OAMRS Health & Dental PLan

Residents of Ontario

WHY GET HEALTH INSURANCE?

You don’t hesitate to insure your home, car, practice and other valuable possessions, so why wouldn’t you insure your most valuable asset — your health?

The OAMRS Health & Dental Plan starts where government coverage ends. Without a plan like this, you may have to pay 100% out of your own pocket for common health care expenses like prescription drugs, dental care, vision care, therapeutic services and more.

After researching many plans OAMRS selected the Manulife program as the best value for our Members. Please tell your co-workers about this exciting new program.

More choices to better fit your needs and budget

The OAMRS Health & Dental Plan has 5 different options for you to choose from — helping you find one that best suits your family’s individual needs and budget.

WHAT’S IN IT FOR YOU?

  • Plans include most core benefits
    You don’t have to pay extra for benefits like vision care, registered specialists and therapists, ambulance services
    and more.
  • No waiting period
    Your benefits start on the first day of the month following registration. There is no waiting period for eligibility.
  • Fast, convenient claims submission
    Your Benefit Card makes it easy for most prescription drug and dental claims to be processed for you electronically so you keep money in your pocket.
  • Acceptance is guaranteed for the Base Health & Dental Plan, and all 4 Dental Plans
    Above plans require no medical questionnaire so your acceptance is guaranteed!

Ready to take the next step and apply? Read on to discover which plan suits you and your family best, check out the 2021 rate guide, or download the application form.

 

Completed application forms can be returned by email to our Life Department, or you may fax your printed form to 416-778-4492. Please note, all applicants must complete Parts A, B, C and D, and Section A.

 

BASE HEALTH & DENTAL PLAN

Guaranteed to Issue (No Medical Information Is Required) †

† All applicants must complete Parts A, B, C and D, and section A.

Prescription Drugs †  
Generic vs brand-name coverage Generic
Shared dispensing fee (subject to applicable co-payment) $6.50 maximum
Birth control Covered
Fertility drugs Not covered
Reimbursement on first amount per anniversary year†† 70% of first $750
Reimbursement on next amount per anniversary year†† None
Maximum per anniversary year†† $525
Dental Services ‡  
Reimbursement on exams, cleanings, fillings, scaling, polishing, root planing, diagnostic, select extractions and other basic dental services 70%
Reimbursement on extensive services including oral surgery, endodontics, periodontics and denture services 70%
Reimbursement on crowns, bridges, dentures and orthodontics Not covered
Combined anniversary year maximums $400 per year
Recall visits 9 months
Hospital Benefits   
Type of accommodation n/a
Maximum charge per day n/a
Reimbursement per anniversary year n/a
Cash benefit in lieu of accommodation n/a
Travel Coverage (to age 65) – maximum $5,000,000 per trip. Unlimited number of trips; Maximum trip length 5 days
Core Benefits  
Registered Specialists & Therapists**
Maximum claims paid

$500 combined per year

Chiropractor ($35 chiropractic x-rays per year), Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist, Dietician.

Per visit maximum $25
Chiropractic X-rays $35 per year
Registered Psychologist or Psychotherapist  
Maximum per first visit $80
Maximum per subsequent visit $65
Maximum visits per year 10
Registered Speech Therapist  
Maximum per first visit $65
Maximum per subsequent visit $45
Maximum visits per year 10
Vision $100 per 2 benefit years plus $60 for Optometrists visits
per 2 benefit years
Homecare & Nursing, Prosthetic Appliances,
and Durable Medical Equipment
For each of Homecare & Nursing, Prosthetic Appliances and Durable
Medical Equipment:
Year 1: $1,000
Year 2: $1,300
Year 3: $1,500
Year 4: $2,000
Year 5+: $2,500
Custom-made Orthotics $225
Accidental Death and Dismemberment
Per adult under 65
Per child or adult 65 and older
$10,000
$4,000
Accidental Dental $2,000 per year
Hearing Aids $300 per 4-year period
Akira by TELUS Health (Virtual Healthcare App) Included
TELUS LivingWell Companion Included
TELUS SmartHome Security Included
Health Service Navigator®* Included
Ambulance Services Unlimited ground and air transportation
Survivor Benefit Available 1 year after policy effective date
Lifetime Maximum $100,000

† Prescription drug coverage applies to costs not covered by your provincial prescription drug insurance plan, up to the maximums stated above. †† Prescription drug coverage is based on Calendar Year for residents of British Columbia and Saskatchewan. For all other provinces, coverage is based on Anniversary Year. Generic Drug – A generally less expensive alternative to an interchangeable brand-name drug product. Please note: Not all drugs have a generic equivalent. If a non-generic drug is purchased, payment will be based on the lowest generic drug cost equivalent, if applicable. If no generic brand exists, payment of the brand-name price will be made at the co-payment level of your plan. Exclusions: smoking cessation drugs, over-the-counter drugs, fertility drugs, birth control drugs, erectile dysfunction drugs, and drugs not requiring a prescription. Other exclusions apply; please consult your policy for details.

