MURAnews - Benefits

Use (and abuse) over the years can leave us with aches and pains, as well as joints and muscles that no longer behave as we would wish. Leading an active life can help, but sometimes we need therapy to overcome these problems.

MURA member Marianne van der Wel is a poster girl for the active, fit retiree. An avid user of the Pulse (weight and strength training gym) at the David Braley Athletic Centre, Marianne's journey back to health started with McMaster’s Sport Medicine & Rehabilitation Centre  and the rehabilitation services offered there, which include Physiotherapy, Athletic Therapy, Massage, Chiropractic and Osteopathy. You may also encounter these services at clinics and practices in the community. Depending on the setting and your needs, therapy may be given by a Physiotherapist, Physiotherapy Assistant, Kinesiologist, Athletic Therapist, Chiropractor or Osteopath.

Marianne has experienced real benefits from Osteopathy and Athletic Therapy combined with a fitness program. “After all the damage I did to my right side sitting in front of computer screens, there is no way that simply working out would have lead to the results I'm getting. My range of motion is so much more, my aches and pains are so much less, and the differences between right side and left side which was quite huge is slowly decreasing.”

There is overlap across Physiotherapy, Athletic Therapy, Massage, Chiropractic, Osteopathy and Kinesiology in terms of the techniques used, but there are differences in the underlying principles of the disciplines, as well as in the training. A short description of each discipline appears below. The MURA website has additional information comparing the purposes and methods of these types of therapy. Physiotherapists, Registered Massage Therapists and Chiropractors are regulated by the Regulated Health Professions Act in Ontario, but Athletic Therapists and Osteopaths are not. Kinesiology is expected to come under the act later in 2012.

Physiotherapy is the treatment of disease, injury, or deformity by joint and soft tissue mobilization, electrical stimulation, cryotherapy (cold), thermotherapy (heat), exercise and massage. It may be delivered by a Physiotherapist (a health professional with a Master’s degree in Physiotherapy) or by a Physiotherapy Assistant under the supervision of a Physiotherapist. Some physiotherapists in the Hamilton area will make home visits following orthopedic surgery and injuries for those who are house bound

Athletic Therapy uses physiotherapy techniques, as well as supportive taping and bracing to return a person to exercise following an injury. Certified Athletic Therapists have an undergraduate degree with specific training in the area of activity-related injury.

Kinesiology is the study of human movement. Kinesiologists apply a range of assessment and therapeutic interventions aimed at enhancing movement. They have completed at least a four-year university degree in Kinesiology.

Massage Therapy uses pressure such as rubbing, kneading or vibration of muscles to relieve tension or pain, increase circulation and improve the mobility of muscle tissue. Registered Massage Therapists have completed a 2-3 year college program.

Chiropractic is a therapy based on manipulation of misalignments of the joints, especially those of the spinal column. Chiropractors receive four years of training at private Chiropractic Colleges.

Osteopathy uses manipulation and massage of the bones, joints, muscles and organs to improve mobility and circulation. Osteopathic Manual Practitioners have a diploma or degree from a private educational institution.

In some cases Physiotherapy may be covered by OHIP, but the other types of therapy described above are not. For specific information on your eligibility for OHIP coverage, call the ServiceOntario INFOline at 1-866-532-3161.

Your McMaster Benefits Plan may also cover some of these services. Check the Extended Health, Dental, and Group Life Benefit Plan booklet specific to your employee group (MUFA, CAW, SEIU, etc.) and year of retirement for details. For information on your personal coverage, visit Sun Life’s web site or McMaster's Human Resources post-retirement benefits Information page, or call Sun Life at 1-800-361-6212, 8 am - 8 pm ET Monday to Friday.

You may also want to refer to an article on funding for physiotherapy in the Fall 2008 issue of MURAnews.

It’s never too late to investigate ways to keep your body moving. As Marianne says “Without your body, where are you going to live"? 

by Janice Rischke & Helen Barton

Hearing loss can occur at any age, but many of us suffer some loss by the time we are in our 50s or 60s. One of the first signs of loss is finding it difficult to distinguish various sounds, such as "s," "sh," "th" and "f".

