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 $900 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 within annual drug maximum.
  • 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 (100% no maximum);
  • 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).
  • Vision care ($250 / 2 consecutive calendar years – includes eye exam).

ENHANCED Extended Health Care Plan:

80% coverage for the following eligible expenses, with a combined annual maximum of $12,000 for both drug and non-drug claims per insured (individual limits apply):

Prescription Drug Coverage:
  • Pay direct drug card to reimburse 90% of drugs on the Manitoba Drug Formulary List to a maximum of $1800 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 within annual drug maximum.
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).
  • Vision care ($350 / 2 consecutive calendar years – includes eye exam).
  • Foot Orthotics ($650 / policy year) and Orthopedic Shoes ($650 / policy year), when medically required.

 

Additional Information on Plans, Application Form and Insurance Certificates:

PDF icon Application for Extended Health Care and Dental Plans (PDF)

PDF icon Extended Health Care Certificate of Insurance (PDF)

PDF icon Plan Summary (PDF)

PDF icon Johnson Group Benefit Claims System Information (PDF)

PDF icon Request for Prior Authorization Form (PDF)

PDF icon Prior Authorization Fact Sheet and FAQ (PDF)

PDF icon Prestige Travel Insurance Coverage for Trips Outside of Canada (PDF)

 

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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