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Policy Year: September 1, 2019 - August 31, 2020

The details below are a summary of benefits, limitations and exclusions do apply. Full benefit details can be found in the Benefit Booklet on the Medavie Blue Cross™ Portal. In the event of a discrepancy between the website and the benefit booklet, the benefit booklet will be taken as true. Overall EHC Maximum of $5,000 per year, per insured.


Drug, Extended Health, Vision and Dental coverage is valid in Canada only.  Travel coverage is valid worldwide.  Please review your policy for full details.


  • Drug Coverage
  • Extended Health Coverage
  • Vision Coverage
  • Dental Coverage
  • Travel Coverage
  • Accident Coverage

Drug Coverage – 50% - 100% Coverage

Overall Maximum of $5,000 per participant per plan year. The termination age for Drug Coverage for the Brock GSA Health & Dental benefits is 80. 


100% Coverage

80% Coverage

Generic Drugs

Brand Drugs

$7 Dispensing Fee Cap

All Other Pharmacies

80% Coverage  

50% Coverage

Generic Drugs

Brand Drugs

$6 Dispensing Fee Cap


Mandatory Generic Product Select

  • 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 which legally require a prescription and are eligible under the benefits will be covered.

Drug Plan also Includes:

  • Contraceptives (incl oral, IUD’s, IUS’s) {One/5 plan years}  

  • Diabetic Supplies (test strips & needles, glucometers may be covered under Extended Health)

  • CNS Stimulants* (80% Coverage, $500/benefit year)

  • Hepatitis C Medications ($1,500/lifetime)

  • Biologic Agents ($1,000/benefit year)

  • Anti-Obesity Drugs, Erectile Dysfunction Drugs, Fertility Treatment, Smoking Cessation Medications with physician's prescription ($500 combined/lifetime on a cost reimbursement basis)

Drug Plan does NOT Include:

  • Gardasil Vaccine

NOTE: Effective April 1, 2019, there are changes to OHIP+ that may affect your coverage. Please click here to learn more. 

Want to know if your drug is eligible for coverage? Check out the Eligible Drug Search tool to find out!

*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. Adderrall, Concerta, Vyvanse, Ritalin, and their generic versions.) 

Practitioner Coverage – 100% Coverage

The termination age for Extended Health Coverage for the Brock GSA Health & Dental benefits is 80. 

Max $40/visit up to $520 per benefit year, per practitioner:

  • Chiropractor
  • Naturopath
  • Speech Therapist
  • Physiotherapist
  • Registered Massage Therapist*
    *Physician's prescription must accompany first Registered Massage Therapist claim*

Max $1000 combined per benefit year, no per visit max**:

  • Psychologist
  • Psychotherapist
  • Social Worker (MSW)
    **Clinical Counsellors and other mental health practitioners who do not meet the above criteria will not be considered eligible for coverage under the plan

Other Medical Coverage – 100% Coverage

$3,000 maximum per benefit year, per insured

Coverage is to maximum indicated, unless otherwise stated:

  • Orthotic Appliances or Orthopedic Shoes (1 pair every 3 years)*
  • Medical Equipment & Supplies (Reasonable & Customary)** ***
  • Ambulance to Nearest Treating Hospital ($1,000/plan year - Reasonable & Customary)

*Prescribed by a medical doctor, an orthopedic surgeon or podiatrist 
**Physician's prescription required 

***For a full listing of eligible expenses, please see the Brochure


Vision Coverage – 100% Coverage

The termination age for Vision Coverage for the Brock GSA Health & Dental plan is 80. 

  • Eye Examinations - 1 standard exam every 24 months (reasonable & customary)
  • Frames, Lenses & Contact Lenses - $250 every 24 months
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, Lenses and Contact Lenses must be purchased from a Canadian provider to be considered eligible under the plan.

Frames are only eligible if purchased in conjunction with prescription lenses.

Lasik or Laser Eye Surgery are NOT covered under the plan.

Vision Pros

Dental Coverage – 50% - 80% Coverage

The termination age for Dental coverage for the Brock GSA Health & Dental benefits is 80. 

Pre-Authorization: It is strongly recommended to obtain a pre-authorization for extensive dental procedures to prevent unexpected costs. Have your dentist send a quote/predetermination along with your name and Student ID to Medavie Blue Cross™ at fax: 506-867-4651.

