August 16, 2024
Yes. The Appeal Process is designed to allow a member to seek further clarification when their benefit claim has been partially or totally declined and they are unclear about or disagree with the reason for the claim denial. In the initial claim adjudication and at every step of the Appeal process the claim is reviewed […]
August 16, 2024
Most drugs that are not “over the counter” with the exception of anti-obesity and anti-smoking drugs are covered under the OSSTF Benefits Plans. However, to help keep our plans sustainable and affordable some prescriptions require prior authorization(pre-approval) to be covered under the OSSTF Benefit Plans. What is Drug Prior Authorization? Some prescriptions (such as medications […]
May 1, 2024
Depending on the level of complexity, some claims may need more time and/or information to process. We encourage you to get an estimate or pre-determination of benefit before you spend your money on high claim cost items, like medical equipment/services, expensive dental work or drugs that need pre-approval. That way, you know upfront whether your claim will be […]
May 1, 2024
To avoid large out-of-pocket expenses that may not be covered by the OSSTF Benefits Plan, we recommend that you submit a pre-determination to OTIP prior to the expenses being incurred. Please contact OTIP Benefits Services at 1‑866‑783‑6847 for more details. […]
The information contained in this website is for general information purposes only. The information is provided by OSSTF Benefits and while we endeavour to keep the information up to date and correct, we make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the website or the information, products, services, or related graphics contained on the website for any purpose. Any reliance you place on such information is therefore strictly at your own risk. All information on this website is subject to change without notice.