Family Coverage Hospital & Convalescent Hospital 100% of room and board charges between standard ward and semi-private rate 100% of room and board charges between standard ward and semi-private rate plus up to $100 per day for private room accommodation 100% of room and board charges if admitted within 24 days following a period as an in-patient in a hospital (180 day maximum) Survivor Benefit on the member s death, coverage continues for 3 months on the insured spouse and/or the insured dependent children. After 3 months for spousal coverage to continue, the spouse must apply within 30 days of termination of coverage and continue to pay the premium Outpatient Facilities 100% of hospital charges for out-patient services on the member s death, coverage continues for 12 months on the insured spouse and/ or the insured dependent children. After 12 months for spousal coverage to continue, the spouse must apply within 30 days of termination of coverage and continue to pay the premium Page 4 of 6

5 PLAN DETAILS: Features Exclusions Covered expense shall not include any charges incurred directly for, as a result of, any one or more of the following: insurrection or war, declared or undeclared, whether or not the insured or insured dependent participated participation in any riot or civil commotion commission of or attempt to commit a criminal offence cosmetic surgery except to the extent necessary to repair disfigurement due to an accident while insured an examination by a physician or surgeon if required for the use of third party dental expenses or work treatment on the teeth or gums except as indicated under accidental dental care, treatment, services or supplies which are not recommended and approved by a physician drugs for the treatment of sexual dysfunction treatment for smoking cessation, treatment for obesity, hair growth stimulants and drugs available without prescriptions services or supplies that are not approved by Health Canada s Health Protection Branch or are not usually provided to treat a medical condition or disease, or are deemed to be experimental in nature, and/or may be in the testing stage will not be reimbursed Not Applicable PLUS Covered expense shall not include any charges incurred directly for, as a result of, any one or more of the following: sunglasses, magnifying glasses or safety glasses, unless needed for the correction of vision Page 5 of 6

6 ACTUAL PLAN COSTS - SUBSIDIZED BY THE GOVERNMENT: PLAN THIS COVERAGE IS INCLUDED IN YOUR $175 ANNUAL CONTRIBUTION Age Single Single + 1 Dependant Child Couple Family < 30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $1, $1, $ $ $1, $1, $1, $1, $2, $3, $1, $1, $2, $3, $1, $1, $2, $2, $1, $1, $2, $2, $1, $1, $2, $2, $1, $1, $2, $3, $2, $2, $4, $5, $5, $6, $11, $12, PLUS PLAN Age Single Single + 1 Dependant Child ANNUAL PLAN COSTS - SELF-FUNDED: Couple Family < 30 $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, $ $ $ $1, $ $ $ $1, $ $ $ $1, $ $ $ $1, $ $ $1, $1, $ $ $1, $1, $ $ $1, $1, Annual premium rates include Ontario Retail Sales Tax (8%), are age-banded and increase as you move into the next age band. These rates are reviewed annually and are subject to change. Calculating your cost for Income Tax Purposes When you apply for your PHBP coverage provided under OPIP, you pay a non-refundable annual contribution, while the balance of the PHBP program cost is subsidized by the Ontario government through Ontario Physicians Services Inc. This subsidization may be considered income to be reported by you for income tax purposes. Each year, to assist in that reporting, the OMA will issue a Premium Summary Statement either to you or to your professional corporation depending on who applies for the funding on the enrolment form. You should consult with your tax advisor to determine how this subsidization should be reported in your circumstances Page 6 of 6

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