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GMS Insurance

For Ontario Residents Only

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Benefits

OmniPlan®

ExtendaPlan®

BasicPlan

Notes

Goods & Services 

Goods and services may be purchased anywhere in Canada.

Goods can be purchased anywhere in Canada. Services must be received in your province of residence.

Goods can be purchased anywhere in Canada. Services must be received in your province of residence.

 

Eye Exams

$90 / 2 years

$90 / 2 years

n/a 

 

Eyeglasses & Contact Lenses 

$200 / 2 years

Included in Eye Exams limit.

n/a 

 

Health Practitioners

Maximum $35 per visit to a maximum of $300 per specialty, per person, per year.

Maximum $35 per visit to a maximum of $250 combined, per person, per year.

n/a

Acupuncture, chiropractic, chiropody/podiatry, clinical psychology, massage therapy, speech therapy, naturopath and physiotherapy treatments.

Hearing Aids

$800 / 5 years

$500 / 5 years

n/a

One year waiting period. 

Health Supplies & Equipment 

$500 / person / year

$500 / person / year

n/a

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

Diabetic Supplies & Equipment 

$300 / person / year

$300 / person / year

n/a

Diabetic supplies and equipment, including testing devices when ordered in writing by a physician. One year waiting period on testing devices. 

Oxygen Equipment

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

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

n/a

Does not cover the cost of oxygen. One year waiting period on CPAP supplies. 

Blood Pressure Monitors 

1 / policy / 5 years 

1 /policy / 5 years  

n/a 

Custom Made Foot Orthotics 

80% 1 / 3 years / adult; 1 / year for children under 16

80% 1 / 5 years / adult; 1 / year for children under 16

n/a

 

Therapeutic Shoes 

$225 / person / year

$225 / person / year

n/a

Require a physician's written prescription. 

Mobility Aids 

$300 / policy / year

$300 / policy / year

n/a

Canes, reaching aids, raised toilet seats, grab bars, bath safety rails and transfer benches when accompanied by a physician's letter of necessity. 

Ostomy Supplies 

$300 / person / year 

$300 / person / year

n/a 

 

Funeral Expenses 

$4,000 for funeral expenses in the case of accidental death

n/a

n/a

 

Out-of-province Referral 

$50,000 / person  lifetime maximum 

$50,000 /  person lifetime maximum 

n/a 

Requires prior written approval from GMS. 

Ambulance 

Unlimited

Unlimited

$2,000 / person / year

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

Air Ambulance 

Unlimited

Unlimited

Unlimited

Transport within your province of residence. 

Casts & Crutches 

Unlimited

Unlimited

Unlimited

Fibreglass casts and the purchase or rental of crutches. 

Preferred Hospital Rooms 

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

$1,000 / person / year

$500 / person / year

Private or semi-private hospital room costs.

Private Duty Nursing 

80% of costs to $5,000 / person / year for in-hospital or in-home as palliative care nursing.

80% of costs to $3,000 / person / year for in-hospital or in-home as palliative care nursing.

80% of costs to $1,500 / person / year for in-hospital nursing.

Must be prescribed by a physician.

In-Hospital Drugs 

$2,000 / person / year

$1,000 / person / year

$1,000 / person / year

 

Accidental Injury to Natural Teeth 

$5,000 / injury

$2,000 / injury

$500 / injury

Services totaling $500 or more must be pre-approved.

Wheelchairs, Motorized Scooters & Adjustable Beds

100% of purchase or rental to a maximum of $1,000 / person / 5 years 

100% of purchase or rental to a maximum of $750 / person / 5 years  

100% of purchase or rental to a maximum of $500 / person / 5 years   

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

Artificial Limbs, Eyes & Larynx 

$5,000 / person / year

$5,000 / person / year

$5,000 / person / year

 

Patient Walkers 

80% of purchase or rental to a maximum of $300 / person / 5 years 

80% of purchase or rental to a maximum of $300 / perdon / 5 years

80% of purchase or rental to a maximum of $300 / person / 5 years

Requires a physician's written order.

Breast Prosthesis 

$325 / 2 years lateral

$650 / 2 years bilateral

$325 / 2 years lateral

$650 / 2 years bilateral

$175 / 2 years lateral

$350 / 2 years bilateral

Excludes surgical brassieres.

Additional Coverage Options

Add any of these options to your GMS Individual Health Plan.

BENEFIT

DESCRIPTION

Prescription Drugs

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 $4.00 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.

Prescription Drugs - Enhanced

Covers the cost of prescription drugs and oral contraceptives up to $5,000 per person, per year. Includes up to $800 coverage per person, per year for prescription medications for pre-existing medical conditions and legal prescriptions for medications not listed under your provincial drug formulary. Pay only $4.00 for each eligible prescription. Use our convenient pay-direct card.

Dental

1st year - 75% to $500; Basic services

2nd year - 80% Basic, 50% Major to $750

3rd year - 80% Basic, 50% Major to $1,000

A three month waiting period applies to all dental services. Services over $500 must be pre-approved by GMS

Hospital Cash

$100 / day, up to maximum of $3,000 per policy year.

Begins on the 4th day of hospitalization, in the case of an accident or illness, or on the 7th day of hospitalization in the case of pregnancy or childbirth. 

Travel

$2 Million coverage

3 options:

15 days per trip 

30 days per trip 

48 days per trip

Subject to exclusions for pre-existing conditions.

Refer to the policy wording for complete detail.

 


Group Medical Services • 2055 Albert Street PO Box 1949 Regina, SK S4P 0E3

Group Medical Services is the operating name for GMS Insurance Inc. in provinces outside of Saskatchewan.

® ExtendaPlan and OmniPlan are registered trademarks of Group Medical Services.

This information is provided to you from the GMS website. While every effort is taken to ensure that all the information is accurate and up-to-date, in case of discrepancies between the content on the GMS website and the content published on this website, the original information on the GMS website shall prevail.

This is not a contract.

Actual terms and conditions are detailed in the policy provided by Group Medical Services. It contains important information concerning details, terms, conditions and limitations. Please read your description of benefits carefully upon receipt.





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GMS

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