Effective April 1, 2019, OHIP+ will no longer provide drug coverage for individuals under the age of 25 who have access to private insurance. Therefore, prescription drug claims for children and youth 24 years of age and younger with private plan coverage will have to be submitted directly to their private plan. Click here for details!

Extended Health Care Summary

Percentage Payable:

100%, except 50% for orthopedic shoes that do not form part of a brace or splint

Deductible:

Nil

Lifetime Maximum Benefit:

$250,000 per individual for health

Drugs:

100% with a & 6.50 dispensing fee Maximum

Lifetime Maximums:

Fertility Drugs to $2,500
Zyban or Champix to $500

Private/Semi-Private Hospital:

None

Ambulance Benefit:

One trip per disability

Out of Hospital Nursing:

$5,000 maximum per calendar year (prior approval required)   

Accidental Dental:

Considered as an Extended Health Care Benefit, Unlimited if treated one year from accident 

Health Practitioners Benefit:

Chiropractor, Physiotherapist, Speech Therapist, Occupational Therapist, Acupuncturist, Chiropodist/Podiatrist, Registered Massage Therapist: $50.00/visit to a maximum of $500 per practitioner per calendar year. Where applicable, X-Rays are covered to a maximum of $20.00 per calendar year for all specialties combined.

Licensed Clinical Psychologist Coverage:

$150 per visit to a max. of $1500 per calendar year effective May 1, 2016.

Orthopedic Shoes Or Orthotics, Combined:

One pair every 3 years to a maximum of $300

Hearing Care Benefit:

$400 in any 24 consecutive month period, excludes repairs or batteries

Durable Medical Equipment & Supplies:

Reasonable and customary charges for the rental of a Wheelchair, Hospital Bed or Breathing Machine

Rental is limited to a maximum of 3 months 

Breast Prosthesis:

Every 2 calendar years

Surgical Brassieres:

2 per calendar year 

Surgical Stockings:

2 pair every 12 consecutive months

Wigs:

Once per lifetime

Glucometer:

Once per lifetime

FreeStyle Libre Flash glucose monitor and sensors effective April 1,2018:

Plan Members and Dependents who use insulin to manage their diabetes are now eligible for coverage of an innovative glucose testing device that eliminates the need for routine finger pricks.

The FreeStyle Libre flash glucose monitoring system includes a reader and wearable sensors which are used to measure glucose levels and provide results on demand. The painless, onesecond scan can even work through clothing.

Effective April 1, 2018, the FreeStyle Libre monitor and sensors will become eligible for Coverage.

Claim Forms

Brochures:

You will require the latest Adobe Acrobat Reader. It is a free program and can be downloaded here.

Teamster Local Union 230 Members' Benefit Fund c/o Benefit Plan Administrators
90 Burnhamthorpe Road West, Suite 300 Mississauga, Ontario L5B 3C3