GMS Health and Dental Insurance
GMS Insurance Individual Health (and Dental) Plans
GMS Insurance, also known as Group Medical Services in Saskatchewan, is a medium sized health insurance company founded over 70 years ago to help the provincial employees of Saskatchewan with their group benefit plans. They offer some simple supplemental health insurance plans to choose from at affordable rates.
A Health Plan from GMS is the easy, affordable way to protect you and your family from the growing list of health care costs not covered by government.
Need a benefits plan? In business for yourself? Leaving an employer plan? Retiring soon?
No matter what stage of life you’re in, supplemental health insurance from GMS is just what the doctor ordered.
Which plan is right for you? Replacement Health Plan or Personal Health Plan?
If you are leaving an employer health plan and apply within 60 days of coverage under that plan ending, you may apply for a Replacement Health Plan. The advantage of this is that your acceptance is guaranteed, and there is no medical questionnaire to answer during application, and no waiting period before your coverage begins. Otherwise, if you are applying late, or for the first time you will need to use a Personal Health Plan.
Replacement Health Plans:
ESSENTIALPLAN
Covers emergency essentials your provincial plan doesn’t – including unlimited air and road ambulance – plus medical equipment, vision care and more.
CHOICEPLAN
All the benefits of EssentialPlan, covering more of your costs, PLUS coverage for vision care, medical emergencies while travelling, and prescription drugs†.
PREMIERPLAN
GMS's most comprehensive benefits package with greater coverage for prescription drugs, dental, vision, physio, massage and more – including coverage for medical emergencies while travelling.
When you get a price quote and use the non-Questionnaire GMS online application (call us to discuss during business hours at 1-888-888-0510):
1) First you choose either the ESSENTIALPLAN, CHOICEPLAN, or PREMIERPLAN; then:
2) You will see the price immediately for each of the three plans, and can enroll and pay online for the following coverage: (see full policy wording for coverage details).
GMS Replacement Health Plan Options | ||||||||||
Benefit | PremierPlan | ChoicePlan | EssentialPlan | Notes | ||||||
Prescription Drugs | 80% to $1,750 | 80% to $1,000 | N/A | Limited to drugs covered under your provincial drug plan (formulary). Includes vaccines and drugs to treat pre-existing conditions. | ||||||
Dental Care |
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Health Practitioners | 100% to $600 combined maximum | 80% to $600 combined maximum | 50% to $600 combined maximum |
Acupuncture, chiropractic, chiropody/podiatry, clinical psychology, massage therapy, speech therapy, naturopath and physiotherapy treatments. | ||||||
Vision Care | $300/2 yrs combined maximum | $150/2 yrs combined maximum | $100/2 yrs combined maximum |
Eye wear and eye exams. | ||||||
Private Duty Nursing | 80% up to $5,000 | 80% up to $3,000 | 80% up to $ 1,000 |
Must be prescribed by a physician. | ||||||
Preferred Hospital Rooms | 80% to $10,000 annual maximum | 80% to $5,000 annual maximum | 80% to $2,000 annual maximum |
Private or semi-private hospital room costs. | ||||||
Hearing Aids | $800/5 yrs | $500/5 yrs | $500/5 yrs | |||||||
Orthopedic Shoes & Custom Made Foot Orthotics | $300 | Orthopedic shoes require a physician’s written prescription. | ||||||||
Ground & Air Ambulance | Unlimited | 100% emergency transport to hospital; 50% return of bedridden patients. | ||||||||
Accidental Dental | $2,000 / injury | Services totalling $500 or more must be pre-approved. | ||||||||
Funeral Expenses | $4,000 | Accidental death. | ||||||||
Medical Equipment & Supplies | $3,000 combined maximum $500/item limit on most equipment and supplies $250 limit on embolic stockings $2,500 lifetime limit on sleep apnea machine |
Including but not limited to casts, crutches, blood pressure monitors, mobility aids and walkers. Full list available in policy wording. | ||||||||
Wheelchairs, Motorized Scooters & Adjustable Beds | 80% to $10,000 combined lifetime maximum | These benefits require a physician’s written order. | ||||||||
Artificial Limbs, Eyes & Larynx | $10,000 combined lifetime maximum | Includes myoelectric limbs. | ||||||||
Breast Prosthesis | $325 single / 2 years; $650 bi-lateral / 2 year | Excludes surgical bras. | ||||||||
Annual Travel | 15 days out of Canada 183 within Canada |
7 days out of Canada 183 within Canada |
n/a |
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Personal Health Plans:
OMNIPLAN®
GMS's most comprehensive benefits package, OmniPlan can help you keep your family in better health with greater coverage for physiotherapy, massage therapy, eye exams and glasses.
EXTENDAPLAN®
With all the essential benefits of BasicPlan and more, ExtendaPlan also covers physiotherapy, massage therapy, hearing aids and a range of medical equipment and supplies.
BASICPLAN
For emergency medical coverage at the lowest possible cost, BasicPlan covers the essentials your provincial health plan doesn’t – including air and ground ambulance, preferred hospital rooms, in-hospital drugs and more.
