Retired Women Teachers of Ontario

THE RWTO HOSPITAL AND HOME CARE PLAN

Benefits
Convalescent Benefit pays you up to $2,100 in cash following hospital confinement of 3 or more days (at $350 per month for up to 6 months) or $72.50 per week for up to 4 weeks following outpatient surgery or surgery requiring hospital confinement of less than 3 days. It is not necessary to prove the length of the hospital stay. Hospital visits for "observation" only are not covered.

Home Nursing Benefit pays you 80% of charges for home nursing care provided by a Nurse, Homemaker, Practical Nurse or Home Service Worker up to $1,500 for each accident or sickness. Home nursing care includes such services as meal preparation, laundry, light housekeeping, administering of medications or assistance with bathing, dressing, etc.

In-Hospital Comfort Benefit pays you $25 per day for each accident or sickness to a maximum of $600 (TV or radio rental, telephone charges, hairdressing, reading material, etc.) - no receipt is required.

Ambulance Benefit pays you up to $135 per year to and/or from hospital confinement and/or outpatient surgery.

Fracture Benefit pays you up to $350 per fracture for each accident.

Transportation Benefit pays you up to $300 per accident or sickness for travel to and from the hospital or doctor's office after a hospital stay or outpatient surgery. Receipts must be submitted.

Cataract Surgery Benefit maximum is $100 per eye. This pays for the cost of prescribed pre- and post-operative medical supplies, including medications, sunglasses, lenses, frames and eye patches.

Patient Transfer Benefit each year pays up to $135 for the cost of a private ambulance to and/or from a hospital or doctor's office following a period of hospital confinement and/or outpatient surgery, when recommended by a physician.

Physician Validation Expense pays up to $50 for each accident or sickness.

Special Equipment Benefit pays up to $200 per year for the rental or purchase of lift chairs, hospital beds, or adjustable beds when recommended by a physician.

Mobility Assistance Benefit is $150 for each injury or illness to pay for the purchase or rental of walkers, crutches or wheelchairs when recommended by a physician.

Assistive Devices Benefit maximum benefit is $100 for each injury or illness. This pays for the rental of grab bars, bath seats, raised toilet seats, and reachers when recommended by a physician.

Physiotherapy Benefit pays up to $200 for the services of a registered physiotherapist if required due to an injury or sickness following a period of confinement in hospital.

Eligibility
Acceptance to this plan is guaranteed within your first year of retirement. After one year of retirement, there is a short medical form to complete and you will need to be approved by the insurance company. Coverage is available to all RWTO members in good standing, and their spouses, who are insured under the Provincial Health Plan in their province of residence. A member who lives in a facility that provides health care and convalescent services as a part of the resident fee is not eligible.

Claiming
Your doctor must complete the Attending Physician's Statement on the reverse side of your claim form.

Cost of the Plan (as of April, 2006)
Members - Annually - $173.88; Monthly - $15.03
Spouses - Annually - $186.84; Monthly - $16.11
Refund Guaranteed If Not Satisfied
If upon receipt of your certificate of insurance you are not entirely satisfied, return the certificate to Manulife Financial within 10 days and your full premium will be refunded.

Renewal Agreement
Provided the application is accurate and acceptable, your certificate cannot be cancelled by Manulife as long as the Plan as a whole is in force, you are a member in good standing of RWTO and pay your premiums when due.

World Wide Protection
This plan is effective 24 hours a day, anywhere in the world.

Available For Any Age
As long as you are in acceptable health and are following an active non-institutional lifestyle at the time of the application.

Guaranteed Enrollment for New Retirees
RWTO members who apply within one year of retirement are guaranteed enrollment in the plan, regardless of health.

Contacts
For an application or more information, contact Manulife Financial at 1-800-268-3763. For more information, you can also contact the RWTO Provincial Insurance Convenor, Judith Hood at 1-519-924-2957, email: jhood@xplornet.com or the Assistant Provincial Insurance Convenor, Carolle Kennedy at 905-723-6685, e-mail: kennedy.c@sympatico.ca. Tthere are local Branch Insurance Convenors at each of the 52 branches of RWTO who can also answer some of your questions

Personal Accidental Death and Dismemberment Insurance Plan is also available exclusively for RWTO members and spouses. Call Manulife Financial for more information.

Some differences between the RTO/ERO's new "Long-Term Care Plan" and the RWTO Hospital and Home Care Plan:
Our RWTO Hospital and Home Care Plan is basically a convalescent care type of insurance. It is a "get-well-again" type of insurance with benefits that pay you after each accident or illness. It is not intended to provide you with continual long-term care.

The Long-Term Care Plan offered by RTO/ERO is a long-term care plan which kicks in only when:

you are unable to feed yourself
you are unable to dress yourself
you have difficulty with toileting
you have difficulty moving about
you have a severe mental disability (i.e. Alzheimer's)

There is a big difference in the cost of the two plans. The RWTO Plan costs only $15.03 per month - a fixed rate for all ages, which hasn't increased in the past seven years. The RTO/ERO Plan has a different rate for each age. For example at age 62 the monthly rate for the least inexpensive plan is $30.08.

RWTO Hospital and Home Care Plan continues to be unique and really does not compete with any other Health Insurance Plan. In fact the two plans actually complement each other, since one is for short-term illnesses or accidents (RWTO), and the other is for long-term care (RTO/ERO). The convalescent benefit under the RWTO Plan which pays up to $2,100 in cash - without receipts - is the most popular and most claimed benefit of the RWTO Plan

Frequently Asked Questions