Your coverage provides a direct telephone number to Great West Life during regular business hours. GWL will work with the hospital out of country and though you may have immediate out-of-pocket expenses to pay at the time, you will be reimbursed. If you pay for additional private coverage, both carriers will co-ordinate their plans ensuring members get maximum payments. Make sure you let the insurance company you contract first know about any other coverage you have.

• Out-of-country for temporary business or pleasure
• Medical expenses include ambulance, physician fees, X-ray, lab fees, provided they are treatment required
• Hospital accommodation is limited to $65.00 per day (this illustrates the value of additional coverage)
• Benefits reimbursed at 100% of eligible expenses except for prescription drugs which are reimbursed at 90%
• Check your benefits booklet for exclusions

Please note: you must maintain your provincial healthcare coverage under OHIP to be eligible for Great West Life coverage. All out-of-country expenses must be submitted to GWL, who will co-ordinate reimbursement with any other carriers. Eligibility requires submission of claims to OHIP within 12 months from the date the expense is incurred.

Note: this is a synopsis – not a full outline of coverage for former members. If you have any special questions, contact Human Resources directly.

Out-of-country claims or emergency in the USA – call 1-800-957-9777. Any other country – call (collect) 1-204-946-1190 and ask to speak to a client service representative in the Out-of-Country Claims Dept.

Note: if you plan on being out-of-country more than 6 months or if you intend to seek medical treatment outside Ontario, we suggest you contact both OHIP and Great West Life to determine coverage.

This update is general in purpose only.

Members are covered by Great West Life under the Supplementary Health coverage, with a prescription for VIVAXIM, ADDERALL XR and for LEVITRA.

When a former member (if qualified) turns age 65 they get their prescription drugs through the Province’s senior drug benefit plan. There is an annual deductible of $100 under that plan and then a dispensing fee. Both the $100 deductible and the dispensing fees are eligible under the Great West Life benefit plan. They will be reimbursed at the prevailing rate for drug coverage which at this time is 95%.

Also, when former members age 65 or more are receiving health services in general that are paid for by the Province OR another private plan and the full amount of the claim is not paid, they should send the remaining costs to GWL for consideration. For additional information contact Human Resources at 416-3253545 or fax 416-325-3573.

Members are invited to email or write the OAFP office with any benefits question or concern. We will make every effort to have your questions addressed quickly. If there is coverage you wish the BOIE to consider, please let us know and we will place the request before the Board when it meets.