Extended Health Coverage
Your extended health coverage runs for as long as you remain an enrolled and eligible student at Kwantlen Polithecnic University - KPU. The plan is provided by Kwantlen Student Association - KSA. Download the Extended Health & Dental Plan coverage leaflet for the 2022-2023 academic year.
Your myBenefits Card allows you direct billing with pharmacies and dental offices. To access direct billing at Paramedical practioners or Vision care services, you must register on the Canada Life online Tool and update you adress 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 |
90% |
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.
Preventative Vaccines to a maximum of $150 per benefits year
$500 in a lifetime for Smoking Cessation products legally requiering a prescription
Advise your doctor and pharmacist that you are on the BC Provincial Formulary.
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 and complete the Drug Exception Form.
Prescription Search Tool
Please use our Prescription Drug Search Tool to find out if your medication is covered by the plan.
|
| Vision |
- |
- $60 for 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 is every 24 months from the initial date of service 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 to $25 per visit 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*
- Chiropractor, including one x-ray examination per benefit year
- Naturopath
*physician's prescription/referral required for indicated services.
|
| Mental Health Practitioners |
80% |
The services of the following practitioners are covered to a maximum of $500 based on reasonable and customary charges per benefit year.
Practitioners must be registered and licensed in their field of practice.
Practitioners:
- Registered Clinical Counsellor - RCC
- Registered Psychologist - RPsych
- Registered Social Worker - RSW
- Registered Clinical Social Worker - RCSW
- Registered member of British Columbia Association of Marriage and Family Therapy - BCAMFT
- Canadian Certified Counsellor - CCC
|
| Medical Equipment & Supplies |
80% |
The plan covers reasonable and customary charges for eligible equipment when prescribed by a physician, podiatrist, chiropodist, or chiropractor.
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
- Walkers
- Hospital beds
- Traction kits
- Braces, Crutches, Splints and Trusses
- Orthopaedics: 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. Modifications, repairs and adjustments to custom-made orthopaedic shoes and/or orthotics are covered without a prescription.
- Prosthesis: The plan covers reasonable and customary charges for artificial limbs or other prosthetic appliances.
|
| 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 Travel Assistance |
- |
Emergency Out of Province Medical and Accidental Death and Dismemberment Coverage
Provides coverage of up to a maximum of $5 million per insured person per coverage period for certain expenses incurred as a result of an emergency while travelling on trips that originated from your Canadian province or territory of residence. It is important to remind you that this coverage is not available in the province where you attend the school or in your country of origin. Your coverage period is 180 days per trip. Coverage is subject to the terms and conditions provided in the Benefits Booklet.
This insurance product is underwritten by AIG Insurance Company of Canada. If you are travelling, download the Travel Medical Assistance Card.
Eligible students enrolled in the Extended Health Plan have this Emergency Travel Assistance coverage. Students must be covered by a Government Health Insurance Plan (GHIP) of a Canadian province or territory or equivalent.
Students covered under the travel policy are in one of the following two classes; this information may be needed if you are contacting AIG regarding your coverage.
- Policy Number: SRG 9429053
- Class I: Domestic Student
- Class II: Foreign Student
If students add their family members to the Student Health Plan, they are also covered by the Emergency Travel Assistance and must be covered by a Government Health Insurance Plan (GHIP) of a Canadian province or territory or equivalent.
|
| 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 the health and dental plan office for a complete schedule of losses.
Your plan covers 80% up to $15/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.
|
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 actually understand the exclusions of the plan before using your benefits.
No benefit is payable for:
- 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 & intrauterine devices)
- 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 enrolled and eligible student at Kwantlen Polithecnic University - KPU. The plan is provided by Kwantlen Student Association - KSA. Download the Extended Health & Dental Plan coverage leaflet for the 2022-2023 academic year.
Your myBenefits Card allows you direct billing with pharmacies and dental offices. To access direct billing at Paramedical practioners or Vision care services, you must register on the Canada Life online Tool and update you adress 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 $750 per benefit year. Please submit an estimate/pre-authorization prior to any dental treatment plan exceeding $500.
The following is the coverage for your Dental Plan:
| Dental Benefits |
Coverage |
| Diagnostic & Preventative |
90% |
- 1 recall examination per benefit year.
- Initial or complete examination, once per dentist in a lifetime.
- Complete series of x-rays and periapical
Maximum 16 films including bitewings in any period of 36 months. Not eligible for dependants under 12 and periapical.
- Bitewings
Maximum 4 films per benefit year.
- Panoramic
1 in any period of 36 months.
- Scaling
2 units per benefit year.
- Polishing
1 unit per benefit year.
- Oral hygiene instruction
1 treatment per lifetime.
- Fluoride
Under 19 years of age, 2 treatments per benefit year.
- Pit and fissure sealants
Under 19 years of age, 1 per molar in any period of 36 months.
- Space maintainers and maintenance
Under 15 years of age, 1 per space per benefit year.
- Anaesthesia
Eligible when done in conjunction with a covered dental procedure.
|
| Minor Restorative |
90% |
- Space maintainers and maintenance
Under 15 years of age.
- Amalgam and tooth coloured fillings
1 per tooth in any period of 24 months.
- Stainless steel and plastic full coverage restorations
Under 15 years of age, 1 per tooth in any period of 36 months.
- Denture adjustments and repairs.
- Relining, rebasing and tissue conditioning
One treatment in any period of 36 months.
|
| Extractions |
60% |
- Extractions
Maximum 2 wisdom teeth per benefit year.
|
| Endodontic & Periodontic |
60% |
- Root canal therapy
- Occlusal equilibration
Maximum 4 units per benefit year.
- periodontal appliances
Maximum 1 appliance per arch in any period of 24 months.
- periodontal appliance repairs, maintenance and adjustments
Maximum 4 adjustments per benefit year.
- additional scaling and/or root planing
Maximum of 5 units per benefit year.
|
| Major Restorative |
50% |
Replacement of an existing inlay, onlay, crown, veneer, and bridge is an eligible expense if the replacement is required to replace an existing inlay, onlay, crown, veneer, and bridge which was installed 5 years before the replacement.
|
| Dental Accident |
80% |
Limited to $1000 per accident. The plan covers 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 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.
This coverage is under the Health Plan. You must be enrolled in the Health Plan to claim the dental accident.
|
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 actually understand the exclusions of 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
- Any group or policyholder sponsored dental care or treatment
- Any dental care or treatment for which the insured is not legally obliged to pay
- Any 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
- Expenses for treatment of root canal therapy, inlays, onlays, crowns, veneers, and bridges started prior to becoming an insured member/dependant under this plan
- Replacement of mislaid, lost or stolen appliances
- Expenses for crowns, inlays, onlays and veneers placed on a tooth not functionally impaired by incisal angle or cuspal damage
- Any charges incurred for other than metal only crowns or pontics, posterior to the second bicuspid tooth
- 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 Practitioners' Fee Guide applicable to where the services were rendered
- 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