Have a large family needing dental coverage?
Well, has GMS (Group Medical Services) got a deal for you.
If you have eight people in your family, you pay for just three on dental. That’s right, the buck stops at three for dental coverage.
This may have been a short note, but sometimes the shorter and to the point the better.
Give us a call at 1.866.856.6799 and press “1″ to speak with us on this today!
As a broker, I have done the math, and we need to have a discussion about benefit priorities.
We are experienced benefit brokers that want to ensure that your money is not thrown away on unnecessary benefit plans that may not pay you anywhere near what you put into them. The truth is, individual benefit plans can be no where near as cost-effective as large company group plans, and this is often what people expect.
Are you really thinking of outlaying $100, 200, or $300 per month without consideration of the facts? A two minute phone call may save you thousands of dollars. We urge you to get the advice that may help you save a good portion of that hard-earned money? And, to set your priorities straight, it would be good to know where it really would hurt, wouldn’t it?
Thank you, and looking forward to speaking with you!
Craig Ferguson
Why does insurance advice have to be technical and complicated?
Confused yet over your benefit plan choices? Well if you are not, then chances are you haven’t looked long enough. Keep going, and you will be really confused in a short time.
Why do I call this article Benefit Plans Sesame Street Style?
Because we need to get back to basics the more confusing an issue gets. Cut down a few trees to see what we have in front of us. The basic ABC’s and 123′s please!
Okay, here goes the logic behind my approach…..
You call for a benefit plan to ensure you are okay in the event of an illness. Because, after all, who will cover those expensive medical drugs right?
Question: How did you get to a point that you need expensive drugs?
Did you get cancer or have a heart attack or stroke that led to those drug costs?
Yes?
Okay, so were you working before? Are you working now? What if you cannot work?
If you cannot work, would you produce an income to pay the bills? The bills, including any premium for the drug plan you called for! Any bill for that matter?
So, priority number one is covering off the income problem, because without income, forget the drug problem, it pales in comparison.
And, this explains why if you are working for a large company they offer life and disability, medical, and dental, right?
The bottom line is that if you are looking for a benefit plan, you should first be looking to cover off the income need – that is, you need to ensure income or it’s game over. Then, the gravy is how you will look at the drugs and dental expenses.
And, if you are in Ontario, should drugs become a huge issue, there is also the Trillium Drug plan to help.
The United States is looking to move to a system (jury out) that is similar to Canada. Their problems are far greater than ours, as a simple pregnancy can be costly.
Which would be worse: the doc telling you you need a prescription or that you cannot work and earn your paycheque?
We have the luxury of having basic medical care in Ontario, Alberta, and Canada that is far superior to the issues facing Americans, and I hate to say it, we have income problems more than medical plan problems.
It really becomes a question of ensuring your lifestyle is not affected with illness or injury, or other medical issue. After that, it is a need to cover off inevitable expenses as cost-effectively as possible.
And that’s the ABC and 123 of that!
We are here to help – 1.866.856.6799
Let me ask you a question or two.
What if you called our office looking for medical and dental benefits for you and your family because you didn’t have any?
And, our office found you a package for say, $150 per month covering medical drugs, semi private hospital, and dental care. Okay.
And you paid your premium for months, but then all of a sudden you got sick.
Still with me? Okay, good….
So now you are sick, and it looks like it is pretty serious, so you get your spouse to talk with the company you work for and they work out how much you will receive income wise when you are off on long term disability.
You have a mortgage and a family, and basically you needed every bit of your income to make it every month.
They give you the news…..your net pay will be about half of what you made net before. Is that okay?
You panic, and then you wonder why you were spending the $150 per month for a “benefit” plan if you could no longer afford to keep it.
You call me up and explain the situation, and I advise you that the plan you were so adamant to buy does not have an income replacement feature, and it therefore cannot make up the 50% loss of wages.
You become even more distraught and you realize that you can no longer even afford to pay for the insurance you bought in case you got sick (which you now are) because you won’t be receiving enough money. What a nightmare.
What went wrong?
What went wrong is that if I didn’t ask you pertinent questions to first ensure your income would be enough if sick or disabled I would have failed you from the start.
When you called in originally for a benefit plan, “my job” would have been to screen out your current circumstances to see where you would be in the event you ended up where you did – disabled and sick, or injured. The bottom line is that you could no longer work to produce an income to live on.
I wouldn’t have done my job because I know that the likelihood of a disability is far greater than dying before age 65, and without income the bills (including health insurance) will not get paid.
