Health and Health Plus coverage provides health-related services not covered by your provincial health insurance plan– including eligible drugs, hospitalization, paramedical services, assistive devices and more– for you and your family. Enjoy the added convenience of a pay-direct drug card as well as $2 million emergency out-of-country travel coverage.
Health Plus is enhanced coverage as shown below, and includes vision benefits.
Co-insurance for health and dental insurance refers to the portion that is paid by the insurance company. For example, a 90% co-insurance means the insurer pays 90% and you pay 10%.
The plan year for Health and Health Plus is January 1st to December 31st. You have 180 days after the end of the benefit year (December 31st) to submit your claim expenses that were incurred during that benefit year.
The table below is intended as a summary of the coverages available under the Health and Health Plus plans to help you compare the two options. Eligible expenses means expenses incurred for services and supplies that are medically necessary for the treatment of an Illness or Injury and do not exceed the reasonable and customary charges for the service or supply being claimed. Actual coverage descriptions are contained in the policy and all claims are subject to the terms, conditions, and limitations contained therein.
For details on converting between Health and Health Plus, see your benefits booklet or contact one of our OMA Insurance Service Representatives who will be happy to help you.