Extended Health Coverage
Your extended health coverage runs for as long as you remain an eligible student at Georgian College. The plan is provided by The Georgian College Students' Association - (GCSA). 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 |
100% |
Maximum of $5000 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.
The maximum amount allowed for a dispensing fee is $8.00. Any amount charged over and above will be payable by the student.
The following drugs are covered if they are listed in the Ontario Provincial Formulary and Interchangeable List in effect on the date of purchase:
- Drugs which require the written prescription of a physician or dentist
- Injectable drugs including allergy serums and insulin
- Extemporaneous preparations or compounds if one of the ingredients is a covered drug
- Certain other drugs that do not require a prescription by law may be covered when prescribed by your physician or dentist. If you have any questions, contact your plan administrator before incurring the expense
- Hepatitis B vaccine, subject to a maximum of $100 per insured, per benefit year. All other vaccines are payable at 80%.
- Nuva Ring (contraceptive), subject to a maximum of $178 per insured, per benefit year
- Oral contraceptives and the patch (birth control)
- All acne preparations excluding Accutane or other acne preparations containing the same medicinal ingredient as Accutane
The following diabetic supplies are covered:
- Insulin syringes.
- Disposable needles for use with non-disposable insulin injection devices.
- Test strips.
- Sensors for flash glucose monitoring machines.
- Lancets.
- Glucose monitoring machines.
- Alcohol swabs.
Vaccinations are covered at 80% based on reasonable and customary charges. Administration costs associated with providing the injection are not covered.
Advise your doctor and pharmacist that you are on the Ontario 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.
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| Vision |
100% |
- 100% of the cost of one eye examination. The exam must be by an ophthalmologist or optometrist.
- $150 for eyeglasses or contact lenses. The eyeglasses frame is not covered by the plan.
The vision coverage renews every 24 months from the initial date of service. Coverage is based on reasonable and customary charges.
Special contact lenses for severe corneal astigmatism, severe corneal scarring, Keratoconus (Conical Cornea) or Aphakia, when they are prescribed by a licensed ophthalmologist or optometrist, provided that visual acuity can be improved to at least 20/40 level whereas it cannot be improved to that level with standard glasses. The maximum is $200 for one complete set of lenses every 24 months from the first date of purchase.
Sunglasses, safety glasses or eyeglasses provided for cosmetic or aesthetic purposes are not covered by the plan.
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| 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 to a maximum of $400 based on reasonable and customary charges, per practitioner, per benefit year.
Practitioners must be registered and licensed in their field of practice.
Practitioners:
- Registered Massage Therapist*
- Physiotherapist
- Speech Therapist
- Naturopath or Chiropractor, including one x-ray examination per benefit year
- Athletic therapist
*physician's prescription/referral required for indicated services.
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| Mental Health Practitioners |
80% |
The services of a psychologist or social worker are covered 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.
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| Medical Equipment & Supplies |
80% |
The plan covers reasonable and customary charged for compound serums, colostomy supplies, injectable drugs and varicose vein injections, if medically necessary. Such drugs or supplies must be either administered by a physician or dentist or prescribed by a physician or dentist and dispensed by a pharmacist. Any charges for administration are not eligible.
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
- Flash Glucose Monitor
Prosthesis
The plan covers reasonable and customary charges when prescribed by a physician for Prosthetic Appliances including:
- Charges for artificial limbs when the loss of the limb occurs while the individual is insured under this benefit. The cost of repair is also covered. Replacement is covered when required due to physiological change, excluding myoelectric appliances. It is recommended that an application for pre-approvable submitted to the insurer.
- Charges for artificial eyes including one polishing or one re-make each benefit year.
- Casts, splints, trusses, braces or crutches, including replacements when medically necessary. It is recommended that an application for pre-approval be submitted to the insurer.
- External breast prosthesis when required due to a total or radical mastectomy that has been performed while you are insured under this benefit. The purchase of 2 surgical brassieres is included to a maximum of $200 each benefit year.
Other Eligible Expenses
- Charges for oxygen, blood or blood products and the equipment required for it's administration;
- Charges for treatment of a sickness by the use of radiotherapy or coagulotherapy;
- Charges for laboratory tests done in a commercial laboratory for diagnosis of a sickness but excluding any tests performed in a physician’s office or a pharmacy.
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| 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.