Students can check to see if the dental code on their pre-determination is eligible on the Plan. Login to the Blue Cross Member Portal to find out! Note that this does not say how much is eligible, just if the code itself is eligible on your plan.


If your claim is the result of a Dental Accident please go to the Accident Coverage section for more information.

Annual combined maximum of $800.00/year/insured       Reimbursement based on Current Dental Fee Guide less one year. Note that specialist fees will be paid at General Practitioner rates.


Examinations (80%)

Complete oral examination (once every 5 years) / Limited & Recall examination (once every 12 months)


Radiographs (80%)

Complete series Periapical or Panoramic (once every 5 years)  / Bitewing (once every 12 months)


Preventative Services (80%)

Dental polishing (1, 15-minute unit every 12 months) / Scaling (2, 15-minute units every 12 months)


Minor Restorative (80%)



Extractions (50%)

Includes wisdom tooth extractions


Anesthesia (50%)

When in conjunction with surgical services


Other Dental Coverage (50%)

Endodontic / Periodontics / Denture Services


Limitations and Exclusions may apply.
Please see the
BROCHURE for full details.

Before You Depart


Keep In Mind

  • 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.
  • 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 HERE for more information.




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


Coverage Includes, but is not limited to:

  • Emergency medical assistance
  • Repatriation of mortal remains (maximum $7,500)
  • Airfare in the event of:
    • Missed return flight due to illness of you or travelling companion
    • Medically required attendant to accompany insured home
    • Cost of airfare for spouse or close relative if confined outside province for at least 7 days
    • 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.
  • Psych 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



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.


Emergency Assistance


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

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


Please have the following information ready:


Personal Information

  1. Your name and Student ID
  2. Your Policy Number 0091964000

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

Medical Information

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


Visa's and Travel Letters


Visa & Travel Letter Request Forms

  • 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.



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 and we can assist with upgrading your coverage.


Provincial Health Coverage


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 HERE for more information.


Travel Advisories


Students planning to travel to counties 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  and the information is updated regularly.  We recommend that you check this website prior to leaving Canada for essential travel information.


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 TravelRight.

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.


We encourage you to review your TravelRight brochure.  If you have any questions, contact us at 1-833-867-3468






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.

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

For baggage claims, please complete this form.

If you wish to speak to an agent:
  • Dial 1-833-867-3468

  • Select prompt 1 for English

  • Select prompt 2

  • then select prompt 5 and ask to speak to the Travel Claims Department.


Still need assistance? Please email 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


Frequently Asked Questions


Do I need to notify my province when I leave?

  • You do not need to notify your province However, you will need to make sure you have extended your provincial coverage if required based on your time out of your province/Canada. For more information, please click here.


I am an international student, does this affect my coverage?

  • Yes, you must have private or provincial health care in place in order for the Student VIP Travel Right coverage to be in place. In addition, the duration of coverage under this plan mirrors the duration of coverage from your alternate insurance. For example, if your private plan covers you for 60 days, we will cover you for 60 days.


How do I get a card before I leave?

  • Your Health and Dental Benefits card is also your travel card. Please click here for your wallet card.


Do I need to notify anyone before I leave Canada/my province?

  • You do not need to notify us. However, there may be a requirement to notify your University International Office if you are going on a school related trip. Please consult your school for these requirements.


How do I get a letter of proof of coverage?

  • If you require a letter of proof of coverage, please click here.


If I need to see a doctor while out of country will I have to pay up front?

  • You may need to pay up front if you do not call us in advance. Please call before seeking medical attention so we can help direct you to a medical facility and arrange direct billing on your behalf. If you do pay up front, you can submit a claim.
  • Please call us:

Travel within Canada and US- 1-800-563-4444

Anywhere else in the world (Call collect) – 1-506-854-2222


A travel advisory has been issued for my destination, what do I do?

  • Please contact us to discuss your coverage options for destinations where a travel advisory has been issued. You can reach us at 1-833-867-3468 and ask to speak to the Travel Department.



Full details can be found in the Travel Brochure.  The termination age for Travel Coverage for the Brock GSA Health & Dental benefits is 70. 


The termination age for Accident Coverage for the Brock GSA Health & Dental plan is 70

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 $10,000 

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: 

  • 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.


Tutorial Expense      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.


Repatriation      Maximum $10,000 

If injury causing loss of life occurs more than 50 kilometers 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.