I would not have done my job because the chances are you will earn millions of dollars in your lifetime, and it takes money to live. I would have failed you as your benefit advisor if we didn’t take the time to look at what would happen if you got into the situation you got into – not out of fault – but out of circumstance.
So when you come to me looking to spend $150 per month on a benefit program, please excuse me for caring, and ensuring that we know what will happen if you get to a point where you need some serious drug coverage.
It is not my job for you to appreciate my concern, but it is my duty to try to go over these important areas with you.
And I share that responsibility with my business partner, Nanette Gozutok. She is at extension 204, and I am at extension 201.
Pull up a chair, pour yourself a coffee, and give us a call. We want to hear about your situation, and discuss your needs.
Well, did you know that periodontal disease is linked to heart disease?
It is. And yes, I am here to scare the daylights out of you!
Put mildly, poor oral health links your teeth to your heart. And you thought you could avoid going to the dentist.
Bacteria is in tremendous number in one’s mouth, so imagine if it should get from an infected gum, into your bloodstream, and bingo, to your heart. Not good, right?
Please see this article for more information on periodontal disease, which affects at least 10 to 15% of the world’s population. Will you allow this to become a health issue for you and your family?
Is it really something to be "cut" from the budget?
If fact, if you do not have a dental plan, and say are self employed looking to cut expenses, then Houston, we have a problem if you think that not going to the dentist is the route for you and your family.
Here’s an interesting article for further reading.
Here’s the deal….
If you are self employed it really is an issue of priorities, tax savings, and many other issues to streamline your business, to make it the most “bottom line” conscious it can be. We have all “wasted money”, and what’s the sense of working for everybody but yourself?
Call us, and we can set you up with good advice and other professionals that specialize in their respective fields, to ensure you are taking advantage of all you can, so you can get to that dentist appointment.
There is help, and it’s a phone call away – 1.866.856.6799.
Why would I need private health insurance? (see original link)
Important Information for Newcomers to Ontario
Most people who are residents of Ontario are eligible for OHIP. But, even if you are eligible, you must live in Ontario for 3 months before your OHIP coverage starts. This is called the “3-month waiting period.” However, you should apply as soon as you arrive in Ontario, have a permanent address, and all the documents you need to apply.
The Canadian Life and Health Insurance Association (CLHIA) recommends that newcomers purchase private health insurance for the 3 months that you are not covered by OHIP. Keep in mind that some insurance companies have rules and deadlines for buying insurance. For example, for some companies, you might have to buy insurance within a certain number of days after arriving in Ontario.
Also, according to the CLHIA, not all health related expenses will be covered with this private insurance. For example, pregnancy-related expenses may not be covered.
Call us to discuss the insurers that can help you! 1.866.856.6799.
Generally, the coverage you need is for “visitors to Canada.” The cost of coverage depends on the company you choose, the coverage package you choose, you and your dependent’s ages, health history and any number of other issues.
NOTE: If you are buying from your country of origin, read the policy to make sure that you are still eligible for coverage if you emigrate to another country. Make sure that it covers one-way travel, because many do not. As well, after you land and are no longer a resident of the country where you got the insurance, you may no longer be eligible for coverage you bought in that country. Read the policy “fine print” and tell the insurance company what your situation is and ask if you will still be covered before you buy.
Service Coverage
It is important to know that there are some services that OHIP does not cover at all. You should check with your doctor or hospital to find out whether a particular procedure or treatment is covered by OHIP.
OHIP may provide partial coverage for:
Private Insurance
Featured Links
Contact the Canadian Life and Health Insurance OmbudService (CLHIO) Consumer Assistance Centre for information about health insurance companies and their products.
Guide to Supplementary Health Insurance – This booklet is designed to help you understand health insurance that supplements your public coverage, including information to help you decide what supplementary health insurance you need
Your employer may offer a group insurance plan that will cover some costs not covered by OHIP, or you can buy an individual plan from a private company. If you belong to a union or professional association, you may also be eligible for group insurance.
You pay a monthly fee for private health insurance plans. Employers cover all or part of the fee for their employees.
Most private health insurance plans include
Useful Resources
Guide to Supplementary Health Insurance – This booklet on supplementary health insurance brings together to answer to many of the questions Canadians ask when they call the Canadian life and health insurance industry’s Consumer Assistance Centre (CAC).
For more information:
Ontario Health Insurance Plan (OHIP) – describes how OHIP works and provides fact sheets, forms, answers to frequently asked questions and a list of OHIP offices across Ontario. Provided by the Ontario Ministry of Health and Long-Term Care.
CALL US and tell us your situation. We are here to help! 1.866.856.6799
If you have just left a large company benefit plan, and are looking for replacement dental coverage, what should you consider?