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| Accidental Death & Dismemberment |
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Accident Benefits
For the purposes of the following benefits, "accident" wherever used means an occurrence due to external, violent, sudden, fortuitous causes which are beyond the Insured's control. This must occur while the insurance is in force.
Accidental Death And Dismemberment
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 $25,000. For a complete schedule of losses please see the Accident Benefits Brochure.
Accident Benefits are provided to students covered under the Georgian College SA Student Health & Dental Plan and Apprentice Students of Georgian College of Applied Arts and Technology
Information regarding coverages included in the Accident Benefits plan can be found in the Accident Benefits Brochure.
Applicable to the Student only. Family members are not eligible for reimbursement of Accidental Death &Dismemberment benefits.
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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
- Over-the-counter products, or medicines available without a prescription;
- Fertility drugs;
- Anti-smoking remedies (e.g. nicorette gum, patches or similar prescribed remedies);
- Injectable vitamins that are non-prescription;
- Patented medicines and G.P. products;
- First-aid and surgical supplies;
- Atomizers, vaporizers;
- Salt and sugar substitutes;
- Infant formula, dietary foods and aids;
- Contact lens care products;
- Diagnostic aids and laboratory tests;
- Contraceptives, other than oral, patch and NuvaRing;
- Lozenges, mouthwash, toothpastes and cosmetics;
- Oral vitamins;
- Items deemed cosmetic, even if a prescription is legally required;
- Male baldness treatments;
- Drugs which in whole or in part a government health plan prohibits from being paid, except to the extent that it permits excess reimbursement;
- Drugs which the Insured Person received without charge;
- Drugs which are experimental in nature;
- Drugs, hormones, products and injections for the treatment of obesity;
- Erectile dysfunction drugs;
- Accutane or other acne preparations containing the same medicinal ingredient as Accutane;
- Anabolic steroids; or
- Sclerosing agents.
Limitations and Exclusions to Extended Health Benefits
- Expenses as a result of any injury or sickness caused by declared or undeclared war or any act thereof;
- Expenses of any kind which would not normally be charged to you if the policy were not in effect;
- Expenses incurred from any injury or sickness sustained as a result of employment when you are covered or eligible to receive benefits under the applicable Workplace Safety and Insurance Board's legislation or similar law;
- Expenses as a result of suicide or any attempt thereat or intentionally self-inflicted injury, while sane or insane;
- Cosmetic medical or surgical care, other than due to an accidental bodily injury sustained while you are insured under this benefit;
- Medical treatment which is experimental or investigational in nature;
- Periodic health examinations, broken appointments, physician's costs for traveling or providing telephone advice, third party examinations, completion of forms or medical reports, travel for health purposes;
- Services, treatment or supplies not included in this benefit;
- Expenses incurred from any injury or sickness as the result of active full-time service in the armed forces of any country;
- Expenses incurred by you if you are not covered under any Federal or Provincial Hospital or Medical Plan or its equivalent;
- Expenses which are not medically required;
- Services or supplies associated with exercise, weight loss, physical fitness or sports, environmental or atmospheric control in the home or workplace;
- Expenses which are prohibited by law from being covered by a private insurance plan;
- Services or supplies received outside of Canada;
- Services, treatments or supplies which the Insured Person received without charge.
- Any other exclusion identified in the policy contract.
Dental Coverage
Your dental coverage runs for as long as you remain an eligible student at Georgian College. The plan is provided by The Georgian College Students' Association - (GCSA). 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 $600 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 |
100% |
One examination and consultation during each benefit year, including any necessary x-rays and diagnostic services at the time of the examination.
Eligible Exams
- Complete oral examinations
- Recall oral examinations
- Emergency or specific oral examinations
- Consultation
Eligible X-rays
- Full mouth series, minimum 16 films, including bitewings in any 36 consecutive months
- Panorex (one in any 36 consecutive months)
- Periapical (no more than 16 films in any 36 consecutive months)
- Occlusal (no more that 4 films in 12 consecutive months)
- Bitewing (no more than 4 films in 12 consecutive months)
- One cleaning and one unit of polishing, including up to 4 units of scaling (above the gum line).
- Fluoride treatments will be limited to one per benefit year
- Oral hygiene instruction, 1 treatment per lifetime
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| Minor Restorative |
75% |
- Amalgam, silicate and composite fillings.
- Tooth-coloured fillings
Limited to once every two years on the same tooth surfaces.
- Space maintainers
For a Dependent Child only, up to and including 14 years of age.
