Overall Maximum of $3,000 per participant per benefit year.
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85% Coverage
60% Coverage
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Tier 1
Tier 2 & Specialty Drugs
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50% Coverage
50% Coverage
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Tier 1
Tier 2 & Specialty Drugs
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Dispensing Fee: 100% of any amount up to $5
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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 benefits will be covered.
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Contraceptives (incl oral, IUD’s, IUS’s) {IUD'S: One/5 Benefit Years}
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Diabetic Supplies (Test strips & needles)
*Glucometers may be covered under Extended Health - Other Medical coverage ($200/Benefit Year)
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Standard Preventative Vaccines **
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CNS Stimulants*** ($600/benefit year)
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Hepatitis C Medications ($1,500/lifetime)
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Biologic Agents ($1,500/benefit year)*
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Gardasil Vaccine
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Anti-Obesity Drugs/Products
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Erectile Dysfunction Drugs
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Fertility Drugs/Treatment
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Smoking Cessation Aids/Remedies
Want to know if your drug is eligible for coverage? Check out our Eligible Drug Search tool to find out!
* Biologic Agents may include drugs to treat severe arthritis, MS, Crohn’s, etc. - such as Humira.
** Vaccinations must be administered by a licensed retail pharmacy to be eligible for coverage, maximum $150 per benefit year.
***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.)
Maximum $30/visit, up to a combined maximum of $500 per benefit year:
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Chiropractor (Includes 1 x-ray)
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Naturopath
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Acupunturist
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Osteopath/Chiropodist/Podiatrist (combined)
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Speech Therapist
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Physiotherapist
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Registered Massage Therapist*
*Prescription required for 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.
Combined maximum of $600 per benefit year:
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Psychologist
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Social Worker (MSW)
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Psychotherapist
Coverage is to maximum indicated, unless otherwise stated:
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Orthotic Appliances or Custom Orthopedic Shoes ($250 per benefit year)** *** ****
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Medical Equipment & Supplies ($500 per benefit year)** ***
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Ambulance to Nearest Treating Hospital ($300/Benefit Year - Reasonable & Customary)
**Prescribed by a medical doctor, an orthopedic surgeon or podiatrist
***For a full listing of eligible expenses, please see the benefit booklet
****Must be obtained from one of the following providers: podiatrist, chiropodist, pedorthist, orthoptist, or chiropractor (with an orthotic agreement on file)
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Eye Examinations, Frames, Lenses & Contact Lenses - $175 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 benefits.
Frames are only eligible if purchased in conjunction with prescription lenses.
Lasik or Laser Eye Surgery are NOT covered under the benefits.
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Pre-Determination: It is strongly recommended to obtain a pre-determination for extensive dental procedures to prevent unexpected costs. Have your dentist send a pre-determination 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 benefits. 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 under your benefits.
If your claim is the result of a Dental Accident please go to the Accident Coverage section for more information.
Annual combined maximum of $1,000.00/year/insured
Reimbursement based on current Alberta Fee Guide plus inflationary adjustment. Note that specialist fees will be at General Practitioner rates.
Complete oral examination (once every 5 years) / Limited/recall examination (once every 12 months)
Complete series Periapical or Panoramic (once every 5 years) / Bitewing (once every 12 months)
Dental polishing (1, 15-minute unit every 12 months) / Scaling (1, 15-minute units every 12 months)
Fillings
Includes wisdom tooth extractions
When in conjunction with surgical services
Endodontic / Periodontics / Denture Services
Limitations and Exclusions may apply.
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.
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.
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.
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), chiropractor ($300)
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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.
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.
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.
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.