Extended Health Coverage
Your extended health coverage is based on your status as a full-time/equivalent student, in an eligible credit program at Mount Royal University. Students taking 9 or more credits during Fall and/or Winter are considered full-time. The plan is provided by The Students' Association of Mount Royal University. 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 practitioners or vision care services, you must register on the my.canadalife.ca and update you 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.
$500 in a lifetime for Smoking Cessation products legally requiring a prescription.
$10 dispensing fee cap.
Advise your doctor and pharmacist that you are on the National 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 |
- |
- $70 for one eye examination. The exam must be by an ophthalmologist or optometrist.
- $150 for eyeglasses or contact lenses.
The vision coverage renews every 24 months from the initial date of service. Coverage is based on reasonable and customary charges.
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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 maximum of $25 per visit and 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:
- physiotherapist*
- registered massage therapist*
- chiropractor, including 1 x-ray examination per benefit year
- speech language pathologist*
- osteopath, including 1 x-ray examination per benefit year
- naturopath
- podiatrist or chiropodist, including one x-ray examination per benefit year
- certified athletic therapist*
*physician's prescription/referral required for indicated services.
|
| Mental Health Practitioners |
80% |
The services of a psychologist or social worker are covered to a maximum of $25 per visit and 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, 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.
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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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| 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 9429056
- 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.
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| Tutorial Insurance |
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Your plan covers 80% up to $15 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.
This insurance are only applicable to the Student. Family members added to the plan are not eligible.
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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:
- 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 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 & DIN 02245977)
- Any other exclusion identified in the policy contract
Dental Coverage
Your extended health coverage is based on your status as a full-time/equivalent student, in an eligible credit program at Mount Royal University. Students taking 9 or more credits during Fall and/or Winter are considered full-time. The plan is provided by The Students' Association of Mount Royal University. 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 practitioners or vision care services, you must register on the my.canadalife.ca and update you 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 $1000 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% |
- 2 recall examination (6 month) per benefit year.
- Initial or complete examination..
- Complete series of x-rays
Maximum 1 in any period of 36 months.
- Bitewings
Maximum 4 films per benefit year.
- Panoramic
1 in any period of 36 months.
- Scaling
2 units per benefit year.
- Polishing
2 unit per benefit year.
- Oral hygiene instruction
1 treatment per lifetime.
- Fluoride
Under 15 years of age, 1 treatment per benefit year.
- Pit and fissure sealants
Under 16 years of age, 1 replacement per tooth, per lifetime, on permanent molars.
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| Minor Restorative |
80% |
- 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.
- Recementation of existing restorations
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| Extractions |
75% |
- Simple extractions or impacted extractions
Maximum 4 teeth per benefit year.
- Anaesthesia
Eligible when done in conjunction with Oral Surgery.
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| Endodontic |
60% |
|
| Periodontic |
60% |
Additional scaling and/or root planing
Maximum 5 units per benefit year.
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| Major Restorative |
15% |
Replacement of an existing crown, bridge or dentures is an eligible expense if the replacement is required to replace an existing crown, bridge or denture which was installed 5 years before the replacement.
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| 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 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 Health 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 disfunction
- Expenses for crowns placed on a tooth not functionally impaired by incisal angle or cuspal damage
- 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