COVID-19 UPDATE #3 - June 9, 2020
Re-opening of regulated health professionals
Dear ETFO ELHT Plan Member,
As the situation with COVID-19 continues to evolve, the ETFO Employee Life and Health Trust (ELHT) continues to work closely with OTIP, our plan administrator, to make proactive and responsible decisions that are grounded in care for our members and the long-term sustainability of our benefits plan.
On Wednesday, May 27, the provincial government announced that Ontario’s regulated health professionals can gradually reopen
their in-person offices if approved by their governing bodies. This includes chiropractors, dentists, massage therapists, optometrists and psychologists. Visit the full
list of regulated health-care providers
.
Despite service providers being given the green light to re-open their offices, how quickly they are able to begin treating patients, and how many patients they will be able to treat in their new reality remains a question. Modifications to their processes and physical workspace, as well as the need for limited protective equipment will most likely mean a slow and gradual return to business as usual for most of these practitioners.
Claims reminders as services re-open
As health services slowly re-open, please keep the following in mind:
1. If your normal provider is unable to accommodate your need for an appointment, please exercise caution when selecting an alternative provider. Some service providers are considered
delisted
by the insurer, Manulife. This means that claims submitted for services provided by a delisted provider would not be covered under your plan. To view a list of delisted
providers:
b.
Click on
My Claims
c.
Scroll to the bottom of the page and go to the Wellness centre
d.
Click on
View list of providers not covered
Be sure to check this list to minimize delays to your claims.
a. Which services you have coverage for
b. If a doctor’s note/referral is required
c. The maximum dollar amount covered for each benefit year
Rescheduling of cancelled appointments
Some members may find their benefits coverage ending soon due to a retirement, an eligible LTO contract ending, or an overage dependant who is covered under their plan will no longer be eligible (e.g. turning 21 and not in school or turning 25). The ETFO ELHT is making exceptions in these cases to allow plan members to complete procedures that were previously booked but could not be finished due to the withdrawal of services by various healthcare practitioners due to COVID-19 and submit them for reimbursement (e.g. previously booked dental procedures). This information was reported to members in the
ETFO ELHT COVID-19 Update #2
, emailed on May 7
th
. For additional information, please visit the
COVID-19 FAQs
posted on the ETFO ELHT website.
If this applies to you, all rescheduled appointments must be
completed
by August 31, 2020
to be considered eligible for reimbursement.
Please contact OTIP Benefits Services at
1-866-783-6847
to provide
appropriate documentation from the provider that indicates the cancelled
and
rescheduled appointment dates once services resume including the patient name, original appointment date, and service that was originally booked. OTIP will provide a reference number that will be needed when the claim is submitted for reimbursement.
Moving forward
There is no doubt the next few weeks and months will continue to bring change and uncertainty. Please visit
www.otip.com/coronavirus f
or information on common questions related to your coverage and COVID-19, .
For questions related to your coverage, claims and enrolment, please call OTIP Benefits Services at 1-866-783-6847 or email at your convenience by:
1. Logging in at
otip.com
2. Clicking on
My Claims
3. Selecting the
Contact us
tab and click
Send a note
.
Stay healthy and safe.
Suzanne Gill, Benefits Coordinator on behalf of the
ETFO ELHT Board of Trustees
