All benefits payable through the Student Plan are based on reasonable and customary charges.
Ambulance
Your plan covers of 100% up to $100 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.
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. Practitioners must be registered and licensed in their field of practice.
The services of the following practitioners are covered:
• Chiropractor - $15 per visit up to 20 visits per benefit year; plus 1 x-ray per benefit year
• Registered massage therapist* - $25 per visit up to 20 visits per benefit year
• Naturopath - $250 per benefit year
• Osteopath - $20 per visit up to $300 per benefit year including 1 X-ray per benefit year
• Physiotherapist* - $55 per visit up to $240 per benefit year
• Speech therapist - $250 per benefit year
• Psychologist or social worker - $500 per benefit year
• Chiropodist, Podiatrist, Acupuncturist - $20 per visit up to $300 for all practitioners combined per benefit year plus 1 X-ray by a Podiatrist per benefit year
*physician’s prescription/referral required for indicated services
Medical Services & 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 100% 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 ($250 per lifetime)
• blood glucose monitor ($150 every 5 benefit years)
Braces, Crutches, Splints, Trusses
Your plan covers 100% 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 100% of reasonable and customary charges when prescribed by a physician for artificial limbs or other prosthetic appliances.
Orthopaedics*
Your plan covers 80% of 1 pair, once every 3 benefit years, up to a maximum of $750 for custom made orthopaedic shoes.
Your plan also covers 80% of 1 pair, once every 3 benefit years, up to a maximum of $300 for custom made foot orthotics.
Footwear, when prescribed by your attending physician, podiatrist or chiropodist and dispensed by your podiatrist, chiropodist, chiropractor, orthotist or pedorthist.
| *IMPORTANT It is strongly recommended that a pre-determination/estimate be submitted to Green Shield to ensure that the guidelines set out by Green Shield for the payment of Orthopaedics are met and to confirm that your claim would be eligible. |
Private Duty Nursing in the Home
Your plan covers 100% to a $25,000 per benefit year maximum. Reimbursement for the services of a Registered Nurse (R.N.) or Registered Practical Nurse/Licensed Practical Nurse (R.P.N./L.P.N.) in the home on a visit or shift basis. No amount will be paid for services which are custodial and/or services which do not require the skill level of a Registered Nurse (R.N.) or Registered Practical Nurse/Licensed Practical Nurse (R.P.N./L.P.N.)
A Pre-Authorization Form for Private Duty Nursing must be completed by the attending physician.
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 100% 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 reasonable and customary charges.
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.