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YOUR COVERAGE

The details below are a summary of benefits, limitations, and exclusions that apply. Full benefit details can be found in the Benefit Booklet.

 

  1. In the event of a discrepancy between the website and the benefit booklet, the benefit booklet will be taken as true. The termination age for the SMUSA Health & Dental Benefits is 70.
  2. Overall Drug, Extended Health and Vision Maximum $5,000 per benefit year, per insured.
  3. Drug, Extended Health, Vision and Dental coverage is valid in Canada only. Travel coverage is valid worldwide. Please review your policy for full details.

**NEW FOR THE 2023-2024 POLICY YEAR**

  • Drug Coverage includes the Gardasil Vaccine, up to $100.
  • Naturopaths and Dieticians are eligible for coverage under Extended Health

Do you want to know the difference between the International Plan and the Health and Dental Benefits Plan? Check the Roadmap

Understand Your Coverage

Know all benefits, limitations, and exclusions that apply.

Coverage valid in Canada only.

 
 

Drug Coverage from 50% - 100% Coverage

Overall Drug Maximum $5,000/Benefit Year - Termination Age: 70

Direct2U Prescriptions:

100% Coverage for Tier 1

80% Coverage for Tier 2 & Specialty Drugs


All Other Pharmacies:

80% Coverage for Tier 1

50% Coverage for Tier 2 & Specialty Drugs

Drug Benefits also Include:

Contraceptives (incl oral, IUD's, IUS's) (IUD's: One/5 Benefit Years)

Gardasil Vaccine ($100/benefit year)

Standard Preventive Vaccines

Diabetic Supplies (test strips & needles) (Glucometers may be covered under Extended Health) 

Hepatitis C Medications ($1,500/lifetime)

Drug Benefits do NOT Include:

✘ Erectile Dysfunction Drugs
 
✘ Fertility Drugs/Treatment
 
✘ Smoking Cessation Aids/Remedies
 
✘ Anti-Obesity Drugs/Products

Want to know if your drug is eligible for coverage? Use the Medavie Blue Cross® Drug Look-Up Tool or our Eligible Drug Search tool to search by DIN or Drug name.

Eligible Drug Search Tool

Mandatory Generic Product Selection

Brand name drugs will be covered up to the amounts listed above up to the cost of the lowest-priced generic equivalent.

Only those drugs that legally require a prescription and are eligible under your benefits will be covered.

Nova Scotia Seniors Pharmacare

*At age 65 students are eligible for the Nova Scotia Seniors Pharmacare program. Click on the button above for more information.

** CNS Stimulants are medications used to increase physical activity, mental alertness, and attention span. They are often used in the treatment of Attention Deficit Disorder and/or Hyperactivity Disorders (i.e. Adderall, Concerta, Vyvanse, Ritalin, and their generic versions).

*** Drug coverage is valid in Canada. If you are traveling for an extended period, you must ask the pharmacy for a 'vacation supply' of your medication before departure to cover you while you are abroad. In an emergent situation abroad, you may be able to claim a prescription provided the medications(s) are Health Canada approved.

 

Dental Coverage from 50% - 70% Coverage

Annual combined maximum of $750.00/year/insured

Examinations (70%): Complete Oral Examination (once every 5 benefit years) / Limited and Recall examinations (once every 12 months)

Radiographs (70%): Complete series Periapical or Panoramic (once every 5 years) / Bitewing (once every 12 months)

Preventative Services (70%): Dental polishing (1, 15-minute unit every 12 months) / Scaling (2, 15-minute units per plan year)

Minor Restorative (70%): Fillings

Extractions (50%): Includes wisdom tooth extractions

Anesthesia (50%): When in conjunction with surgical services

Other Dental Coverage (70%): Endodontic / Periodontics

*Limitations and Exclusions may apply. Reimbursement based on Current Dental Fee Guide. Note that specialist fees will be paid at General Practitioner rates.

Students can check to see if the dental code on their predetermination is eligible on the plan. Login to the Blue Cross Member Portal to find out! Note: This does not say how much is eligible, just if the code itself is eligible under your benefits or not.

Blue Cross Member Portal

Predetermination: It is strongly recommended to obtain a predetermination for extensive dental procedures to prevent unexpected costs. Have your dentist send a quote/predetermination electronically to Medavie Blue Cross® at fax: 506-867-4651. If your claim is the result of a Dental Accident please go to the Accident Coverage section for more information.

 

Vision Coverage - 80% Coverage

Eye Examinations, Frames, Lenses & Contact Lenses - $150 per benefit year

Use Code: VPSTVIP8 for 8% off at Vision Pros
 

Frames, Lenses and Contact Lenses must be purchased from a Canadian provider to be considered eligible under the benefits.

This coverage excludes expenses incurred for non-corrective sunglasses and safety glasses.

Please make sure to include your prescription (no more than 2 years old) along with your receipt when submitting claims for reimbursement.

