Health Insurance

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The coverage under the RTAM Health Care Plan provides comprehensive services to meet your needs and make sure you're financially prepared for any unforeseen costs.

 

Extended Health Care Plan Options:

There are two (2) Extended Health Care (EHC) plans available to RTAM members:  

  • CORE
  • ENHANCED

CORE Extended Health Care Plan:

80% coverage for the following eligible expenses, with a combined annual maximum of $10,000 for both drug and non-drug claims per insured (individual limits apply):

Prescription Drug Coverage:
  • Pay direct drug card to reimburse 80% of drugs on the Manitoba Drug Formulary List to a maximum of $600 per insured per policy year*.
    • Subject to mandatory generic substitution pricing;
    • $6 dispensing fee cap and 8% mark-up limit.
    • $100 for vaccinations per insured per policy year.
  • Prescription drug coverage includes:
    • Drugs, sera and injectables, and compounds / mixtures requiring a prescription and dispensed by a licensed pharmacist;
    • Both non-prescription drugs (with a Drug Identification Number) and supplies required as a result of colostomy or ileostomy and/or treatment of cystic fibrosis, diabetes (e.g., test strips), heart disease or Parkinson’s.
Non-Drug Core Coverage:
  • Accidental Dental ($1,000 / policy year);
  • Ambulance Service ($350 / occurrence);
  • Hearing Aids ($2,000 / 5 consecutive calendar years);
  • Home Care ($50 / day, up to 10 days after minimum of 24 hour hospital stay);
  • Medical Aids and Appliances ($1,000 / 2 consecutive calendar years);
  • Foot Orthotics ($500 / policy year) and Orthopedic Shoes ($500 / policy year), when medically required.
  • 11 Paramedical Services ($300 maximum per practitioner / policy year).
  • Prescribed Health Education Programs ($300 lifetime maximum per individual).
  • Private Duty Nursing ($3,000 / 3 consecutive calendar years).
  • Hospital ($100 / day for private or semi-private).
  • IMPROVED Vision care ($250 / 2 consecutive calendar years – includes eye exam).

ENHANCED Extended Health Care Plan:

All the benefits of the CORE Extended Health Care Plan with benefit enhancements.

100% coverage for eligible expenses (individual limits apply), with a $10,000 annual maximum for non-drug benefits. The annual maximum for prescription drugs is dependent on your Manitoba Pharmacare deductible.

Note: Pharmacare deductible limits are required by Johnson Inc. every April 1st.

Prescription Drug Coverage:
  • 100% reimburse for drugs on the Manitoba Drug Formulary List. The annual drug maximum and premiums vary based on your Manitoba Pharmacare deductible. For rates, please contact Johnson Inc., or view the Certificate of Insurance.
Non-Drug Enhanced Coverage:

The same benefits as under the CORE plan, with the following increases in coverage:

  • Private Duty Nursing ($6,000 / 3 consecutive calendar years);
  • Paramedical Services ($500 maximum per practitioner / policy year).
  • MPROVED Vision care ($350 / 2 consecutive calendar years – includes eye exam)

 

Additional Information on Plans, Application Form and Insurance Certificates:

Application Form for Health & Dental Plans

Certificate of Insurance for Extended Health

Certificate of Insurance for Prestige Travel

Plan Summary

Johnson's New 2018 Claims Processing System

Prior Authorization Form

Prior Authorization Fact Sheet

 

Health coverage is more affordable than you think:

  • Coverage limits and reimbursement levels are flexible, to keep your monthly costs within your budget.
  • Monthly premiums are tax deductible.

With great features:

  • No age limit.
  • Direct-to-pharmacy reimbursement, so you won’t be out of pocket for covered drug costs.
  • No interruption in your coverage when changing jobs.

 

* Note: Policy year runs from April 1 – March 31, and calendar year runs from January 1 – December 31.

 

Johnson Inc. (Johnson) is a licensed insurance intermediary. Johnson provides administrative, consulting and/or claims administration/payment services. Insurance products are underwritten by various insurance providers. *Certain conditions, limitations, eligibility may apply. Policy wordings prevail.

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