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Replacement Health Insurance
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What is Replacement Health? Do I need it?
Leaving a group benefits plan shouldn’t mean losing the health services and supports you count on. Replacement Health is health insurance for retirees and the newly self-employed. We designed our health plans to give similar coverage to the group insurance you’re used to from your employer, but with GMS’s signature service combination of support, honesty, and ease.
Whether you’re recently retired or starting a new business on your own, what sets Replacement Health apart is our acceptance guarantee. This means you’re guaranteed coverage for the same health conditions and medications you had under your group plain.
The GMS difference
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Comprehensive coverage. Don’t let a new venture or chapter stop you from accessing the services and supports you need.
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Expert help when you need it. The GMS Customer Care team is here to answer questions and cheer you on.
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Easy to enroll. Easy to claim. Skip the medical questions with guaranteed acceptance and submit your claims online to get cash back sooner.
Three easy to choose, easy to use health plans
EssentialPlan, ChoicePlan, and PremierPlan all deliver big benefits:
Compare Replacement Health coverage
| Benefit | EssentialPlan | ChoicePlan | PremierPlan |
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| Prescription Drugs
GMS Replacement Health customers aren’t limited to the drugs listed on provincial drug plans. We offer up to 80% coverage for drugs on our prescription drug list. Check out our Prescription Drug Lookup Tool to learn more.
| Not included | 80% coverage (maximum $1,250) | 80% coverage to (maximum $2,500). |
| Dental Care (Preventative, Basic, and Major Services)
Preventative services include things like cleaning and polishing; basic services include things like exams, x-rays, and root canals; and major services include things like bridges, crowns, and full or partial dentures.
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| Accidental Dental | $2,000 maximum per injury | $2,000 maximum per injury | $2,000 maximum per injury |
| Private Duty Nursing | 80% coverage (maximum $1,000) | 80% coverage (maximum $3,000) | 80% coverage (maximum $5,000) |
| Preferred Hospital Room | 80% coverage (maximum $2,000) | 80% coverage (maximum $5,000) | 80% coverage (maximum $10,000) |
| Custom Foot Orthotics & Orthopedic Shoes | $300 | $300 | $300 |
| Health Practitioners
Covers services like massage, acupuncture, physiotherapy, and more.
| 50% coverage ($600 combined maximum) | 80% coverage ($600 combined maximum) | 100% coverage ($600 combined maximum) |
| Counselling Services
Covers psychologists, clinical counsellors, registered social workers, and psychotherapists.
| Combined maximum of $65 per visit x 5 visits | Combined maximum of $65 per visit x 10 visits | Combined maximum of $65 per visit x 10 visits |
| Vision Care
Covers eyewear and eye exams.
| $100 per two years combined maximum, including one eye exam every two years | $150 per two years combined maximum, including one eye exam every two years | $300 per two years combined maximum, including one eye exam every two years |
| Hearing Aids | $500 every five years | $500 every five years | $800 every five years |
| Ground & Air Ambulance | Unlimited | Unlimited | Unlimited |
| Medical Equipment & Supplies
Covers things like splints, braces, air casts, and shoulder immobilizers.
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| Wheelchairs, Motorized Scooters & Hospital Beds | 80% coverage to $10,000 combined lifetime maximum | 80% coverage to $10,000 combined lifetime maximum | 80% coverage to $10,000 combined lifetime maximum |
| Artificial Limbs, Eyes & Larynx | $10,000 combined lifetime maximum | $10,000 combined lifetime maximum | $10,000 combined lifetime maximum |
| Breast Prosthesis | $325 (lateral) and $650 (bilateral) every two years | $325 (lateral) and $650 (bilateral) every two years | $325 (lateral) and $650 (bilateral) every two years |
| Annual Travel | Not included |
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| GMS Care Network | Included | Included | Included |
Coverage is per person. This is a summary of benefits only.
Not sure which plan is right for you?
We’re happy to make a recommendation. Our Help Me Choose tool can recommend a plan for you in minutes.
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Looking for a resource?
Check out the GMS Resource Hub for a sample policy, forms, and other helpful information about replacement health insurance.
Frequently asked questions (FAQs)
- Am I eligible to buy a Replacement Health plan?
You can buy Replacement Health insurance if your coverage starts within 90 days of leaving a group plan. Replacement Health insurance is an excellent option if you recently retired, left your job to start a new business, are changing jobs, aged out of your parents’ work benefits plan, or changed your work hours and lost coverage as a result.
- What’s the difference between a Replacement Health plan and a Personal Health plan?
Both are great health insurance options (if we do say so ourselves) because they cover health care costs that government plans don’t. Although they have similar benefits, Replacement Health plans are only available to people losing coverage from a group benefits plan. With Replacement Health, you’ll maintain coverage for conditions you were covered for under your group plan. Replacement Health plans come bundled based on typical group package offerings, so if flexibility is what you’re after then you may want to check out our Personal Health insurance plans. These plans are underwritten and priced based on a series of medical questions.
- When can my Replacement Health coverage start?
As long as your coverage starts within 90 days of your group benefits ending, the date is up to you.
Don’t see your question here? Check out our full list of Replacement Health insurance FAQs or contact us and we’ll get you an answer.
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