ExtendaPlan®

For Ontario Residents Only

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ExtendaPlan® provides comprehensive insurance with a wide range of benefits including coverage for medical emergencies, medical supplies & equipment, as well as a variety of health specialists.

BENEFITS	DETAILS
Eye Exams	$90 maximum per person in the two (2) most recent policy years, including the current policy year.
Eyeglasses and Contact Lenses	This benefit includes payment for eyeglasses, contact lenses and/or corrective laser eye surgery. Eyeglasses and contact lenses require the written prescription of a physician or optometrist. Sunglasses and eyeglasses for cosmetic purposes are excluded. Included in Eye Exam limit.
Goods & Services	Goods may be purchased anywhere in Canada and services must be provided within your province of residence.
Health Practitioners	Covers the cost for acupuncture, chiropractic, chiropody/podiatry, clinical psychology, massage therapy, speech therapy, naturopath and physiotherapy treatments; $35 maximum per visit to an overall maximum of $250 for all health practitioners, per person per year
Hearing Aids	Covers the cost of a hearing aid; maximum $500 per person, per 5 years (one year waiting period applies)
Health Supplies & Equipment	Covers the cost of various health supplies and equipment like rib belts, air casts and shoulder immobilizers to an overall maximum of $500 per person per year (see the policy wording for a complete list of eligible items; requires a physician's written prescription)
Diabetic Supplies & Equipment	Covers the costs of diabetic supplies and equipment, including testing devices, when ordered in writing by a physician; maximum $300 per person per year (one year waiting period on testing devices)
Oxygen Equipment	Covers the cost of oxygen equipment rental and/or CPAP supplies when ordered in writing by a physician; maximum $500 per person per year to a lifetime maximum of $1,500 (does not cover the cost of oxygen and a one year waiting period applies to CPAP supplies)
Blood Pressure Monitors	Covers the cost of a blood pressure monitor when ordered in writing by a physician; maximum 1 per policy per 5 years
Custom Made Foot Orthotics	Covers 80% of the cost for custom made foot orthotics with a maximum of one pair per person per 5 years for adults; and a maximum of one pair per person per year for children under 16
Therapeutic Shoes	Covers the cost to purchase, repair or replace customized therapeutic shoes to a maximum of $225 per person per year
Mobility Aids	Covers the cost of canes, reaching aids, raised toilet seats, grab bars, bathtub/toilet safety rails and bathtub/transfer benches when accompanied by a physician's letter of necessity; maximum $300 per policy per year
Ostomy Supplies	Covers the cost of ostomy supplies when required for use in the home to a maximum of $300 per person per year
Out-of-province Referral	Covers the costs of a physician, anaesthetic, radiology, laboratory, hospital and ambulance services outside your province of residence, for treatment which is not available in your province of residence; lifetime maximum of $50,000 person (requires a written recommendation from a specialist physician and prior written approval of GMS)
Ambulance	Covers the cost of emergency transport by a road ambulance to the nearest hospital or health centre and 50% of the costs for return to your province of residence if you are bedridden at the time of your discharge; maximum unlimited
Air Ambulance	Covers the cost of emergency transport, within your province of residence, by air ambulance to the nearest hospital or health centre; maximum unlimited (requires authorization by a physician and prior approval by GMS)
Casts & Crutches	Covers the cost of fibreglass casts and the purchase or rental of crutches; maximum unlimited
Preferred Hospital Rooms	Covers the cost of private or semi-private hospital rooms; maximum $1,000 per person per year
Private Duty Nursing	Covers 80% of costs to $3,000 per person per year for in-hospital nursing or in-home palliative care.
In-Hospital Drugs	Covers the cost of prescription drugs, which are not covered by provincial prescription drug service plans, for patients in hospital; maximum $1,000 per person per year
Accidental Injury to Natural Teeth	Covers the cost for dental services resulting from an accidental injury; maximum $2,000 per injury (services totaling $500 or more must be pre-approved by GMS)
Wheelchairs, Motorized Scooters & Adjustable Beds	Covers 80% of the cost to purchase or rent a wheelchair, motorized scooter, and/or adjustable bed when ordered in writing by a physician; maximum of $750 per person per 5 years (a one year waiting period applies)
Artificial Limbs, Eyes & Larynx	Covers the cost of artificial limbs, eyes and/or larynx to a maximum of $5,000 per person per year
Patient Walkers	Covers 80% of the cost to purchase or rent a patient walker to a maximum of $300 per 5 years per person (requires a physician's written order)
Breast Prosthesis	Covers the cost of an artificial breast prosthesis to a maximum of $325 per 2 years if lateral and $650 per 2 years if bilateral (a physician's written referral is required for bilateral mastectomy patients; excludes surgical brassieres)

Additional Coverage:

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.

*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, experimental and non-formulary drugs.

Prescription Drugs - Enhanced

Covers the cost of prescription drugs and oral contraceptives up to $5,000 per person, per year. Includes coverage up to $800 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.

*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 medication is listed under your province's drug formulary, contact your provincial health department or ministry, or consult with your physician.

Dental Care

Basic services include oral exam, 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

Hospital Cash

GMS will pay $100 per day for up to 30 consecutive days 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.

Annual Travel Option

Travel coverage includes the following benefits in the case of medical emergencies:

Hospitalization and hospital services
Physicians and surgeons
Diagnostic Services
Out-patient Treatment
Prescription Drugs - maximum 30 day prescription
Private Duty Nursing - $5,000
Road and Air Ambulance
Special Attendant if returned to Canada by air
Return of Family Member - $1,000
Paramedical Services - $300
Accidental Dental - $2,000 for accidents and $500 for dental pain
Return of Remains - $7,000
Family to Bedside - $3,000 for airfare and $750 for out-of-pocket expenses
Family Transportation - airfare, meals and accommodations up to $2,000
Return of Vehicle - $2,000
Return of Cat or Dog - $300
Child Care - $500
Escort of Insured Child - one way economy airfare
Coverage Continuation - 72 hours
Out-of-pocket Expenses - $1,000
24-hour Travel Assistance Services

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, 30 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.

*If you have received medical treatment or experienced symptoms within 180 days before your trip, certain exclusions may apply. Please read the policy wording and understand it before you travel. Out-of-Canada travel coverage is not available to persons age 80 and over under the Individual Health Travel option. Those of age 80 or older may apply for coverage under the GMS TravelStar® Daily Travel Plan.

This is a summary of benefits. Please refer to the policy wording for complete details.

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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