Well, it depends of course on a number of factors:
One thing is for sure, keep going to the dentist to ensure health!
So, what else can you expect from a personal, or family dental plan, otherwise known as individual dental coverage?
The premium range per person in the current market is approximately $50 to $70 per month. Family discounts can apply, and depending on the company and your situation, you may find better rates.
The biggest question related to your quest to find dental insurance is the question of “why”?
Why are you looking for coverage? Is it because you had a plan and lost it? Or is it because you need dental work right now?
If you have been an employee in the past, and are now on your own as a self-employed worker, the bigger question you must ask yourself is what are the big risk issues?
We fail to see what is not an issue.
We can see dental bills. We cannot, unless ill, see the impact of a disability.
You may know of others that have been disabled and lost everything. And this would drive the point home.
Now, going to the dentist should be a priority. Did you know that your teeth and gums can affect your heart? Well, periodontal disease leads to heart disease if you get an infection in your gums, that travels in your bloodstream. It can cause major heart issues, even heart attacks.
So, if you are without dental coverage, that is not the end of the world. Not going to the dentist may be.
Some dental offices give special rates to patients that do not have dental coverage. If you are self employed, this may mean a health savings account, coupled with a good discount will ensure you pay the least amount for a given amount of dental work. And isn’t that the goal? Make the cost of going to the dentist as cheap as possible?
We offer dental coverage from many major carriers including Blue Cross, Manulife, and Group Medical Services. The health savings account option for the self-employed is provided by Benecaid.
We can help ensure you are provided with an overview and specific information enough to make an educated decision.
But as a strong proponent of ensuring there is money first, for the next dollar you spend on you new benefit plan, should it be used to ensure your income, or cover a bill?
Without income, we cannot pay the bills, including the insurance bills.
And that’s food for thought.
Depending on your personal situation, and that of your family, the right medical and dental insurance choices can be a daunting dilemma.
We do not serve one master. In other words, we are not tied to any one insurance company, and therefore are free to offer you the solutions (plans) that fit your particular needs.
How do we determine your needs?
Good question.
The size of your family, any pre existing medical conditions, and any current medication use is of obvious importance.
From there, what features are most important to you? Different companies and plans may have variances in this area.
If you are a diabetic with expensive testing strips, which company might actually cover a portion of this pre-existing condition?
All good issues. All good questions.
So, the next time you consider going online to try to invent this insurance wheel on your own, ask yourself an all important question. “Am I getting the best plan that fits my family best, at the best possible rate?”
Without a qualified broker that has already “invented that wheel”, you may be throwing away a lot of hard earned money, without proper consideration. Not a good place to be.
Our searching for you is on us! We do not charge to listen and suggest what would be best.
Of course, if you take out a plan through us, we do get paid by the insurance company.
Call us today, and let’s see what’s up! In Ontario and Alberta, 1.866.856.6799.
Oh, and if you want to send an email, look for the envelope on the left or right side, and it will link to a contact request form.
Thank you.
Craig
Group Medical Services has proven itself to be a contender in the benefit field for Canadians. Please look closely at these plan features, and give us a call to see if they would fit your needs:
Information provided by GMS:
No matter what stage of life you’re in, you can ensure your family’s health care security, with supplemental health insurance coverage for everyday health needs, unexpected medical emergencies and protection from rising health, drug and dental costs.
OmniPlan®
Your premier health insurance choice. You get extensive health benefit coverage including health practitioner services like physiotherapy and message therapy, vision care, glasses and much more.
ExtendaPlan®
Comprehensive coverage with a wide range of benefits including coverage for medical emergencies, medical supplies & equipment and a variety of health specialists.
BasicPlan
Ideal coverage for unexpected emergencies including those essential health benefits not covered under your provincial health plan – like ambulance services, preferred hospital rooms and in-hospital drugs.
Additional Coverage Options
Complete your coverage with options for Prescription Drugs, Dental Care, Hospital Cash and Travel Medical.
Why Select an Individual Health Plan from GMS?