Frames are only eligible if purchased in conjunction with prescription lenses. Lasik or Laser Eye Surgery are NOT covered under the benefits.

 

Extended Health Coverage from 80% - 100% Coverage

Practitioner Coverage - 80% Coverage

Maximum $55/visit, up to a combined maximum of $350 per benefit year

Physiotherapist

Registered Massage Therapist*

*Physician's Prescription must accompany first [RMT] claim each new policy year, if prescription is less than 12 months from date of issue, it can be used in subsequent policy years.

100% Coverage, $1,000 combined/benefit year

Psychologist**

Social Worker (MSW)**

Psychotherapist**

Clinical Counsellor**

**Any other mental health practitioners who do not meet the above criteria will not be considered eligible for coverage under the benefits

**Psychotherapists must be in good standing with the college in their province, as well as registered as a provider with Medavie Blue Cross and be issued a provider number.

Note: Psycho-educational assessments & other assessments are not eligible for coverage

80% Coverage, $45 per visit maximum, $350 combined per benefit year

Chiropractor

Chiropodist

Podiatrist

Osteopath

Naturopath

Dietician

Other Medical Coverage - 80% Coverage

Coverage is to maximum indicated, unless otherwise stated:

Medical Equipment & Supplies ($500 per benefit year) *** ****

Ambulance to Nearest Treating Hospital ($1,000/benefit year - Reasonable & Customary)

***Prescription required from a medical Doctor
****For a full listing of eligible expenses, please see the benefit booklet

 

Travel Coverage

365 Days per Trip, $2,000,000 Maximum

Emergency medical assistance

Repatriation of mortal remains (maximum $7,500)

Airfare in the event of :

  1. Missed return flight due to illness of you or travelling companion
  2. Medically required attendant to accompany insured home
  3. Cost of airfare for spouse or close relative if confined outside province for at least 7 days
  4. Cost of airfare to return unsupervised children under the age of 15 home when only available supervising guardian is hospitalized

Cost of return of patient's vehicle when patient or family is unable to do so (maximum $1,000)

Costs incurred by family (when patient is detained in hospital) for meals and accommodation (maximum $150/day up to 20 days) ($3,000 Maximum/incident)

Trip cancellation ($5,000 Maximum)

Lost luggage coverage ($500 Maximum)

International students will have 30 days of coverage in their home country for emergency services if provincial or equivalent coverage is extended as well.

Psychological Coverage abroad- If you seek services abroad, you may claim your visits upon return to Canada and may be eligible for a refund. All claims are adjudicated in accordance with policy wording and eligible claims are refunded in Canadian dollars

Exclusions

Expenses incurred for injuries and/or illness as a result of the insured’s reckless behavior while on a trip, including international non-compliance with a prescribed treatment or therapy, or intentional misuse of medication or reckless disregard for their own health or safety while engaging in activities or treatment thereof, or accidents relating thereto.

Have you returned from your trip and need to make a claim?

For medical claims abroad (doctor visits, hospital visits, x-rays, lab work, etc.), please complete the Travel Claim Form Request and your claim form will be emailed to you

Travel Claim Form Request

For trip cancellation or interruption please complete below form

Trip Cancellation Form

The attending physician form found here must also be completed if your trip cancellation or interruption is due to medical reasons

Attending Physician Form

For baggage claims, please complete this form and submit it to the Travel Claims Department

Baggage Claims Form

To speak to an agent dial 1-833-564-4444, select prompt 1 for English

Still need assistance? Please email info@studentvip.ca or Live Chat with us by heading to the home page of this site and clicking the "Live Chat" button

Important Reminders

All claims must be accompanied by original receipts and the original claim form

Time Limit to Submit a Claim: Blue Cross must receive proof of claim within 4 months of the date the expense was incurred to be eligible for maximum reimbursement under the benefit. Blue Cross will accept claims up to 12 months from the date the expense was incurred However, the claim may be subject to reductions

Please take copies or scans of ALL documents and receipts before submitting your claim

 

Learn More About your Travel Coverage

Travel Advisories

Students planning to travel to countries with travel advisories issued to them should check to ensure coverage will be enforced while abroad, even if not planning to travel to an affected area

The Foreign Affairs and International Trade Canada website includes Travel Warnings and Advisories for specific countries experiencing civil unrest. Their website is www.travel.gc.ca and the information is updated regularly. We recommend that you check this website prior to leaving Canada for essential travel information

We encourage you to review your Travel Right brochure. If you have any questions, contact us at 1-833-564-4444

When a Travel Warning or Advisory has been issued for a country that you are travelling to, it is important for you to be aware of the impact this may have on your Out-of-Canada Emergency Medical benefit with Travel Right
Although your coverage itself may be allowed, expenses incurred while travelling in a country (or specific region of a country) for which there is a Government of Canada travel warning to avoid all travel or non-essential travel, when such travel warning was issued before the departure date and the loss or expense is related to the reason for which the travel warning was issued; or participation in a criminal act or attempt to commit a criminal act, regardless of whether charges are laid or a conviction is obtained; insurrection, war (declared or not), the hostile action of the armed forces of any country or participation in any riot or civil commotion, may not be eligible for coverage depending on the nature of the claim. All other benefit exclusions apply




Travel Right Brochure

Emergency Assistance

Are you currently travelling and need to contact your travel provider?