Here are ten other signs that you may be developing hearing problems:

• You have trouble hearing when there is noise in the background or when several people talk at once.
• You have trouble hearing on the telephone.
• You have to strain to understand a conversation.
• Many people seem to mumble or not speak clearly.
• You misunderstand what others are saying and respond inappropriately.
• You often ask people to repeat themselves.
• You have trouble understanding the speech of women and children.
• People complain that you turn the TV volume up too high.
• People get annoyed because you misunderstand what they say.
• You hear a ringing, roaring or hissing sound a lot. Or some sounds seem too loud.

If you are concerned about your hearing, it is best to talk to your doctor. It may be as simple as having your ears flushed, or your doctor may refer you to an audiologist for a hearing test or audiogram.

Please see Hearing Aid Benefit (MURAnews, Summer 2020), and Hearing Aid Benefit, (MURAnews Summer 2013 and Winter 2010, for information on funding for hearing aids. If you do not have access to the internet, MURA will be pleased to send you a copy of this article. Contact MURA by email or phone at 905-525-9140, extension 23171.

Should you use your $10K coverage to reduce the premium when purchasing additional private insurance? As reported in the Summer 2011 newsletter, the $10,000 retiree out-of-province/country emergency medical coverage can be used as first payor on a claim. Thus, when purchasing additional private insurance with a deductible, you can use the $10,000, or whatever portion of it you have remaining under the McMaster plan, to coordinate with the private insurance.

This means you can use your McMaster benefit to cover the deductible on any private insurance plan that offers that option. The higher the deductible, the less expensive the premium will be.

HR strongly recommends retirees purchase additional coverage appropriate for the location to which they will be travelling. MURA Council endorses this advice.

If you are purchasing additional individual travel insurance using your McMaster coverage as a deductible, be sure to contact Allianz Global Assistance if you have an out-of-province medical emergency to ensure your claim is properly coordinated. Allianz Global Assistance contact information is on the printable Travel Card in the Retiree Out of Province Coverage Summary document on the HR web site.

Be sure you know how much of your $10,000 benefit you have remaining. If you have never made a claim since retiring, you’ll have the full $10,000. But the McMaster benefit has a lifetime maximum of $10,000. For example, if you’ve already had a claim for $3,000, you’ll only have $7,000 remaining. The current amount of your benefit can be obtained from Sun Life at 1-800-361-6212.

Some companies offer a deductible, some don’t. Those that MURA is currently aware of range from 0 to 50% reduction in rates for a $10,000 deductible, and premiums vary greatly from company to company, by age, and by health status, so you’ll want to shop around.

But should you use your McMaster coverage to reduce your premium when purchasing additional private insurance, or not?

There are no hard and fast rules to follow when making this decision, but here are some things to think about that may help you decide.

Originally published as Update On $10,000 Out-Of-Province Emergency Medical Coverage, Fall 2011

Updated September 2021

You should let Parking Services know about any changes to your address or vehicle information. You can do this by email, online, in person (during the pandemic by appointment only), or by post to:

Security & Parking Services
McMaster University
1280 Main Street West
T32, Room 106
Hamilton, ON L8S 4K1

Retired McMaster University faculty and staff can apply for an on-campus retiree parking permit at no charge, with one exception. If you resume working for the University, you will need to pay for your parking permit. Please note that retiree permits are not transferable to other people.

More information and the online form to apply for retiree parking for the first time may be found at the McMaster Parking Services Retiree Parking page.

by Mary Johnston

Timing is important when you receive a new eyeglass prescription. Timing is also crucial when you find you need to buy new glasses or contact lenses or need to undergo laser eye correction surgery.

Although the dollar amounts vary from plan to plan, all of the Extended Health, Dental, and Group Life Benefit plans for McMaster retirees allow for reimbursement of costs related to contact lenses, eyeglasses or laser eye correction surgery once every 24 months.

Be careful. The 24-month rule is strictly enforced by Sun Life, the University’s benefit plan administrator. If the receipt submitted with your claim is even one day less than 24 months since your last claim, the claim will be denied. This will be the case even if your new prescription is a consequence of cataract surgery.