When you get a price quote and use the two-step GMS online application (call us to discuss during business hours at 1-888-888-0510):
1) First you choose either the OMNIPLAN®, EXTENDAPLAN®, or BASICPLAN; then:
2) You can add any of the following additional benefit packages (full policy wording):
- Dental Care: Choose coverage up to $1,000 per person for checkups, cleanings, x-rays, fillings, dentures, crowns, bridges and more. Plus, when you present a GMS pay-direct card at participating dental offices your claim is adjudicated on the spot. The biggest benefit will be your smile!
- Basic Prescription Drugs: We’ll pay up to $3,500 per person for newly prescribed drugs not fully covered by your provincial drug plan. You only pay a $4 deductible for each eligible prescription and save on out-of-pocket expenses when you use a GMS pay-direct card at participating pharmacies.
- Enhanced Prescription Drugs: Up to $5,000 in coverage for newly prescribed drugs with $800 of the $5,000 available to cover drugs for pre-existing conditions, special status drugs and select lifestyle medications and drugs not covered by your provincial drug plan. You only pay a $4 deductible for each eligible prescription and a convenient GMS pay-direct card is included.
- Annual Travel Coverage: Medical emergencies abroad can be astronomically expensive. Fortunately, our Annual Travel option is anything but. It provides emergency medical coverage for trips you take throughout the year. Covered trips can be up to 15, 30 or 48 days. The choice is yours.
- Hospital Cash: In the event of an extended hospital stay, Hospital Cash provides coverage for out-of-pocket expenses such as in-room television, Wi-Fi, telephone service and parking costs. Up to $100 per day to a maximum of $3,000 per policy year.
GMS Personal Health Plan Options | ||||
Benefit | OmniPlan® | ExtendaPlan® | BasicPlan | Notes |
Eye Exams | $90/2 years | $120/2 years | n/a | |
Eyeglasses & Contact Lenses | $200/2 years | Included in Eye Exams limit | n/a | |
Health Practitioners | $300 maximum per specialty | $250 combined maximum | n/a | Acupuncture, chiropractic, chiropody/podiatry, clinical psychology, massage therapy, speech therapy, naturopath and physiotherapy treatments. |
Hearing Aids | $800/5 years | $500/5 years | n/a | One year waiting period. |
Health Supplies & Equipment | $500 | $500 | n/a | See policy wording for a complete list of eligible items. Requires a physician’s written prescription. |
Diabetic Supplies & Equipment | $300 | $300 | n/a | Diabetic supplies and equipment, including testing devices when ordered in writing by a physician. |
Oxygen Equipment | $500/year; $2,500 lifetime maximum | $500/year; $1,500 lifetime maximum | n/a | Does not cover the cost of oxygen or CPAP machines. |
Blood Pressure Monitors | 1/policy/5 years | 1/policy/5 years | n/a | |
Custom Made Foot Orthotics | 80%/3 years | 80%/5 years | n/a | |
Orthopedic Shoes | $225 | $225 | n/a | Require a physician’s written prescription. |
Mobility Aids | $300 | $300 | 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 | $300 | $300 | n/a | |
Funeral Expenses | $4,000 | n/a | n/a | Accidental death. |
Out-of-Province Referral | $50,000 lifetime maximum/person | $50,000 lifetime maximum/person | n/a | Requires prior written approval from GMS. |
Ambulance | Unlimited | Unlimited | $2,000 | 100% emergency transport to hospital; 50% return of bedridden patients. |
Air Ambulance | Unlimited | Unlimited | Unlimited | Transport within your province of residence. |
Casts & Crutches | Unlimited | Unlimited | Unlimited | Fibreglass casts and the purchase or rental of crutches. |
Preferred Hospital Rooms | 45 days to $3,500 | $1,000 | $500 | Private or semi-private hospital room costs. |
Private Duty Nursing | 80% to $5,000 | 80% to $3,000 | 80% to $1,500 (in-hospital only) | Must be prescribed by a physician. |
In-Hospital Drugs | $2,000 | $1,000 | $1,000 | |
Accidental Dental | $5,000/injury | $2,000/injury | $500/injury | Services totalling $500 or more must be pre-approved. |
Wheelchairs, Motorized Scooters & Adjustable Beds | $1,000/person/5 years | $750/person/5 years | $500/person/5 years | These benefits have a one year waiting period and require a physician’s written order. |
Artificial Limbs, Eyes & Larynx | $5,000 | $5,000 | $5,000 | |
Patient Walkers | 80% to $300/person/5 years | 80% to $300/person/5 years | 80% to $300/person/5 years | Requires a physician’s written order. |
Breast Prosthesis | $325 single; $650 bi-lateral/2 years |
$325 single; $650 bi-lateral/2 years |
$175 single; $350 bi-lateral/2 years |
Excludes surgical bras. |
Travel (included for Saskatchewan residents) |
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n/a | Subject to exclusions for pre-existing conditions See the policy wording for complete detail. Applicants aged 80 and over are covered for in-Canada travel only. |