DENTAL PLAN

Prescription drugs are not included.
  Base
Dental Plan
Bronze Dental Plan Silver
Dental Plan
Gold Dental Plan
Dental Services ‡
Reimbursement on exams, cleanings, fillings, scaling, polishing, root planing, diagnostic, select extractions and other basic dental services Year 1: 50%
Year 2+: 70%
Year 1: 50%
Year 2+: 70%
Year 1: 60%
Year 2+: 80%
Year 1: 60%
Year 2+: 80%
Reimbursement on extensive services including oral surgery, endodontics, periodontics and denture services Year 1: 50%
Year 2+: 70%
Year 1: 50%
Year 2+: 70%
Year 1: 60%
Year 2+: 80%
Year 1: 60%
Year 2+: 80%
Reimbursement on crowns, bridges, dentures and orthodontics Not covered Not covered Not covered Year 1 & 2: 0%
Year 3+: 60%
($800 maximum every 2 consecutive years)
Combined anniversary year maximums $400 per year $500 per year Year 1: $600
Year 2+: $900
Year 1: $750
Year 2: $1,000
Year 3: $1,200
Year 4: $1,200
Year 5+: $1,500
Recall visits 9 months 9 months 9 months 6 months

 

Core Benefits

 

Registered Specialists & Therapists**
Maximum claims paid

$500 combined
per year

Chiropractor ($35 chiropractic x-rays per year), Chiropodist, Osteopath, Naturopath, Podiatrist, Registered Massage Therapist, Acupuncturist, Dietician.

Per visit maximum

$20

Chiropractic X-rays

$35 per year

Registered Psychologist or Psychotherapist

 

Maximum per first visit

$80

Maximum per subsequent visit

$65

Maximum visits per year

10

Registered Speech Therapist

 

Maximum per first visit

$65

Maximum per subsequent visit

$45

Maximum visits per year

10

Vision

$100 per 2 benefit years plus $60 for Optometrists visits per 2 benefit years

Homecare & Nursing, Prosthetic Appliances, and Durable Medical Equipment

 

For each of Homecare & Nursing, Prosthetic Appliances and Durable Medical Equipment

Year 1: $1,000
Year 2: $1,300
Year 3: $1,500
Year 4: $2,000
Year 5+: $2,500

Custom-made Orthotics

$225

Accidental Death and Dismemberment

$10,000 per adult under 65
$4,000 per child or adult 65 and over

Accidental Dental

$2,000 per year

Hearing Aids

$300 per 4-year period

Akira by TELUS Health (Virtual Healthcare App)

Included

TELUS LivingWell Companion

Included

TELUS SmartHome Security

Included

Health Service Navigator®

Included

Ambulance Services

Unlimited ground and air transportation

Survivor Benefit

Available 1 year after policy effective date

Lifetime Maximum

$100,000

All references to “year” refer to Anniversary Year. When it relates to Hearing Aids and Vision benefits, year refers to Benefit Year. Anniversary Year refers to the consecutive 12-month period following the effective date of your policy, and each 12-month period thereafter. Benefit Year refers to the consecutive 12-month period following the date a claim for a specific benefit is first incurred under your policy. Calendar Year means the 12-month period commencing January 1 and ending December 31. ‡ Note: If applicable, dental coverage begins at the age when dental coverage under your provincial health insurance plan coverage ends. ** Benefits are only payable after yearly maximums allowed under your provincial health insurance plan have been reached, if applicable. *Manulife cannot guarantee the availability of this benefit indefinitely.

Join Our Mailing List

I want to know when important changes happen in the insurance industry that can affect my insurance.

Sign Up

Get In Touch

Contact us for a free, no-obligation quote today.

825 Queen Street East
Toronto, Ontario
M4M 1H8

(416) 778-8000

sales@bairdmacgregor.com

How Can We Help?

2 + 4 =