Also note that the 24-month rule means you cannot make two claims to reach your maximum during a 24-month period. For example, if your 24-month maximum is $250 and you claim $150 for the replacement of one lens you cannot claim the additional $100 for another purchase during the same 24 months.

It is a good idea to check your eligibility before going to your optometrist or ophthalmologist. You have two options to find out the exact date when you will be eligible for a claim:

• Contact Sun Life at 1-800-361-6212 between 7am and 8pm Monday to Friday. Be sure to have your member ID # and policy number (25018) ready.
  
• Sign in to the Sun Life Plan Members Services web site. You will need to obtain an ID and password from Sun Life to use this site.
  

For information about benefits and Sun Life coverage check your benefits plan booklet, contact Human Resources Services at 905-525-9140, Ext. 26466 or e-mail working@mcmaster.ca. You can also check the HR Retiree Information website.  

- by Helen Barton and Les Robb

The recent contract negotiated between the University and the Canadian Auto Workers Union Local 555 (CAW555), which represents most non-management salaried staff and technicians at McMaster, includes clauses which change dramatically the post-retirement benefits for employees hired into this group in the future and likely will change their pension arrangements as well.

The cost of post retirement health benefits will be increased for all new employees. Retirees with less than 20 years service will pay 100% of the monthly cost of contributions for the McMaster retiree benefit plan, if they opt to stay in the plan. Those with longer service will pay a fraction of the contribution costs on a sliding scale (ranging from 25% for service longer than 30 years to 75% for service between 20 and 25 years).

The pension arrangements for new hires have been sent to arbitration and the outcome won’t be known for some time. The University had proposed that future hires into positions represented by CAW555 would participate in a group RRSP plan rather than the salaried pension plan. In this, the University would match employee contributions (as compared to paying about twice the employee contributions for current service in the Salaried Pension Plan). The Union wanted to keep the current arrangements for new hires. The two sides will now make proposals to an arbitrator who will make the final decision. This is not final offer arbitration of the sort Faculty have recourse to in contract negotiations, but one that allows the arbitrator to pick one side or the other, or to ‘split the difference’ and decide on something between the two positions. The parties will make proposals to the arbitrator which may or may not be the same as the positions they held at the end of negotiations. Although it is not yet a matter that is decided, it is worth a thought or two about the arrangement the University has suggested and, in fact, already imposed on employees in The Management Group (TMG). A group RRSP is similar to a defined contribution plan but would not be registered with the Financial Services Commission of Ontario and as a consequence would not have the requirements of transparency and the protections of that body. The pension risk would be entirely shifted from the University to the individual employee. After the University makes its matching contribution to the RRSP it has no further obligation to the employee. Contrast that with the pension we receive where the monthly payment is guaranteed and we can even look forward to some inflation increases when markets do well. It is a huge change in the employee-employer relationship.

The direction the University is taking here is not new. The hourly rated employees and TMG have already been pressured to accept differential treatment of new hires and the University seems to want to move down this path with all of its employee groups.

Should those of us in the Salaried Pension Plan and, more particularly, those of us who are retired be concerned about these changes? We think there is no serious reason for concern in the near term but do have some concerns about the longer term.

Our pensions are guaranteed by the University and the University is required by law to continue to make payments (including payments to eliminate the deficit) as long as the University keeps operating. There is no reason to expect the University is headed for bankruptcy, and the University has made statements that it has no intention of winding up the plan (see the Your Pension is Safe FAQ).

For the longer term, it is hard to be so confident. There is a concern that the employer might change its mind about winding up the Salaried Pension Plan and pay out a lump sum to all the retirees, and as time passes there will be fewer active members in the Salaried Plan to defend it. For some, this might be a good thing, but for most it would likely bring a host of headaches. Recall that all of us who are on pensions had the option of taking a cash equivalent at the time of retirement and chose not to do so. Presumably we prefer the pension payments and not having to worry about investing those funds. Moreover, anyone who looked carefully at the cash option knows that it was not possible to buy an annuity on the market for anything like the amount you would get for the “cash equivalent” of your pension. These concerns are probably decades off, but we would be putting our head in the sand to ignore these prospects.

