Ontario Teachers Insurance Plan  
Home


Retiree Health, Dental and Travel Insurance

RTIP Existing Member

 

 Why choose RTIP?

 

Figuring out what to do about health, travel and dental benefits is one of the most important decisions you will make in retirement. There are a lot of factors to consider and it isn’t always easy to know where to begin. RTIP offers five plans, with four different prescription drug maximums, which all include extended health care protection including travel and the option to add dental coverage at any time.
 

What plan is right for you?

 

To start, find out what your current annual prescription drug costs are. If you aren't sure, call your pharmacist; they can help. Once you have this number, you will be able to review our many plan options and choose the plan with coverage limits that best suit you and your family.

 

 RTIP Gold Elite RTIP PlusRTIP Gold $1000 drug max RTIP Gold $500 drug maxRTIP Basic

 


 

Included in all RTIP Plans

RTIP Deluxe Travel

CAREpath

The CAREpath Cancer Assistance Program provides services to help you navigate the complex health care system to ensure you receive the very best cancer-related treatment and support.
Express Scripts Stretch your prescription drug benefit dollars further when you use the Express Scripts Canada Pharmacy home delivery program for your maintenance medication.
Edvantage With over 45 partnered companies across Ontario, RTIP members have free access to discounts, contests and special events through Edvantage.

 

 Optional Coverage

 RTIP Dental Coverage

 

 

 


 

Still unsure? The extended health care benefits chart will help you identify the RTIP plan that best suits your needs.

 

You are not locked in! As an education employee, you may be retiring earlier than the average Canadian, and your extended health care needs will likely change over time. This is why RTIP offers multiple plans. You can choose the coverage that best suits your needs now, and when your needs change, you can increase or decrease your coverage at your next renewal (January 1).* 

 

We understand that the decisions you make about your health are important ones, so we want you to know all the facts before making them. If you still have questions, please contact a life and living benefits sales representative at 1.800.267.6847.

 

*Once you decrease your health coverage, you must wait two years before you are able to increase your coverage again. An increase to the Gold Elite plan or an increase of more than one plan level requires medical evidence of insurability.

 


 

Additional Plan Information

 


 

Still have questions?

Talk to an OTIP life and living benefits sales representative – call 1.800.267.6847 today!
More information about planning for retirement >

 


 

What else is in it for me?

RTIP offers more than just outstanding insurance coverage. You’ll also get valuable health and lifestyle benefits, and convenience features like online claims submission and direct deposit. As an RTIP member, you will have access to:

  • CAREpath – our cancer assistance program giving you access to our navigation system, survivor support program and the helpful cancer information line.
  • Edvantage – savings, contests and special events including deals on travel, tickets and Goodlife memberships, just to name a few
  • Save more money when you use the Express Scripts Canada Pharmacy home delivery program for your maintenance prescription medications. You are reimbursed at 90% and you can receive up to a 90-day supply for one low $9 dispensing fee.
  • Online claims submission and direct deposit – fast and convenient reimbursement: when you have a claim, you deal with us, not a third party.
  • Our generic drug substitution program gets you more for your benefits dollars.
  • No taxes or membership fees.
  • Non-commissioned sales staff who will never try to sell you something you don’t need. We’re here to help!
  • A highly professional Benefits Services team who will walk you through any changes and  answer questions once your RTIP policy is in force.
  • Access to our suite of individual products including home, auto, life and living benefits insurance. Keep it simple by making OTIP your one-stop shop for all your insurance needs.

Useful Terms

Coordination of Benefits – If you have health or dental coverage under another plan, you can get up to 100% of your eligible expenses covered. Industry-wide procedures, determined by Canadian Life and Health Insurance Association (CLHIA) guidelines, establish which plan considers a claim first. Through coordination of benefits, you can submit the unpaid part of a claim to the second plan for payment. For example, if this plan pays 80% of an expense, the other plan may pay the remaining 20%.

Deductible – The eligible expenses we deduct from your claim before your plan pays a benefit.

Reasonable & Customary Charges – Those charges that are usually made in the absence of coverage for a specific type of care, service or supply, based on representative fees and prices in the geographic area in which the charges for the care, service or supply were incurred, as determined by the Insurer.

Drug Identification Number – The Drug Identification Number (DIN) is the number located on the label of prescription and over-the-counter drug products that have been evaluated by the Therapeutic Products Directorate (TPD) and approved for sale in Canada. A DIN lets the user know that the product has undergone and passed a review of its formulation, labeling and instructions for use. A drug product sold in Canada without a DIN is not in compliance with Canadian law.

Predetermination of Benefits 

  • A predetermination of benefits tells you if a dental procedure or service is covered by your plan and what your portion of the costs will be. Your dentist can provide you with the forms, which must then be completed and submitted to OTIP. You will receive a copy of OTIP’s assessment of the predetermination, outlining how much of the procedure is covered by your plan, to share with your dentist.
  • Please be advised, we cannot provide a predetermination for dental lab fees. You should ask your dentist for a predetermination if the procedure is costly (i.e., over $500). Your dentist should submit x-rays for predeterminations of all major services. The x-rays will be promptly returned to your dentist once the review is complete.


Explanation of Benefits – You will receive an explanation of benefits (EOB) from OTIP for each claim you submit. An EOB is a statement of benefits paid or expenses reimbursed and will be attached to your claim cheque or posted online if you take advantage of our direct deposit service. You will need this statement if you are coordinating your benefits between two plans.

Copayment – The copayment is the contribution you are required to make towards certain expenses covered under the group plan.

Dispensing Fee – As part of their professional practice, pharmacists receive a dispensing fee for filling prescriptions.  The dispensing fee compensates the pharmacist for providing professional services such as patient counselling, monitoring drug therapy, providing drug information to physicians and dispensing drug products. It also covers stocking of medication, maintaining patient medication records, general operating costs such as employees' salaries, rent, etc.  The ministry also pays a mark-up to pharmacists, for most ODB eligible prescriptions, which is intended to cover these distribution and inventory carrying costs.

There are two kinds of dispensing fees in Ontario:   the Ontario Drug Benefit (ODB) dispensing fee, and the "usual and customary" dispensing fee for non-ODB prescriptions.

Ontario Drug Benefit Program – As an Ontario resident, you are covered by the Ontario Drug Benefit (ODB) Program starting on the first day of the month following your 65th birthday. This means that many of your prescriptions may be covered by the government. All RTIP plans will pay a portion of the $100 ODB deductible charged to most Ontario residents.
More information.

Trillium Drug Program – The Trillium Drug Program provides assistance for residents of Ontario who have high medical expenses. Trillium application kits are available at your local pharmacy or by calling 1-800-575-5386. The application form and guide are also available online on the Government of Ontario Web site (www.gov.on.ca) under Forms.

 

 

 

Assistive Devices Program – The Assistive Devices Program (ADP) provides consumer-centered support and funding to Ontario residents who have long-term physical disabilities and also provides access to personalized assistive devices appropriate for the individual’s basic needs. The ADP covers over 8,000 separate pieces of equipment and supplies in several categories and provides grants for ostomy supplies, breast prostheses and needles and syringes for insulin-dependent seniors. For more information, please call the Assistive Devices Program at 1-800-268-6021.

Useful Links


OTIP provides these links as resources to our members; however, we cannot
guarantee that they will be able to answer all your questions. The links are provided for
your use at your own discretion. OTIP does not necessarily support and/or endorse the
information contained in these links.

Print Page     
School Break Sweepstakes Get an auto quote in less than 5 minutes! OTIP Insight - Subscribe today to our free quarterly e-newsletter

Request a Quote