GMS个人健康和牙科保险

GMS Replacement Health Plan

GMS个人健康(和牙科)保险

Group Medical Services是GMS Insurance Inc.在萨斯喀彻温以外省份使用的经营名称,是一家中型健康保险公司,成立于70年前,旨在帮助萨斯喀彻温省的省级雇员制定团体健康保险福利计划。他们提供了一些简单的补充医疗保险,为您提供可承受的保单价格。

购买GMS的健康计划是一种简便,经济的方法保护您和您的家人免受因政府医疗制度未涵盖及日益增长的医疗费用的困扰。无论您处于人生的哪一阶段,GMS的补充医疗保险都能满足您的需要。

您是否需要医疗保险福利计划? 是企业团体还是个人?您是否有离职打算?自主创业? 即将退休?更换工作过渡期?

无论您处于人生的哪一阶段,GMS的补充医疗保险都能满足您的需要。

您适合什么计划?延伸健康保险计划或个人健康保险计划?

如果您要离开雇主团体健康保险计划并在该计划终止的60天内申请,则可以申请延伸健康保险计划。这样做的好处保证接受您的申请,无需询问健康状况,新保单即可生效,没有等待期,没有诸多限制 ,没有任何麻烦 。如果您在60天以后申请或是第一次申请,您则需要选择个人健康保险计划

延伸健康保险计划:

基本计划 ESSENTIALPLAN

涵盖您省级健康计划所没有的紧急医疗服用 - 包括无限次 救护车服务(陆地及空中),医疗器材及用品(包括但不限于打石膏、拐杖、血压计、行动辅助器及步行器),视力护理(眼镜及验眼)等。

精选计划 CHOICEPLAN
包括所有基本计划所有福利, 在视力保健的PLUS保险,旅行中的医疗紧急情况以及处方药的保额有增加。

至尊计划 PREMIERPLAN
GMS的最全面的福利包,涵盖了处方药,牙科,视力,身体,按摩等更多方面的保险,包括旅行时的医疗紧急情况。

当您获得报价并使用无需回答医学问卷的 GMS在线申请程序时(可在我们的工作时间致电1-888-888-0510进行讨论):
1)首先,您先选择基本计划(ESSENTIALPLAN),精选计划(CHOICEPLAN)或至尊计划(PREMIERPLAN);然后:

2)您将立即看到三个计划中每个计划的价格,并且可以在线注册并为以下保险覆盖范围付费:(有关覆盖范围的详细信息,请参阅完整的保单用语)。

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
Services: 80% preventative & basic, 50% major
$1,500
combined maximum
$1,250
combined
maximum
$1,000
combined
maximum
 
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
  • Emergency medical coverage while travelling
  • 90 day stability age 69 and under
  • 180 day stability age 70+
  • Applicants aged 80 and over are covered for in-Canada travel only
  • $1,000,000 lifetime maximum

个人健康保险计划: 

全方位计划 OMNIPLAN®
全方位计划是GMS最全面的福利保障计划,可以为您的家人提供更佳的理疗,按摩疗法,眼科检查和眼镜护理,让您的家人更健康。
特级计划 EXTENDAPLAN®
除了基本计划(Basic Plan)的所有基本优点之外,特级计划(Extenda Plan)还涵盖了理疗,按摩疗法,助听器以及一系列医疗设备和用品。
基本计划 BASICPLAN
基本计划为(BasicPlan)可以覆盖您省级医疗计划所没有的基本保障-包括空中和地面救护车,首选住院病房及住院用药等等。

当您获得报价并使用两步式GMS在线申请程序(可在我们工作时间致电1-888-888-0510进行讨论)时:

1) 首先,您选择全方位计划(OMNIPLAN®),特级计划(EXTENDAPLAN®)或基本计划(BASICPLAN);然后:

2) 您可以添加以下任何其他附加福利(完整的保单政策):

  • 牙科护理: 选择最高每人$ 1,000的承保范围,包含检查,洗牙,X光,补牙,假牙,牙冠,齿桥等。另外,当您在合作牙科诊所出示您的GMS直付卡时,即可当场进行理赔。您的笑容就是最大的福利!
  • 基本处方药:我们将为您支付最高每人$3,500来涵盖您的省级药物计划未完全涵盖新开的处方药(省政府药物计划列表中的药物)。每张合格的处方,您只需支付$4的免赔金额,如果在合作药店使用GMS直付卡,可省下现款支付费用。
  • 增强处方药: 提供每人高达$5,000以购买新处方药(省政府药物计划列表中的药物)。其中$ 800可用于支付: 已有疾病药物, 特殊状况药物, 常用药及您的省级药物计划未涵盖的药物。您只需为每个符合条件的处方支付$4的免赔额,并且随附一张便捷的GMS直接付款卡。
  • 全年旅游保障: 在国外接受紧急医疗,费用往往是天文数字,幸好GMS的全年旅游保障选项不算昂贵,它能为您提供全年外出旅游时的紧急医疗保障。旅游期可长达15、30或48天,任君选择。
  • 住院现金计划: 如需延长住院时间,医院现金可支付自付费用,例如室内电视,Wi-Fi,电话服务和停车费。每天最高$100,每保单年度最多$3,000。
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)
  • 30 days out of Canada
  • 183 days within Canada
  • $2,000,000 annual maximum
  • Option of 48 or 63 days out of Canada
  • 183 days within Canada
  • $2,000,000 annual maximum
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.