GMS Group Advantage® Health Plans

Benefit
(coverage per person)
SILVER
(3+ employees)
GOLD
(3+ employees)
PLATINUM
(6+ employees)
Eye Exams, Glasses, Contact Lenses & Surgery $60 per 2 years (eye exams only) $150 per 2 years $300 per 2 years
Health Practitioners n/a $300 combined $300 per specialist per year
Hearing Aids n/a $500 per 5 years $500 per 3 years
Diabetic Supplies & Equipment $300 $300 $500
Oxygen Equipment $500 $500 $500
Blood Pressure Monitor n/a n/a 1 per policy per 5 years
Custom made Foot Orthotics 1 pair every 5 years for adults 1 pair every year for children under 16 years of age 1 pair every 5 years for adults 1 pair every year for children under 16 years of age 1 pair every 5 years for adults 1 pair every year for children under 16 years of age
Therapeutic Shoes n/a $200 $200
Ostomy Supplies $300 $300 $300
Out-of-Province Referral (within Canada) n/a $50,000 lifetime $50,000 lifetime
Ambulance $1,500 Unlimited Unlimited
Air Ambulance Unlimited Unlimited Unlimited
Casts & Crutches Unlimited Unlimited Unlimited
Preferred Hospital Rooms Unlimited Unlimited Unlimited
Private Duty Nursing $2,500 $2,500 $5,000
Accidental Injury to Natural Teeth $2,000 per injury $2,000 per injury $2,000 per injury
Wheelchairs, Motorized Scooters & Adjustable Beds $500 per policy per 5 years $500 per policy per 5 years $500 per policy per 5 years
Artificial Limbs, Eyes, & Larynx $10,000 lifetime $10,000 lifetime $10,000 lifetime
Patient Walkers $200 per policy per 3 years $200 per policy per 3 years $200 per policy per 3 years
Breast Prosthesis 1 if lateral / 2 if bilateral per 2 years 1 if lateral / 2 if bilateral per 2 years 1 if lateral / 2 if bilateral per 2 years
Health Supplies & Equipment (wigs, splints, compressors, braces with metal parts, trusses, rib belts, sacroiliac corsets, embolic stockings, aero chambers and more) $500 combined $500 combined $500 combined
Travel Coverage (30 days, unlimited number of trips) n/a $5 million total coverage $5 million total coverage
Prescription Drug Coverage (coverage per person, per year) 70% of cost up to $500 Formulary Drugs Only Vaccines/Immunizations 80% of cost up to $1,500 Formulary & Non-Formulary Drugs Vaccines/Immunizations 100% of cost up to $5,000 Formulary & Non-Formulary Drugs Vaccines/Immunizations
Pay-direct Card Included Included Included