Here is a basic comparison of plans that will vary by province:
| Goods & Services | Goods and services may be purchased anywhere in Canada. | Goods can be purchased anywhere in Canada. Services must be received in your province of residence. | Goods can be purchased anywhere in Canada. Services must be received in your province of residence. | |
| Eye Exam | $75 / 2 most recent policy years | N/A | N/A | |
| Eye Glasses, Contacts, or Laser Eye Surgery | $200 / 2 most recent policy years | N/A | N/A | |
| Health Practitioners | Maximum $35 per visit to a maximum of $300 per specialty, per person, per policy year | Maximum $35 per visit to a maximum of $250 combined per person, per policy year | N/A | Acupuncture, chiropractic, chiropody/podiatry, clinical psychology, speech therapy, massage therapy, naturopath and physiotherapy treatments. |
| Hearing Aids | $800 / 5 years | $500 / 5 years | N/A | One year waiting period. |
| Health Supplies & Equipment | $500 / person / year | $500 / person / year | N/A | See policy wording for a complete list of eligible items. Requires a Physician’s written prescription. |
| Diabetic Supplies & Equipment | $300 / person / year | $300 / person / year | N/A | Diabetic supplies and equipment, including testing devices when ordered in writing by a Physician. One year waiting period on testing devices. |
| Oxygen Supplies & Equipment | $500 / person / year to a lifetime maximum of $2,500 | $500 / person / year to a lifetime maximum of $1,500 |
N/A | Does not cover the cost of oxygen. One year waiting period on CPAP supplies. |
| Blood Pressure Monitors | 1 in a 5 year period | 1 in a 5 year period | N/A | Require Physician’s written order. |
| Custom Foot Orthotics | 80% - 1 per 3 years per adult and 1 per year for children under 16 | 80% – 1 per 5 years per adult and 1 per year for children under 16 | N/A | |
| Therapeutic Shoes | $200 / person / year | $200 / person / year | N/A | Require a Physician’s written prescription. |
| Mobility Aids | $300 / policy / year | $300 / policy / year | N/A | Canes, reaching aids, raised toilet seats, grab bars, bath safety rails and transfer benches when accompanied by a Physician’s letter of necessity. |
| Ostomy Supplies & Equipment | $300 / person / year | $300 / person / year | N/A | |
| Accidental Death |
$4,000 for funeral expenses in the case of accidental death | N/A | N/A | |
| Out-of-Province Referral | $50,000 / lifetime | $50,000 / lifetime | N/A | Requires prior written approval from GMS. |
| Ground Ambulance | Unlimited | Unlimited | $2,000 / person / year | 100% emergency transport to hospital; 50% return of bedridden patients. |
| Air Ambulance | $8,000 / person / year | $5,000 / person / year | $3,000 / person / year | Transport within your province of residence. |
| Casts and Crutches | Unlimited | Unlimited | Unlimited | Fibreglass casts and the purchase or rental of crutches. |
| Preferred Hospital Rooms | 45 days up to $3,500 / person / year | $1,000 / person / year | $500 / person / year | Private or semi-private hospital room costs |
| Private Duty Nursing | 80% to $2,500 per person per year for in-hospital or in-home as palliative care nursing. | 80% to $2,500 per person per year for in-hospital or in-home as palliative care nursing. | 80% to $1,500 per person per year for in-hospital nursing. | In-home nursing is for palliative care only; must be prescribed by a Physician. |
| In-Hospital Prescription Drugs | $2,000 / person / year | $1,000 / person / year | $1,000 / person / year | |
| Accidental Injury to Natural Teeth | $5,000 / injury | $2,000 / injury | $500 / injury | Services over $300 must be pre-approved. |
| Wheelchairs, Motorized Scooters & Adjustable Beds | 100% of purchase or rental to a maximum of $1000 / 5 years | 100% of purchase or rental to a maximum of $750 / 5 years | 100% of purchase or rental to a maximum of $500 / 5 years | These benefits have a one year waiting period and require a Physician’s written order. |
| Artificial Limbs, Eyes & Larynx | $5000 / person / year | $5000 / person / year | $5000 / person / year | |
| Patient Walker | 80% of purchase or rental to a max. of $300 / 5 years / policy | 80% of purchase or rental to a max. of $300 / 5 years / policy | 80% of purchase or rental to a max. of $300 / 5 years / policy | This benefit has a one year waiting period, and requires a Physician’s written order. |
| Breast Prosthesis | $325 / 2 yrs lateral $650 / 2 yrs bilateral |
$325 / 2 yrs lateral $650 / 2 yrs bilateral |
$175 / 2 yrs lateral $350 / 2 yrs bilateral |
Excludes surgical brassieres. |
| Additional Coverage Options | ||||
| Prescription Drugs |
Coverage for prescription drugs listed under your provincial drug formulary (as detailed under your province’s drug or pharmacare plan/program) up to $3,500 per person, per year. Pay only $4.00 for each eligible prescription. Use our convenient pay-direct card and reduce your out-of-pocket expenses. Prescriptions for pre-existing medical conditions are not eligible for coverage. | |||
| Prescription Drugs - Enhanced |
Coverage for prescription drugs and oral contraceptives up to $5,000 per person, per year. Includes up to $500 coverage per person, per year for prescription medications for pre-existing medical conditions and legal prescriptions for medications not listed under your provincial drug formulary. Pay only $4.00 for each eligible prescription. Use our convenient pay-direct card. | |||
| Dental |
1st yr - 75% to $500; basic services 2nd yr - 80% basic, 50% major to $750 3rd yr - 80% basic, 50% major to $1,000A three month waiting period applies to all dental services. Services over $300 must be pre-approved by GMS. |
|||
| Hospital Cash | $100 / day, up to 30 consecutive days.Begins on the 4th day of hospitalization and on the 7th day if hospitalization is due to maternity. 30 day waiting period. | |||
| Travel |
$2 Million coverage3 options: 15 days per trip 30 days per trip 48 days per tripSubject to exclusions for pre-existing conditions. GMS indiv policy wording for complete detail. |
|||
Were you looking for Blue Cross Tangible Disability Plans? – - click here!
