Use this form to claim for Drug, Extended Heath & Vision claims.
Take this form to your dentist for completion before submission. We recommend students show their dentist their Health Benefits Card and have the dental office submit their claim electronically, or request a "Standard Dental Claim Form" in lieu of using this form.
Use this form to set up direct deposit and receive your drug, extended health, and vision claim reimbursements faster. Please email your completed form to uwsa@medavie.bluecross.ca or mail it in to one of the addresses listed on the form.
If you have returned home from your trip and need to make a claim, please click here for more information.
Find the details of your 365-day travel coverage here.
Full benefit details can be found on the Blue Cross Portal
Students are encouraged to use the Online platform to submit any opt-in/out requests to their benefits during the term in which they begin their studies.
Please visit the Frequently Asked Questions section to learn more about the opt-in/out processes.
This form is used for students requesting special authorization for a specific drug to be covered under their benefits. For students requesting a CNS Cap Removal, or Monitored Medication Request, please contact Student VIP directly. Note that submission of this form does not guarantee your request will be granted.
Submit exception requests by sending as an "e-Claim" on the Blue Cross Member portal, or by mailing it to Medavie Blue Cross™ at: 644 Main St., PO Box 220, Moncton, NB E1C 8L3 or by fax to 1-844-661-2640.
If you require a Proof of Coverage letter for outbound travel for either a travel visa, applications for government programs or proof for other reasons, please email info@studentvip.ca to request this.