Extended Health Coverage
Your extended health coverage runs for as long as you remain an eligible student at Camosun College. The plan is provided by The Camosun College Student Society. Download the Extended Health & Dental Plan coverage leaflet for the 2022-2023 academic year.
Your myBenefits Card allows you to direct bill with pharmacies and dental offices. To access direct billing at paramedical practitioners or vision care services, you must register on the my.canadalife.com and update your address on your profile.
Students can save money on certain eligible services if they visit one of our select savings members.
The following is the coverage for your Health Plan:
| Health Benefits |
Coverage |
| Prescription Drugs |
80% |
Maximum of $3000 per benefit year. The maximum amount payable to an eligible brand name drug will be limited to the lowest priced item in the appropriate generic category.
Advise your doctor and pharmacist that you are on the BC Provincial Formulary.
Prescription Search Tool
Please use our Prescription Drug Search Tool to find out if your medication is covered by the plan.
Drug Exception Process
In the event that the drugs covered are not effective in treating your condition, or a drug that is effective is not covered, an exception process is in place. Download the Drug Exception Form for your general practitioner to fill out, and they can send the form directly to Canada Life on your behalf.
|
| Vision |
100% |
One eye examination, eyeglasses or contact lenses by an ophthalmologist or optometrist, limited to a combined maximum of $125.
The vision coverage renews every 24 months from the initial date of service. Coverage is based on reasonable and customary charges.
|
| Paramedical Practitioners |
80% |
Student benefits are payable after any Provincial Health Care benefits have been exhausted. This plan does not cover user fees.
The services of the following practitioners are covered up $30 per visit to a maximum of $360 based on reasonable and customary charges, per practitioner, per benefit year.
Practitioners must be registered and licensed in their field of practice.
Practitioners:
- Physiotherapist*
- Registered massage therapist*
- Certified athletic therapist*
- Chiropractor, including one x-ray examination per benefit year
- Naturopath
- Osteopath, including one x-ray examination per benefit year
- Podiatrist/chiropodist, including 1 x-ray examination per benefit year
- Acupuncturist
- Speech language pathologist covered at 80% to a maximum of $300
*physician's prescription/referral required for indicated services.
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| Mental Health Practitioners |
80% |
The services of a clinical psychologists, qualified social workers, registered clinical counselors or Canadian clinical counselors are covered up to $40 per visit to a maximum of $400 based on reasonable and customary charges per benefit year.
Practitioners must be registered and licensed in their field of practice.
|
| Medical Equipment & Supplies |
80% |
The plan covers reasonable and customary charges for eligible equipment when prescribed by a physician.
Prescription and pre-authorization may be required. Not solely for athletic use.
Eligible durable equipment includes, but is not limited to, items such as:
- Wheelchairs and wheelchair repairs (lifetime maximum of $250)
- Walkers
- Hospital beds
- Traction kits
- Braces, Crutches, Splints, Trusses when prescribed by a physician and are not solely for athletic use
- 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 foot, per benefit year for custom-made orthopaedic shoes and orthotics, repairs and modifications when required for the correction of deformity of the bones and muscles. Provided the orthopaedics are not solely for athletic use and are prescribed by a physician, podiatrist, chiropodist, or chiropractor.
- Diabetic Supplies
to a maximum of $150 of eligible expenses incurred during a 5 year period for Blood glucose monitors when prescribed by a physician.
|
| Ambulance |
80% |
To a maximum of $250 per occurrence. This coverage is applied after the provincial deduction.
The plan covers a licensed ground ambulance or emergency air service that transports the patient (student) 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.
|
| Emergency Out of Country Travel Insurance |
100% |
Your plan covers 100% up to a maximum of $5,000,000 per lifetime of medical expenses incurred as a result of a medical emergency arising while you are traveling outside Canada for vacation, business or education purposes. To qualify for benefits, you must be covered by the government health plan in your home province. For additional details on this benefit download your Travel Assist Brochure.
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| Other Insurance |
- |
The student plan also offers the following complementary insurances:
These insurances are only applicable to the Student. Family members added to the plan are not eligible.
Your plan provides coverage for the loss of life or limb and for paralysis caused by an accident. The amount of your life benefit is $5,000. Please contact health and dental plan office for a complete schedule of losses.
Your plan covers 80% up to $20 per hour to a maximum of $2,000 per benefit year for private tutorial service if the student is confined to home or hospital for a minimum of 15 consecutive school days.
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Limitations and Exclusions to Health Benefits
An exclusion is a condition or instance that is not covered by the Health Plan. it's important to review and understand exclusions to the plan before using your benefits.
No benefit is payable for:
Limitations and Exclusions to Prescription Drug Benefits
- Expenses for which benefits are payable under a Workers' Compensation Act or a similar statute
- Expenses incurred due to intentionally self-inflicted injuries
- Expenses incurred due to civil disorder or war, whether or not war was declared
- Expenses for services and products, rendered or prescribed by a person who ordinarily resides in the patient's home or who is related to the patient by blood or marriage
- Expenses for which benefits are payable under a government plan
- Expenses for benefits which are legally prohibited by the government from coverage
- Any services or supplies received by an insured person in their home country if their home country is not Canada
- Out-of-province expenses for elective (non-emergency) medical treatment or surgery
- Expenses for drugs which, in the insurer's opinion, are experimental
- Expenses for dietary supplements, vitamins and infant foods
- Expenses for contraceptives (other than oral)
- Expenses for smoking cessation aids
- Drugs for the treatment of erectile dysfunction
- Expenses for drugs if they are used for the treatment of infertility
- Expenses for the services of a homemaker
- Expenses for items purchased solely for athletic use
- Dental expenses, except those specifically provided under eligible expenses for treatment of accidental injuries to natural teeth
- Utilization fees which are imposed by the Provincial Health Care Plan for the use of a service
- Expenses for the regular treatment of an injury or disease which existed before the member's or dependant's departure from his/her province of residence
- Immunizations and vaccines (Hepatitis B will be covered, except for Recombivax HB preservative free - DIN 02245976 and DIN 02245977)
- Any other exclusion identified in the policy contract
Dental Coverage
Your dental coverage runs for as long as you remain an eligible student at Camosun College. The plan is provided by The Camosun College Student Society. Download the Extended Health & Dental Plan coverage leaflet for the 2022-2023 academic year.