Blue Cross in Ontario offers comprehensive medical and dental coverage, “Blue Choice” is a great choice for several reasons, if it fits your needs. Here are the details:
Core Health Benefits |
If you’re not covered by a company health plan, Blue Choice is the cost-effective way to ensure you’re protected. It provides coverage that compliments your provincial health plan, with a wide range of extended health care benefits like vision care, hearing aids, nursing care, dental, prescription drugs and hospital coverage at an affordable monthly premium.
Benefits based on a yearly schedule commencing from the effective date of your policy.
Coverage for residents of Ontario only. Limitations may apply, see contract for details.
All Blue Choice contracts with Core Health Benefits include the following:
Blue Cross Assistance Program
We are pleased to provide our clients with the Blue Cross Assistance Program. This new program includes Health Consulting and Support Services, Information and Prevention Services, and Partner privileges and discounts.
When you enroll in a health plan from Ontario Blue Cross, you automatically have access to these services 24 hours a day, 7 days a week.
Our staff will provide you with:
• Access to a Registered Nurse to answer your questions and provide advice and guidance on your health related questions
• Home Support Services following a hospital stay
• Referrals to specialists and health organizations in your area
• and much more
Blue Cross Assistance offers exclusive benefits with our health care partners and as part of this essential program, you also have access to quality services at discounted rates through Ontario Blue Cross partnerships.
Upon enrollment, all customers will receive a booklet detailing the benefits of this exciting new program along with an Assistance Program card. Simply present your card, and enjoy quality products and services at a preferred rate.
Blue Cross Assistance. Another unique and valuable feature added to your health care plan.
Extended Health Care
(The following benefits are reimbursed at 80%, up to specified maximum. Amounts refer to each covered person.)
(The following benefits are reimbursed at 100%, up to specified maximum. Amounts refer to each covered person.)
Registered Therapists and Specialists
Costs and number of appointments vary for visits to an Acupuncturist, Chiropodist, Chiropractor, Massage Therapist, Naturopath, Osteopath, Physiotherapist, Podiatrist, Psychologist and Speech therapist.
| Specialist | Initial Visit | Subsequent Visit | Max. Number |
| Acupuncturist | $20 | $20 | 25 |
| Chiropodist | $20 | $20 | 25 |
| Chiropractor | $20 | $20 | 25 |
| Massage Therapist | $20 | $20 | 20 |
| Naturopath | $20 | $20 | 25 |
| Osteopath | $20 | $20 | 25 |
| Physiotherapist | $20 | $20 | 25 |
| Podiatrist | $20 | $20 | 25 |
| Psychologist | $75 | $60 | 20 |
| Speech Therapist | $60 | $40 | 12 |
Benefits are payable only after the yearly maximum allowed under the Ontario Health Insurance Plan (OHIP) has been reached.
A written recommendation from a physician is required for massage therapy.
Travel Insurance – 15-day medical coverage (Available only to persons under 75 years of age)
Enjoy a 15-day annual travel plan with all Blue Choice Core Health Benefit Plans
Our plan provides emergency medical coverage while travelling outside the province and includes:
Accidental Death and Loss of Use (available only to persons under 75 years of age)
Maximum payable amount:
|
Prescription Drug Benefit (optional)
|
|
Dental Benefit (optional)
|
|
Hospital Benefit (optional)
|
Blue Choice with Optional Hospital Coverage includes:
Benefits are not paid for hospitalization due to pregnancy or pregnancy-related conditions during the first eight-months following the effective date of coverage.