Multiple restorations on a common surface placed on the same service date will be considered a single restoration. The maximum benefit payable will not exceed the fee for a five surface restoration regarding the same tooth during one sitting.
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| Extractions and Oral Surgery |
75% |
- Extractions of teeth and residual root removal
limited to two wisdom teeth in any policy year;
- Surgical excision, surgical enucleation and surgical movement of teeth;
- Surgical incision and drainage, surgical incision for removal of foreign bodies and antral surgery;
- Gingivoplasty, stomatoplasty, vestibuloplasty and all alveoloplastys;
- General anaesthesia;
- Remodelling of floor of the mouth, reconstruction of alveolar ridge;
- Extensions of mucous folds, bone grafts to the jaw and prosthetic augmentations to the jaw;
- Replantation and repositioning of teeth;
- Treatment of fractures, repairs of lacerations;
- Frenectomy, hemorrhage control, treatment of salivary glands;
- Treatment of maxillofacial deformities.
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| Endodontic |
10% |
Endodontic services including where applicable, treatment plan, local anaesthesia, tooth isolation, clinical procedures, sutures, appropriate radiographs and follow-up care for:
- Pulpotomy (not in conjunction with root canal therapy if rendered within 30 days)
- Root canal therapy
- Apexification
- Periapal sevices
- Root amputation
- Hemisection
- Intentional removal, apical filling and reimplantation
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| Major Restorative |
10% |
- Crowns, including treatment plan, occlusal records, local anaesthesia, subgingival preparation of the tooth and supporting structures, removal of decay and old restoration, tooth preparations, pulp protection, impressions, temporary coverage, insertion, occlusal adjustment and cementation, repairs and removal.
- Removable prosthodontics will include, where applicable, treatment plan, impressions, jaw relation records, try-in, insertion, occlusal equilibration and 3 months post-insertion care on complete dentures, transitional dentures, acrylic dentures and cast partial dentures.
- Fixed prosthodontics will include, where applicable, treatment plan, occlusal records, local anaesthesia, subgingival preparation of the tooth and supporting structures, removal of decay and old restoration, tooth preparation, pulp protection, impressions, temporary coverage, splinting, intraoral indexing for soldering purposes, insertion, occlusal adjustments and cementation on pontic, retainers, abutments and repairs.
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| Periodontic & Other Oral Surgery |
10% |
- Non-surgical procedures
- Definitive surgical procedures
- Adjunctive surgical procedures
- Occlusal equilibration
- Periodontal appliances including impression and insertion (one appliance per arch in 24 consecutive months)
- Periodontal appliance repair, maintenance and adjustment (no more than 4 units in any benefit year)
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| Dental Accident |
100% |
Maximum of $2,000 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:
- Services or supplies required as a result of declared or undeclared war or any act thereof;
- Services or supplies required as a result of suicide or any attempt thereat or intentionally self-inflicted Injury, while sane or insane;
- Professional fees for an anesthetist;
- Protective appliances for athletic purposes;
- Implants and any dental service associated with implants;
- Replacement of fixed bridge pontics, retainers, abutments, crowns, or removable complete or partial dentures unless:
- Made necessary by the extraction of a natural tooth while insured hereunder,
- The crown is at least five years old,
- The existing appliance is at least five years old and cannot be made serviceable, or
- The existing appliance is temporary and is replaced with a permanent bridge pontic or denture within 12 months of the date on which the temporary appliance was installed;
- Services not included in the list of defined eligible services;
- Cosmetic surgery or treatment when classified as such by Canada Life;
- Expenses recoverable from other benefit sections of this policy;
- Expenses which are provided for by any Federal, Provincial, or Municipal government plan, or which would have been provided for if the Insured Person had applied for coverage under such plan;
- Expenses of any kind which would not normally be charged to the Insured Person if the insurance provide by this policy were not in effect;
- Completion of claim forms, advice by phone, or charges for missed or cancelled appointments;
- Replacement of lost, misplaced or stolen appliances or dentures;
- Initial crowns, bridges, retainers, abutments or complete or partial dentures required to replace a tooth or teeth missing prior to coverage becoming effective;
- Nutritional counseling, oral hygiene and dental plaque control programs; or
- Any dental treatment which is not yet approved by the Canadian Dental Association or which is clearly experimental in nature;
- Services or supplies received outside of Canada;
- Any other exclusion identified in the policy contract.