Semi-Private Hospital Plan

Even with a healthy lifestyle, sometimes a hospital stay is unavoidable. RTO/ERO is committed to ensuring that our members and their dependents have access to the best possible hospital and home care coverage for their insurance dollar.  With premium rates and coverage the same for all ages, coverage for semi-private hospital room accommodation, and home care services, getting the assistance you need just got a little bit easier.

As with all of our group plans, coverage is available to you, your spouse and your dependent children.  Please see the eligibility section for details.

RTO/ERO members own and manage this group plan, regularly reviewing the coverage and rates to ensure the best value for money. RTO/ERO is a not-for-profit organization. Surpluses above and beyond reserve requirements are “refunded” to the RTO/ERO Health Plans and become part of RTO/ERO’s Health Premium Stabilization Fund.

There are many services aimed at making your Semi-Private Hospital Plan coverage more convenient, including:

• Claim payments deposited directly to your bank account
• Electronic notification of your claim payments
• Annual Benefit Statement and Tax Letter
• Secure, online access to claims and benefit information
• Walk-in service for administration and claim services in the Greater Toronto Area

See the Semi-Private Hospital Plan summary of benefits below or review the full Plan information document (PDF). And remember, each and every RTO/ERO District has a District Health Services and Insurance representative to assist members. That's just another way RTO/ERO is “Here for you now, Here for your future.”

Semi-Private Hospital Benefit

• 95% reimbursement
• Unlimited maximum
• Covers the daily semi-private room charges for acute care in a licensed hospital

Convalescent Home Care Benefit

• 80% reimbursement
• Covers home care following a hospitalization of at least 24 hours, up to $75/day, maximum of 30 days
• Includes three days of home care following non-elective day surgery up to a maximum of $75/day
• Includes a temporary stay in a long term care facility following a 24 hour hospitalization, up to $75/day, annual maximum of 30 days (total days of care, when combined with convalescent home care, cannot exceed 30 days per calendar year).