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Student Health & Wellness!mystudentplan is a benefits plan for students and can provide coverage for prescription drugs, vision care, dental care, mental health counseling, and more. The plan is designed to supplement provincial health insurance and provide additional access to medical services.

 

Plan Details

The Student Plan covers prescription drugs, vision, dental care, paramedical practitioners, ambulance, and medical equipment & supplies, among others.

Extended Health Coverage

Your extended health coverage runs for as long as you remain an enrolled and eligible student at Ontario Tech University. For more information about enrollment and eligibility, please visit the Plan Enrollment section.

Plan Leaflet

Get a summary of eligible expenses and maximum reimbursements of your Health and Dental Plan.

Plan Card

Your Plan Card allows you direct billing with pharmacies and dental offices.

Select Savings

Get a student discount and save money on certain eligible services by visiting one of our members.

The following is the coverage for your Health Plan:

Health Benefits Coverage
Prescription Drugs 80%

Maximum of $3,000 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 $10.00. Any amount charged over and above will be payable by the student.

  • 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
  • Contraceptive patch
  • Nuva Ring (contraceptive)
  • Oral contraceptives
  • All acne preparations excluding Accutane or other acne preparations containing the same medicinal ingredient as Accutane
  • IUD's
  • