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Coronavirus (COVID-19) : Information for plan members


OTIP cares about the health and well-being of our members and has compiled information to help keep you informed. Please review our FAQ below for important information, including:

For the latest information on this developing situation, please visit the Government of Canada’s website: www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html.
 

Travel Coverage

Should I avoid travel to affected regions?

The Government of Canada has issued a Level 3 global travel advisory to avoid all non-essential travel outside of Canada. Visit the Government of Canada’s website for the latest travel advice.

What happens if I get sick while travelling abroad?

In the event of an illness or medical emergency, you, your family member or travelling companion covered under the plan must call Allianz as soon as possible. The phone number can be found on the back of your benefits card. It is important to make the call using a landline phone if possible as your mobile phone may not work.

The 24/7 emergency medical assistance contact centre provides immediate assistance to travellers in their language of choice, such as:

  • Referral to local medical care and/or legal assistance
  • Monitoring of medical care
  • Paying medical bills where possible
  • Arranging medical transportation for the patient
  • Return home of dependent children
  • Communicating with family members
  • Assisting with replacing lost or stolen travel documents or tickets
  • Arranging for the return of a vehicle
  • Returning the remains of the deceased traveller

For more details on emergency travel assistance, please review our article “Going out of country? Take your benefits card with you”.

Does my Emergency Out-of-Country insurance cover me if I get the coronavirus while travelling?

When travelling, if you (or a covered member of your family) have a medical emergency and get sick (with the coronavirus or another illness), your Out-of-Country coverage will pay for your emergency medical treatments. Your benefits booklet contains details about your Emergency Out-of-Country benefits.

As an employee benefits plan member or an RTIP/ARM member, what happens if I am placed in quarantine by a doctor or public health official or am locked down while I am travelling?

If you or a family member experience a medical emergency and get sick while travelling and are quarantined/locked down, you would be eligible for coverage under your emergency Out-of-province/Out-of-Canada benefit, subject to the terms of your plan/policy. In addition, Trip Interruption coverage (part of your Emergency Travel Assistance plan) will cover your costs for food, accommodations, and return transportation home (example: if you miss your originally scheduled flight), subject to the terms of your plan/policy.

If you are placed in medical quarantine or are locked down while travelling, but are not having a medical emergency, your plan does not provide any coverage for trip interruption costs. This is because the plan is intended to protect you if you have a medical emergency and get sick. If you are diagnosed as positive for COVID-19 (or another illness) while in quarantine, you are eligible for coverage subject to the terms of your plan/policy.

What happens if I am quarantined by a doctor or public health official or am locked down, but I’m nearing the maximum number of days eligible for coverage while out-of-country?

If you are quarantined/locked down but nearing the maximum number of days of eligible coverage, your Emergency Out-of-Province/Out-of-Canada coverage will be extended until you are stable, released from quarantine and able to secure safe passage home.

This applies as long as you are under quarantine/locked down – whether you have been diagnosed or not, and have not been out of the country for more than the maximum number of days allowed by your plan, as of March 19. Coverage is based on the specific terms of your plan/policy.
 

Trip Cancellation

The Government of Canada issued a Level 3 global travel advisory to avoid all non-essential travel outside of Canada and has advised Canadians to return home as soon as possible.

If you are a member of an employee group benefits plan, your plan does not provide Trip Cancellation.

RTIP/ARM Members Only:

Can I cancel my trip due to the Government of Canada’s global Level 3 Travel Advisory?

Trip Cancellation/Interruption coverage is included in your plan. If you wish to cancel travel due to Government of Canada related travel advisories, coverage only applies if your travel was booked prior to the Government of Canada issuing a Level 3 or Level 4 travel advisory for your intended destination.

Please note that the Government of Canada’s travel warning regarding cruise ships is considered a Level 3. Therefore, as long as the trip was booked before the advisory took effect, RTIP/ARM members are covered under the Trip Cancellation benefit.

What if I get sick with COVID-19 and need to cancel a trip I have planned?

As an RTIP/ARM member, your Trip Cancellation benefits would typically allow for coverage where you (or your travel companion) develop a new medical condition (including COVID-19) and are not able to travel, subject to the terms of your contract and provided the cancellation takes place before your departure date.

The following Trip Cancellation/Interruption coverage is included in your plan if you meet the criteria outlined above and as detailed in your benefits booklet:

  • Up to $6,000 per person, per trip, for pre-paid, non-refundable, unused expenses if you are unable to travel or continue to travel as a result of death, illness, or serious injury to yourself or a family member.
  • Return airfare in the event of trip interruption

Further details of what’s covered in your deluxe travel insurance can be found on our website and in your benefits booklet.

How do I make a claim to cancel my trip?

Please follow the steps below to submit a Trip Cancellation claim:

  1. Visit www.otip.com/forms and open the Extended Health Benefits Claim Form
  2. Complete the form and attach the following documentation:
    1. Reason for travel
    2. Travel dates
    3. Reason for cancellation
      1. If because of travel advisory, this simply needs to be stated.
      2. Please ensure you have notified all travel service providers of the cancellation in order to avoid forfeiting any credits or refunds for which you may have been eligible.
      3. If due to illness, injury or accident, please provide a letter from a physician outlining the nature of the patient’s illness and the medical reasons why the patient is unable to travel, including the estimated date they will be fit to travel again.
    4. A copy of the trip itinerary
    5. Original unused tickets, vouchers, etc.
    6. Original receipts for all pre-paid travel expenses being claimed
    7. Documentation that all of the pre-paid travel expenses are non-refundable, eligible for credit or in the case of airline tickets, changeable to another travel date for a small fee. Only the change fee would be eligible. As a rule, the change fee amount cannot exceed the original cost of the ticket.
    8. Original receipt showing the change fee has been paid, if applicable.

