Drug Coverage – 70% - 90% Coverage
Overall Drug Maximum $3,250/Benefit Year
Direct2U + Pharmasave:
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90% Coverage
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Dispensing Fee: 100% of any amount up to $10
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All Other Pharmacies:
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70% Coverage
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Dispensing Fee: 100% of any amount up to $10
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Mandatory Generic Product Selection:
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Brand name drugs will be covered up to the amounts listed above, up to the cost of the lowest-priced generic equivalent.
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Only those drugs which legally require a prescription and are eligible under the plan will be covered.
Drug Plan Also Includes:
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Standard Preventative Vaccines*
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Contraceptives - Oral, IUDs, Injectable
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Diabetic Supplies (Test strips & needles) {Glucometers may be covered under Extended Health- $200/benefit year}
* Vaccines are on a cost-reimbursement basis. Students pay upfront & submit a Health Claim Form for reimbursement. Vaccines must be administered by a licensed retail pharmacy to be eligible for coverage.
Practitioner Coverage - 80%-100% Coverage
100% Coverage, up to $30/visit maximum & up to $300/practitioner per benefit year
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Chiropractor
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Podiatrist/Chiropodist
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Speech Therapist
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Occupational Therapist
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Physiotherapist*
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Registered Massage Therapist*
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Dietitian/Nutritionist
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Osteopath
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Naturopath ($50/visit maximum)
*Physician's Prescription must accompany first RMT/Physiotherapist claim each benefit year. If prescription is less than 12 months from date of issue, it can be used in subsequent benefit years.
100% Coverage, up to $100/visit maximum & up to a $700 combined maximum per benefit year
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Psychologist
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Psychotherapist
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Social Worker (MSW)
80% Coverage, up to $1,000 maximum per benefit year
Other Medical Coverage
Coverage is to maximum indicated, unless otherwise stated:
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Custom Orthopedic Shoes (50% coverage up to $250/benefit year)*
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Medical Equipment & Supplies (Reasonable & Customary)** ***
For a list of practitioners on our Preferred Provider Network, please click here.
*Prescribed by a medical doctor, chiropodist or podiatrist
**Physician's prescription required
***For a full listing of eligible expenses, please see the Brochure
Vision Coverage - 100% Coverage
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$100 every 24 months for Eye Exams
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$175 every 24 months for Frames, Lenses, Contact Lenses or Laser Eye Surgery
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.
Use code: VPSTVIP8 for 8% off at Vision Pros
Dental Coverage – 10% - 100% Coverage
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®
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.
If your claim is the result of a Dental Accident please go to the Accident Coverage section for more information.
Annual combined maximum of $650.00/year/insured Reimbursement based on Current Dental Fee Guide. Note that specialist fees will be paid at General Practitioner rates.
Examinations (100%)
Complete Oral Examination (once every 2 benefit years) / Recall examinations (once every 6 months) / Limited or specific exam (once every benefit year)
Radiographs (100%)
Complete series Periapical or Panoramic (once per 2 years) / Bitewing (once per benefit year)
Preventative Services (100%)
Dental polishing (1x 15-minute unit every 6 months) / Scaling (4x 15-minute units every 12 months)
Minor Restorative (100%)
Fillings
Major Restorative (80%)
Crowns
Extractions (50%)
Includes Wisdom Tooth Extractions
Other Dental Coverage (10%)
Endodontics / Periodontics
Limitations and Exclusions may apply.
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.
What is Covered?
Accidental Death & Dismemberment 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.
Accidental Dental 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.
Accidental Medical 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:
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Duty nurse ($50/hour, $5,000 maximum)
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Ambulance ($5,000)
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Semi-private hospital room ($5,000)
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Wheelchair rental (Reasonable & Customary)
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Fee for services of a licensed physiotherapist ($500)
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Hearing aids, crutches, splints, casts, trusses and braces, excluding replacement (Reasonable & Customary)
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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.
Tutorial Expense Maximum $20/hour up to $2,000
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.
Repatriation Maximum $5,000
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.
(New for 2022-23)
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.