Your myBenefits Card allows you to direct bill with pharmacies and dental offices. To access direct billing at paramedical practitioners or vision care services, you must register on the my.canadalife.com and update your address on your profile.
Students can save money on certain eligible services if they visit one of our select savings members.
The Dental Plan covers up a maximum of $800 per benefit year. Please submit an estimate/pre-authorization prior to any dental treatment plan exceeding $300.
The following is the coverage for your Dental Plan:
| Dental Benefits |
Coverage |
| Diagnostic & Preventative |
80% |
- Recall examination, 1 per benefit year
- Initial or complete examination, once per dentist in a lifetime
- Complete series of x-rays, up to 16 films including bitewings, 1 in any 36 month period, not eligible for dependent children under 12
- Bitewings, 2 films per benefit year
- Panoramic, 1 in any 36 month period
- Polishing, 1 unit per benefit year
- Scaling, 2 units per benefit year
- Fluoride, for dependent children under the age 19, 1 treatment in a benefit year
- Oral hygiene instruction, one treatment per lifetime
- Pit & fissure sealant, for dependent children under the age 19, once per molar in any 36 month period
|
| Minor Restorative |
70% |
- Amalgam (silver) fillings and composite resin (tooth coloured)
- Stainless steel and plastic full coverage restoration, for dependent children under the age of 15, 1 per tooth in any 36 month period
- Recementation of fixed prosthetics
- Denture adjustments and repairs
- Denture relining, rebasing and tissue conditioning, once every 36 months
- Space maintainers & maintenance for dependent children under the age 15, one per space, per benefit year
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| Extractions |
50% |
- Extractions, not more than 2 wisdom teeth per benefit year
- Anaesthesia, eligible when done in conjunction with oral surgical procedures
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| Periodontic |
50% |
- Additional scaling and/or root planing, maximum of 2 units per benefit year
- Occlusal equilibration, not more than 4 units per benefit year
- Periodontal appliances, not more than 1 appliance per arch in any 24 month period
- Periodontal appliance repairs, maintenance and adjustments, 4 adjustments per benefit year
- Oral surgical procedures
- Anaesthesia, eligible when done in conjunction with oral surgical procedures
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| Endodontic |
50% |
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| Dental Accident |
80% |
Maximum of $1,000 per accident for of the cost of the services of treatment of injury to sound natural teeth (treatment must commence within 30 days of the accident and be completed within 12 months of accident; authorization required). Treatment must start within 30 days after the accident unless delayed by a medical condition. A sound tooth is any tooth that did not require restorative treatment immediately before the accident. A natural tooth is any tooth that has not been artificially replaced.
No benefits are paid for:
- Accidental damage to dentures
- Dental treatment completed more than 12 months after the accident
- Orthodontic diagnostic services or treatment
Services must be performed within 12 months of accident. If treatment is scheduled to occur more that 90 days after the impact, a treatment plan must be submitted before the end of the 90-day period.
Pre-authorization required. An estimate for all dental accident services MUST be submitted to Canada Life. If you go ahead with treatment without a pre-determination being approved, you are doing so at the risk of the expenses being yours.
In the event of a dental accident, you must complete a Standard Dental Association claim form, to download the form, visit the submitting claim section.
This coverage is under the Health Plan. You must be enrolled in the Health Plan to claim for dental accidents.
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Payment of dental benefits is based on the General Practitioners Dental Association suggested fee guide or the Insurance Reimbursement Rate set by the Canadian Life and Health Insurance Association Inc. (CLHIA) when a fee guide is not available. For services provided by a dental specialist, payment is based upon the General Practitioners Dental Association suggested fee guide.
Alternate Benefit - When there are two or more courses of treatment available to adequately correct a dental condition, reimbursement may be based on the cost of the least expensive treatment, which provides adequate care to the Insured.
Limitations and Exclusions to Dental Benefits
An exclusion is a condition or instance that is not covered by the Dental Plan. it's important to review and understand exclusions to the plan before using your benefits.
No benefit is payable for:
- Any cause for which the insured may apply for and receive protection, exemption or compensation under any Workers' Compensation Act
- Self-inflicted injuries while sane or insane
- War, insurrection or hostilities of any kind whether or not the insured was a participant in such actions
- Participation in any riot or civil commotion
- Services or supplies received outside of Canada
- Committing or attempting to commit a criminal offence or provoking an assault
- Dental care, treatment or supplies primarily for cosmetic purposes
- Failing to keep scheduled appointments
- File transfers, the completion of claim forms or other documentation
- Any dental treatment for the correction of temporomandibular joint dysfunction
- Replacement of mislaid, lost or stolen appliances
- Expenses for full mouth reconstructions for vertical dimension correction or to repair or restore teeth damaged or worn due to attrition or vertical wear or to restore occlusion
- Any services or supplies for implantology including tooth implantation and surgical insertion of fabricated implants
- Any dental procedure which is not listed in the descriptions of dental benefits indicated herein
- Charges that are in excess of the fees stated in the Dental Association General Dentist Fee Guide applicable to this benefit
- Where coverage for services is provided under any government plan
- Where services would be provided without charge in the absence of this policy
- Any other exclusions identified in the policy contract