Air Miles/Rewards Programs:

Expenses paid using rewards points are not eligible under the plan.  Any costs incurred to recover rewards are also not eligible for consideration.

If you book a trip with rewards points (e.g. Air Miles or Aeroplan) and subsequently cancel the trip, only the prepaid expenses paid with ‘cash’ would be eligible for consideration (e.g. taxes and booking fees).
 

Trip Interruption

All Trip Interruption claims, including those related to illness or medical emergency or those related to a travel advisory, must go through Allianz as soon as possible. The phone number can be found on the back of your benefits card. For more details on emergency travel assistance, please review our article “Going out of country? Take your benefits card with you”.

If you are a member of an employee group benefits plan, Trip Interruption coverage only applies if you get sick or injured while you are travelling. Please refer to your benefits booklet for specific coverage details.

If you are a retired member with RTIP/ARM health insurance, and you wish to come home early from a trip due to the Government of Canada’s Level 3 travel advisory issued after your departure date, you can be reimbursed for expenses to travel home and unused expenses, subject to the terms of your plan.
 

Prescriptions

Has Ontario lifted the 30-day supply limit on prescription medications?

On June 11, the Ontario government lifted the recommended 30-day supply limit on prescription drugs.

Ontario was one of several provinces that imposed limits on the supply of prescription drugs that pharmacies were able to dispense, following a recommendation from the Canadian Pharmacists Association. Restrictions took effect in March to protect the supply of prescription medication available to all Canadians during a crisis like COVID-19.

Members are encouraged to return to requesting a three-month supply of maintenance medications to limit dispensing fees. Learn more about maintenance medications and dispensing fees. Remember, most pharmacies will also deliver medications, so there’s no need to leave home for refills if you don’t want to.
 

Service Providers and Appointments

When can I start scheduling appointments with regulated health professionals again?

On Wednesday, May 27, the provincial government announced that Ontario’s regulated health professionals can gradually reopen their in-person offices if approved by their governing bodies. This includes chiropractors, dentists, massage therapists, optometrists and psychologists. Visit the full list of regulated health-care providers.

Most practitioners are being required to limit the number of in person visits and make modifications to their processes and physical workspaces, including the use of personal protective equipment. As such, many practitioners will be following a slow and gradual return to business.

Can I reschedule and submit a claim for an appointment that I had to cancel because of COVID-19 if I or my dependants no longer have coverage?

We understand that many practitioners had to cancel appointments during the COVID-19 crisis to help slow the spread of the virus. Your ability to make a claim for a rescheduled appointment will depend on the plan you previously had coverage with and the circumstances as to why you no longer have coverage. Please call OTIP Benefits Services at 1-866-783-6847 to discuss your personal situation and for more information.

What if I can’t get an appointment with my normal health professional or service provider?

If your normal provider is unable to accommodate your need for an appointment, you may select an alternative provider. We encourage you to exercise caution when selecting an alternative provider. Some service providers have been delisted by the insurer, Manulife. This means that claims submitted for services provided by a delisted provider would not be covered under your plan. To view a list of delisted providers:

If you are a member of an employee group benefits plan:

  1. Log in at www.otip.com
  2. Click on My Claims
  3. Scroll to the bottom of the page and go to the Wellness centre
  4. Click on View list of providers not covered


If you are a retired member with RTIP/ARM health insurance:

  1. Visit www.otip.com and click the Log in button
  2. From the drop-down menu, select RTIP/ARM (for retired members)
  3. Enter your Plan contract and Member certificate numbers, which can be found on your benefits card, as well as the password you created when you registered
  4. Scroll to the bottom of the page and go to the Wellness centre
  5. Click on View list of providers not covered

 

Are virtual appointments covered under my plan?

We recognize that during these unprecedented times, some service providers are offering virtual appointments to clients. Virtual appointments will be covered under your group benefit plan, provided the practitioner is:

  • Licensed and registered in the province in which they are practicing
  • Providing services within the scope of the provider’s license
  • Practicing within the guidelines of their governing body (i.e. service by phone or other electronic device is approved by the practitioner’s governing board)

Based on the provincial guidelines today, eligible expenses for virtual appointments will be considered for:

  • Dietitian
  • Naturopath
  • Occupational therapist
  • Optometrist
  • Physiotherapist
  • Psychologist
  • Social worker
  • Speech therapist

Please note that guidelines around the type of services allowed as well as specific protocols in providing virtual therapy are variable by governing body. We recommend that you speak with your professional to get clarification on the specific services they can render online.
 

RTIP/ARM Opt-out

We understand the COVID-19 pandemic has created great uncertainty and additional financial challenges for some of our members. With this in mind, OTIP has made an exception to allow RTIP/ARM members to suspend their coverage until the end of the benefit year on December 31. The following options are available for 2020:

  1. Maintain your benefits coverage. Your coverage will remain in force and your benefit maximums for services such as paramedical and dental will be maintained until the end of the year on December 31.
  2. Cancel your coverage until December 31. If this option is of interest to you, please call OTIP Benefits Services at 1-866-783-6847 for more information. Please note that this option will only be provided up until the end of the current Ontario state of emergency.


Note

This FAQ is intended to provide plan members with general information regarding their coverage in relation to COVID-19 inquiries. It is not intended to be comprehensive. If there is discrepancy between the information in this guide and the benefits booklet, the terms and details of the benefits booklet apply. Please refer to your benefits booklet for full plan terms and details or call OTIP Benefits Services at 1-866-783-6847. To email OTIP, please visit the Contact Us page and select ‘send us an online note’ for instructions on how to send a secure email to Benefits Services.


 

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