Individual Health Plan Forms & Publications
To Begin, Select Your Home Province
Forms, brochures, policy wordings and other helpful documents are available for download and print in Adobe Acrobat PDF format. Residents of BC, AB, SK, MB, ON, NS, PE and NF should select their home province to find those forms appropriate for them.
| Individual Health Forms & Publications | |
| Application Form | |
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Purchase GMS Individual Health Coverage Online For BasicPlan, ExtendaPlan® , OmniPlan® and Prescription Drug, Dental Care, Hospital Cash, Medical Second Opinion and Annual Travel Options - it's fast, safe and secure! |
| Claims and Information Update/Request Forms | |
| Health and Dental Claims | |
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Health and Dental Claim Form For health and dental claims submitted for the following plans: GMS Individual Health Plans, GMS Group Advantage® and GMS Insured Group Benefit Plans. |
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Group ASO Plan Claim Form For health and dental claims submitted by members of an Administrative Services Only (ASO) Group Plan. |
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Hospital Cash Claim Form For Individual Health Plans with the Hospital Cash Option. Only for Hospital Cash claims. |
| How to submit health and dental claims | |
| Travel Medical Claims | |
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Travel Emergency Medical Claim Form Applicable to all emergency medical claims made while traveling outside your province of residence. Includes claims made in relation to these products: TravelStar® Single Trip Daily & Multi-Trip Annual Travel, Immigrants & Visitors to Canada Plan, StudentPlan, GMS Individual Health Plans. Also used for GMS Group Advantage® and GMS Insured Group Benefit Plans that include travel coverage. |
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Trip Cancellation & Interruption Claim Form For TravelStar® Trip Cancellation & Interruption claims. |
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Baggage Claim Form For TravelStar® Baggage Loss, Damage & Delay claims and Golf Clubs, Skis, Sports Equipment, Laptop & Computer Equipment claims. |
| How to submit travel medical claims | |
| Other Forms | |
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Individual Information Update Form For coordinating benefits from an existing health insurance plan with your GMS Individual Health Plan (Required if you have existing health coverage. See your policy for a definition of coverage that applies) |
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Pre-Authorized Debit Agreement Authorizes a monthly debit from your bank account to pay your premiums. This form can also be used to make changes to your Pre-Authorized Debit information. |
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Pre-Authorized Debit Cancellation Notice Cancels a monthly debit from your bank account. |
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Request for Information Form Request for the release of personal GMS information |
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Consent to Disclose Personal Information Form Authorization for the release of personal information by GMS |
Group Medical Services documents are available in Adobe Acrobat PDF format. Download Adobe Acrobat Reader here.
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