OMA Encore65 helps doctors live independently longer.
It’s way too early to think about retiring. But when you do eventually decide to start transitioning your practice, your enjoyment of your later years will depend a lot on how you spend them. We all look forward to many active years enjoying our independence and the freedom to live life on our own terms.
Much of your independence comes from being able to live comfortably in your own home without becoming a burden on family and friends. But an accident, injury or deteriorating physical or mental abilities can put that independence at risk, and make remaining in your own home an expensive or even untenable option.
We’re always innovating, because we know doctors.
OMA Encore65 is an exclusive new coverage developed by OMA Insurance that brings an additional value to doctors who have their Disability Insurance coverage with us. Starting September 1st, 2015, members enroled in the OMA Disability Insurance (DI) benefit physician plan will be automatically enroled in OMA Encore65, a first-of-its-kind benefit that helps members over the age of 65 live independently in their own home – even if they have stopped working and long after traditional disability insurance may have ended. OMA Encore65 benefits grow with insured members: for each full year of active coverage, members will earn allocations based on the amount of coverage in place over that year. Plus, for insured members who already hold their DI policy with OMA Insurance on introduction of this new coverage, benefits for past participation will be funded from OMA Insurance Reserves. In addition to these Core benefits, members may be eligible to purchase Optional Benefits with proof of good health.
After age 65, OMA Encore65 coverage may be used in three separate ways to help you maintain your independence:
Home Care: A little help around the house.
The older you get, the more burdensome your day-to-day chores can become. That is why we designed OMA Encore65 Home Care coverage to provide up to 36 monthly payments to help out members who qualify. Home Care payments can help with home care needs like cleaning, cooking or personal hygiene, leaving you free to enjoy your home, not struggle with it.
Home Renovation: Make your home just a little more sweet.
As your physical abilities begin to decline, it can get a lot more difficult getting around in the home you love. OMA Encore65 Home Renovation helps you pay for helpful renovations – like stair lifts, walk-in tubs and safety grab bars – that make life easier and safer, and keep you living independently in your own home longer. After paying for any qualifying medically necessary renovations, members simply submit their receipts to be reimbursed up to the benefit amount.
Fracture Coverage: Lump sum payments help smooth out the bumps.
In your later years, an accident or injury can take longer to heal and be more difficult to recover from, becoming a disruptive challenge to living in your own home. OMA Encore65 Fracture Payment provides a one-time lump sum payment to qualifying members who break a common bone and meet the claim criteria. Use your payment as you feel best meets your needs – such as to cover unforeseen medical expenses, rent medical equipment or obtain temporary help around the house – letting you get back on your feet, comfortably in your own home.
The Fracture Benefit is only available under the Core Plan, as allocated under Benefit Allocations - Core Plan
The Fracture Benefit is limited to the payment of one Fracture benefit for an Insured Member for a Fracture that occurs on or after an Insured Member's coverage begins under the Group Policy. If the Insured Member suffers multiple Fractures as a result of one Accident, the Company will pay only the highest lump sum amount of any Fracture suffered on approval of the claim.
| Fracture of:||Amount Payable|
| two or more vertebrae||$5,000|
| one vertebrae||$2,000|
| compression Fracture||$1,000|
| depressed Fracture||$5,000|
OMA Encore65 is a unique, added benefit for eligible members who have OMA Disability Insurance, and does not require additional premium payments. Benefits begin to accrue when a member participates as a practicing physician in an eligible policy. Each year, a portion of total OMA DI premiums for eligible policies will be allocated to fund OMA Encore65 Core benefits based on each eligible insured member’s combined DI benefit amount for each of their active policies. Members who had in-force DI coverage as of August 31st, 2014 will receive a one-time allocation of past participation Core benefits from the OMA Insurance Reserves. Your OMA Encore65 coverage will appear on your annual renewal statement. OMA Encore65 Optional benefits are available to eligible physicians for an additional premium.
You can’t have too much of a good thing
Members can also choose to top-up their Home Care and Home Renovation coverage through additional member-paid premiums, subject to eligibility and underwriting conditions being met. Home Care coverage can be increased in increments of $500 in monthly benefit, to a maximum of $4,500 a month. Home Renovation coverage can be increased in $2,250 increments up to a value of $9,000. Your OMA Insurance Services team can tell you more about underwriting, eligibility and premiums for optional coverage.
OMA Encore65 Core benefits are automatically granted to physicians enroled in an eligible OMA Disability Insurance plan. To apply for the Optional benefits, members must:
- be a Canadian resident at the time of application
- be enroled in the OMA Encore65 core benefits, and
- provide proof of good health.
How benefits grow
OMA Encore65 benefits only begin accumulating after a member becomes covered under a DI physician plan. Medical students and residents do not accrue benefits. Benefits accrue annually, based on the September 1st to August 31st policy year, and members must have participated for the full policy year in order to earn benefits: partial years in the DI plan do not earn benefits. Members continue to earn benefits up to age 70 as long as they have active DI coverage and are not on DI claim. If a member is enroled in a DI program before age 55, OMA Encore65 core benefits will be vested at the later of age 55 or ten years in OMA Encore65, and they will be eligible to claim as of age 65, once claim criteria are met. Members who enrol on or after age 55 must participate in OMA Encore65 for a minimum of 10 consecutive years before becoming vested and eligible to make a claim. Once vested, OMA Encore65 coverage will not terminate, and members are entitled to receive qualifying benefits even if they cease DI coverage.
For more detailed information on eligibility, vesting requirements and claims, contact your OMA Insurance Services team.
It’s your encore. Make the most of it.
OMA Encore65 is just one of the ways OMA Insurance continues to develop valuable, innovative products designed specifically to meet the needs of doctors – at every stage of their lives and careers. With OMA Encore65, your coverage now lasts even longer than your career.
Information provided here is intended for general guidance and is not a contract. If any discrepancies exist between this information and the issued policy or certificate, the latter shall prevail.