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OPIP - Optional Self Funded Coverage

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Optional Self Funded Coverage

​​The OMA Priority Insurance Program (OPIP) was designed to ensure that Ontario physicians have access to the type of benefits that many Ontarians receive as part of an employee benefits program. However, many physicians may want to enhance their protection by purchasing additional coverage above the core coverages.   ​
Health and dental expenses can add up quickly. With the costs of drugs and health care on the rise, an illness or hospital stay can expose you to significant and unexpected financial demands.

What can I pur​​chase?​

OMA Insurance recognizes that doctors sometimes want their coverage to go beyond basic protection and offer more comprehensive coverage that includes enhanced benefits for themselves and their family. For this reason we offer exclusive optional upgrades which, when added to OPIP, go beyond basic coverage to offer added protection. Health Plus, Dental/Dental Plus, and additional Critical Illness coverage are all available.​

Want to know more​ about these optional upgrades?

Optional Self-Funded Coverage (OSF) under OPIP offers $50,000 of Critical Illness coverage for your spouse and an additional $50,000 for you, without medical evidence, at the time of your initial OPIP application.

With Health Plus you and your family can receive improved coverage for prescription drugs, hospitalization, paramedical services, assistive devices and more, plus vision care is included.

Dental includes coverage for preventative and diagnostic treatments to help members and their dependents pay for eligible dental procedures. Dental Plus is enhanced coverage that includes Major Services for procedures such as crowns and bridges and, after a one year waiting period, orthodontics. Check out the table that summarizes the coverages for Dental and Dental Plus plans to help you compare the two options.  ​

Your Subsidized Coverage You can purchase these
Optional Self-Funded Coverages
Dental Dental
Critical Illness
Health & Critical Illness
(for Critical Illness you must be under age 65)
Health -
$350 Health Spending
Account (HSA) & Critical Illness
(if opted out of Health, and for Critical Illness you must be under age 65)
$500 HSA
(if opted out of Health)
- -

Rate Inform​ation

Coverage is simple and affordable. Premiums depend on a variety of factors such as age, smoking status and gender. To learn more about rates visit the OPIP premium pages for DentalCritical Illness​ and Health.

Eligibility for Optional Self-Funded Coverage under OPIP Program

​Optional self-funded coverage under OPIP is available to members under the age of 64, who meet the OPIP eligibility requirements​.

Members' spouses and dependent children under age 18 (or 25 if a full-time student) are also eligible to participate in OPIP and the self funding options if the member meets eligibility requirements.

Members, under the age of 79, may also be eligible to purchase Health Plus and Dental coverage outside of OPIP. ​

To learn more about these unique and customizable solutions, contact us by email at​ or by phone at 1.800.758.1641.