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Supplemental Health

All benefits payable through the Student Plan are based on reasonable and customary charges.

Ambulance
Your plan covers 80% for licensed ground ambulance or emergency air service that transports the patient to the nearest hospital equipped to provide the required treatment when the physical condition of the patient prevents the use of another means of transportation. If the patient requires the services of a registered nurse during the flight, the services and return airfare for a registered nurse are covered.

Nursing
Your plan covers 80% up to a maximum of $10,000 per benefit year for the services of a registered nurse (R.N.), registered nursing assistant (R.N.A.), certified nursing assistant (C.N.A.), or licensed practical nurse (L.P.N.) when provided in the patient’s home. To qualify as an eligible expense the patient’s treatment must require the level of expertise of an R.N., R.N.A., C.N.A., or L.P.N.

Practitioners
Student benefits are payable after any Provincial Health Care benefits have been exhausted. This plan does not cover user fees. Student specific rates are available for some of the indicated services, information can be found in Select Savings.

The services of the following practitioners are covered at 70% to a maximum of $300 per practitioner, per benefit year. Practitioners must be registered and licensed in their field of practice.

• chiropractor, including one x-ray examination per benefit year
• registered massage therapist*
• naturopath
• osteopath, including one x-ray examination per benefit year
• physiotherapist*
• speech therapist*
• podiatrist or chiropodist, including 1 x-ray examination per benefit year
• psychologist, social worker or registered clinical counselor

*physician’s prescription/referral required for indicated services

Medical Equipment & Supplies
It is recommended that an application for pre-approval be submitted to the insurer for any item that would be claimed under the Medical Services & Supplies benefit.

Medical Equipment
Your plan covers 80% of reasonable and customary charges for eligible equipment when prescribed by a physician. Eligible durable equipment includes, but is not limited to, items such as:

• wheel chairs
• wheel chair repairs (lifetime maximum of $250)
• walkers
• hospital beds
• traction kits

Braces, Crutches, Splints, Trusses
Your plan covers 80% of reasonable and customary charges when prescribed by a physician and are not solely for athletic use for braces, crutches, splints, and trusses.

Prosthesis
Your plan covers 80% of reasonable and customary charges when prescribed by a physician for artificial limbs or other prosthetic appliances.

Orthopaedics*
Your plan covers 80% up to a maximum of $150 per benefit year for custom-made orthopaedic shoes and/or orthotics when they are required for the correction of deformity of the bones and muscles and provided they are not solely for athletic use and are prescribed by a physician, podiatrist, chiropodist or chiropractor. Modifications, repairs and adjustments to custom-made orthopaedic shoes and/or orthotics are covered without a prescription.

*IMPORTANT It is strongly recommended that a pre-determination/estimate be submitted to Great-West Life to ensure that the guidelines set out by Great-West Life for the payment of Orthopaedics are met and to confirm that your claim would be eligible.

Dental Accident
IMPORTANT! Dental Accident Pre-determination: An estimate for all dental accident services MUST be submitted to the health plan insurer. If you go ahead with treatment without a pre-determination being approved, you are doing so at the risk of the expenses being yours.

The plan covers 80% of the cost of the services of a dental surgeon, limited to the fees provided in the current General Practitioners fee guide, including dental prosthesis, required for the treatment of a fractured jaw or accidental injuries to natural teeth or jaw if caused by external, violent and accidental means. Services must be performed within 12 months of the accident. Dental Accident benefits are payable through the Health plan and limited to $1,000 per accident.

Treatment must be completed within 12 months of the impact. If treatment is scheduled to occur more than 90 days after the impact, a treatment plan must be submitted to the insurer before the end of the 90 day period.

Out of Province Referral
Your plan covers 80% of the following hospital and medical services provided in Canada or the United States which are not offered in the province of residence and are performed following written referral by the attending physician in the patient’s province of residence to a maximum of $10,000 per lifetime:

1) hospital room and board at the ward rate
2) hospital services and supplies
3) diagnosis and treatment by physicians

The physician must give full details of the treatment and must be approved by the insurer in advance. You must apply and provide the insurer with a statement from your provincial health plan that describes what it will cover.

Select Health Savings
To enhance your existing coverage, select providers have agreed to help students by providing savings on certain plan eligible services. You must present your myBenefits Card at each visit. For further information on participating providers check out the Select Savings tab.

Service Members


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