In response to the directions the University was taking on pensions and benefits during negotiations, MURA Council wrote to Peter George, McMaster’s President, and to Matthew Root, President of CAW555, on behalf of retirees to express our concerns about the breakdown of the sense of community that will undoubtedly be caused by a two-tier system and the ever-increasing number of new employees with inferior benefits. MURA urged both sides to work toward a solution that would keep all salaried employees in the defined benefit pension plan, and provide an equitable health benefits package to new employees.

by Kathy Ryan

The Ontario Drug Benefit program (ODB), part of the Ontario Public Drug Program

Information from the Benefits & Pension Unit, McMaster University

When you reach age 65, ask your pharmacist for current coverage details of the ODB. Seniors aged 65 or more need only their Health Card to show their eligibility for ODB when going to purchase prescription drugs.

Please check your McMaster retiree benefit booklet to confirm the benefits you are entitled to. If you are eligible to claim reimbursements for prescription drug expenses through Sun Life after age 65 (depending upon your McMaster retiree plan) you may submit claims to Sun Life for deductibles and dispensing fees not covered by ODB; save up receipts to submit a reasonable amount.

All McMaster plans reimburse members for expenses incurred within a benefit year (July - June) that are submitted by the September 30th following the end of a benefit year. For example, any ODP deductibles paid from July 1, 2008 to June 30, 2009, must be submitted to Sun Life by September 30, 2009.

Information from the Ontario Ministry of Health and Long-Term Care (as at June 15, 2009)

Who? Through the ODB Program, the Ministry of Health and Long Term Care covers a portion of the cost of prescription drug products listed in the ODB Comparative Drug Index (Formulary), as well as some exceptional cases. Ontario residents belonging to one of the following groups who have a valid Ontario health card are eligible for drug coverage under the ODB Program:

• people 65 years of age and older
  
• residents of long-term care homes
• residents of homes for special care
• people receiving professional services under the home care program
• Trillium Drug Program registrants
• people receiving social assistance (Ontario Works or Ontario Disability Support Program assistance)

What?

• The drug products must be prescribed by an authorized Ontario prescriber and must be listed on the formulary, including some nutritional products and diabetic testing agents.
• Drug products that are not listed on the formulary are also considered for coverage through the ministry’s Exceptional Access Program (EAP) on a case-by-case basis following a written request by a patient’s physician.

Where?

The ODB Program automatically pays for the above listed drug products for people eligible for ODB coverage if the drugs are purchased:

• in an accredited Ontario pharmacy that is on-line with the ministry’s Health Network System; or
• from an Ontario doctor licensed to sell prescription drug products who is on-line with the ministry’s Health Network System.

 Your Cost

Under the ODB program, ODB eligible recipients may be asked to pay some portion of their prescription drug product cost as follows:

• Single seniors (people aged 65 or older) who have an annual net income above $19,300 after taxes and senior couples with a combined annual net income above $32,300 after taxes  pay a $100 deductible per senior per year in ODB eligible prescription charges before they are eligible for drug coverage under the ODB program. After the $100 deductible is paid, they pay up to $6.11 toward the dispensing fee each time they fill an ODB eligible prescription.
• Seniors who have an annual net income under the above mentioned levels and all other ODB eligible recipients, including Trillium Drug Program recipients (after their Trillium deductible is paid), may be asked to pay up to $2 each time they fill a prescription for an ODB eligible drug product.

Note that for ODB deductible purposes, the benefit year starts on August 1 and ends on July 31 of the following year.

For more information see the Ontario government's Get coverage for prescription drugs, or phone the ministry INFOline at: 1-866-532-3161

by Joe Laposa  

In December 2006, the Ontario Assistive Devices Program (ADP) initiated funding of insulin pumps and supplies for children aged 18 years or younger with Type 1 diabetes (a condition in which the body produces no insulin, and hence ingested food cannot be converted into energy).