  1. Within Canada (not your home province) and the United States: 1-800-563-4444
  2. Anywhere else in the world, call collect: 1-506-854-2222

Please have the following information ready:

1. Personal Information

  1. Your name and Student ID
  2. Your Policy Number 0091939000

2. Travel Information

  1. Travel dates: departure date and return date (from/to) the home province
  2. Travel destination: City, State/Province (when applicable), Country
  3. Travel purpose

3. Medical Information

  1. Description of the medical emergency or need (symptoms, circumstances, etc.)
  2. Date of medical emergency or first onset of symptoms

Provincial Coverage & Travel

Those with a valid provincial health plan card may still have partial coverage for some emergency services while travelling abroad. For more information please visit the Ministry of Health website for the province your coverage is with

Travel coverage offered through the plan is only valid if your provincial health care is in force for the entire duration of your travel. Please contact your provincial Ministry of Health office or download the appropriate travel flyer for more information

Before You Depart

Travel coverage cannot be extended past August 31 each policy year. If your travel duration exceeds August 31, please contact your health plan office or Student VIP for more information

365 days of coverage may not be valid for international students. Please contact the health plan office or Student VIP for confirmation before you leave the province




Provincial Health Care Information

Visa & Travel Letter Requests

Students requiring proof of coverage for their Visa application may complete the Visa & Travel Letter Request Form, your request will be reviewed and the letter e-mailed to you in 3-5 business days

Students only require a travel letter if the country they are travelling to requires a letter for entry into the country, or if they have to apply for a travel visa

Domestic students travelling to Cuba do not require a travel letter, your provincial health coverage should be sufficient for entry into Cuba




Visa & Travel Letter Request Form

J1 Visas

Applicants for a J1 Visa require specific levels of coverage in order to obtain the visa. We have provided an enhancement to the travel coverage to meet all requirements. If you are J1 visa applicant, please contact us at info@studentvip.ca and we can assist with upgrading your coverage

Frequently Asked Question

Have questions about your travel coverage, Download the FAQ Info sheet for some answers to commonly asked questions.




Download FAQ Infosheet
 

Accident Coverage

What is an Accident?

An accident means an occurrence due to external, violent, sudden, fortuitous causes beyond the insured’s control, which must occur while the student is insured under this policy.

Accidental Medical up to Maximum $10,000

If within 30 days from the accident causing injury, the insured obtains medical treatment in Canada may be reimbursed for the following reasonable and necessary expenses to the specified maximum per Insured for all injuries resulting from any one accident:

Duty nurse ($50/hour, $5,000 maximum)

Ambulance ($5,000)

Semi-private hospital room ($5,000)

Wheelchair rental (Reasonable & Customary)

Fee for services of a licensed physiotherapist ($500), chiropractor ($300)

Hearing aids, crutches, splints, casts, trusses and braces, excluding replacement (Reasonable & Customary)

HIV Post-Exposure Prophylaxis (PEP) for bodily injuries sustained in the performance of duties required by your program of study

Expenses must be incurred in Canada, within 52 weeks of the date of the accident causing injury, incurred for only therapeutic and not elective treatment, and supported by original receipts.

Day Care Benefit Maximum 5%, up to $5,000 per year/5 Year Total

If the Insured sustains an Injury that results in payment being made for loss of life. The Insurer will pay the reasonable and necessary day care expenses incurred for any dependent Child 12 years of age and under. Child must be enrolled in a legally licensed day care centre on the date of accident or within 365 days following the date of accident.

Accidental Death & Dismemberment up to Maximum $5,000

Payment of a stipulated sum for loss of life or limb through accidental means, provided such loss occurs within 365 days after the date of accident causing such loss.

Tutorial Expense up to Maximum $20/hour up to $5,000

If insured suffers injury resulting in hospital or medically necessary bed rest and is confined for at least 15 consecutive school days, as determined by a physician, the insurer will pay for the private tutorial services of a qualified teacher.

Accidental Dental up to Maximum $2,000

Injury to whole and sound teeth, and within 30 days from the day of the accident obtains treatment in Canada from a qualified dentist. Reimbursement will only be provided on expenses which are: incurred in Canada, incurred within 52 weeks of the date of the accident causing injury, incurred only for therapeutic and not elective or aesthetic treatment, and supported by an original standard dental claim form.

Repatriation up to Maximum $10,000

If injury causing loss of life occurs more than 50 kilometres from insured’s permanent city of residence and within 365 days of the date of the accident causing injury, the insurer shall pay the actual expenses incurred for preparing the deceased insured for burial or cremation and shipment of the body to the city of residence of the deceased insured.




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