1.Do I have out of country healthcare coverage?
Yes. Please refer to Emergency Out of Province coverage for details of coverage available under your Labour Accident Money Program (LAMP).
2.May I assign my reimbursement to my healthcare provider?
This Plan does not allow assignment of benefits to providers. All reimbursement payments for healthcare expenses will be paid directly to the member. The only exception is payment to a Rehabilitation/Convalescent facility.
3.Do I have to send original receipts with my claim form?
Yes, original receipts are required. The only exception is when you are submitting a claim for co- ordination of benefits for consideration of expenses already paid/assessed by the primary insurance carrier.
4.Can I submit my expenses without a completed claim form?
No. A signed completed claim form is required to ensure your privacy is protected and that you are aware of what expenses are being charged to your file.
5.Do I need a prescription from my doctor to get massage treatment?
Yes. Your Plan will consider services of a registered massage therapist only if you have a prescription from your physician indicating diagnosis and type of treatment required.
6.Will I be covered for aspirin or similar drugs if my doctor prescribes the drug?
Your Plan does not cover any drugs that can be purchased over the counter (OTC) without a physician’s prescription. Although your doctor may have given you a prescription for aspirin you do not require a prescription to purchase this drug therefore it would not be covered by your Plan. You may wish to consult with your pharmacist at time of purchase to ensure the drug is not an OTC. This will save you the unnecessary cost of the dispensing fee.
7.How do I get approval for in home nursing care?
Contact the claims office and ask them to forward a nursing care questionnaire to you. This questionnaire must be completed by the patient’s attending physician. Once completed, return the form to the claims department for consideration. You will receive written approval or denial indicating the level of financial reimbursement available to you.
8.Who pays for my drugs once I reach 65 years old?
As a resident of Ontario you must apply for drug coverage under the Ontario Drug Benefit Program (ODB) prior to your 65th birthday. Your pharmacist can assist you obtaining and completing the required provincial forms.
9.Can I purchase my orthotics from any provider?
Your Plan requires that you have your orthotics PRESCRIBED by a physician or a chiropodist/podiatrist. Your Plan requires your orthotics to be DISPENSED by a physician, chiropodist/podiatrist, orthotist or pedorthist.
If your provider is not indicated above your claim will be denied.