As of September 2008, Type 1 insulin-dependent diabetics 19 years of age or older are eligible to receive funding for insulin pump therapy. Upon referral by a family physician to a registered ADP diabetes team (such as the one at McMaster University), a patient’s suitability for pump therapy is assessed, eligibility for funding assistance is determined, and help is given in the completion of the ADP funding application form. After discussions with authorized insulin pump companies and deciding on the pump of his/her choice, the patient begins a 3-month trial period with the apparatus. A follow-up session with the ADP diabetes team provides a final evaluation of the patient. If satisfactory, 100% the cost of the pump is paid directly to the vendor. As well, the client receives, four times a year, $600 cheques from ADP to cover pump supplies.

Type 1 diabetes accounts for only 10% of the diabetic population, while Type 2 diabetes is nine times more prevalent. In this condition, the body produces insufficient insulin, or cannot effectively use the insulin that is produced. Only about 30% of the patients with Type 2 diabetes require injection of insulin, and it is not clear at the present whether these patients would benefit from pump therapy. In the next few years an expert panel is expected to complete deliberations concerning the suitability of funding of insulin pumps and supplies for Type 2 diabetics.

For more information, contact the ADP at 1-800-268-6021 or visit their web site.

by Marianne Van der Wel

I spent a wonderful summer walking back and forth to McMaster University's Sports Medicine clinic twice a week for physiotherapy to get my knees “realigned” after I had a knee injury a year ago. I was aware that I had some retiree health insurance coverage through McMaster but I was not aware that being over 65 years of age I was eligible for coverage under OHIP. I received excellent treatment at McMaster's Sports clinic, a private clinic not eligible for OHIP reimbursement. Regrettably, it will take a while for my pocket book to recover. Thanks to an inquiry from a fellow MURA member, Jean Emberley, and with the benefit of some subsequent research, I am now a lot better informed about physio coverage in Ontario. Here's the scoop:

1) Conditions under which you can get OHIP coverage

• If you are 65 years and over or 19 years and younger, you can get coverage for up to 100 visits per year if you get your treatments at a designated OHIP physiotherapy clinic.
• For ages 20-64 if you had a recent condition that required an overnight stay as an inpatient in a hospital, you are covered at those designated clinics for up to 50 visits. NOTE: The initial physio assessment fee is NOT covered by OHIP regardless of your eligibility for treatment coverage.

2) OHIP-recognized clinics versus private clinics

Since Ontario changed its regulations regarding tax supported physiotherapy in 2005, Ontarians now have a mixture of private and OHIP-designated physio clinics. OHIP will only cover the cost of treatment at OHIP-recognized clinics. For more information call the Ontario College of Physiotherapists at 416-591-3828 or 1-800-583-5885 or visit their website. On the website, you can find OHIP-supported clinics in your area by following the Publicly-Funded Physiotherapy Clinics link on the home page. When visiting such clinics, you will need a physician’s referral.

3) Varying Rates and Facilities

Rates at both private and OHIP-designated clinics vary considerably. Initial assessment fees (which OHIP does not cover) can range from $45-$85. Treatment sessions that follow can range from $45-$75. Even at OHIP-supported facilities, OHIP may not pick up the entire treatment fee. Be sure to check with the clinic of your choice how much above the OHIP fee (if any) you will need to pay or have covered by any private insurance you have.

Facilities: In researching this article, I found that the equipment, number of employees, proportion of licensed physiotherapists to clinic assistants, hours of operation and allotted space for the various physio facilities vary considerably at both private and OHIP-supported clinics. Some are state-of-the-art and others not. Please be on guard!

4) Private Coverage

McMaster’s retiree health benefit plans provide partial coverage. Generally this amounts to $15 or more per visit, up to a maximum of $250-$300 per year. Check your benefits booklet or call McMaster Human Resources (905-525-9140 Ext. 22247) for your personal coverage.

5) Conclusion

Although my wallet is lighter, my knees are doing much better. I do wish I had this information at the start of the summer so I could have made an informed choice when choosing a clinic. Hopefully, this information will assist you in choosing a physio clinic in Ontario.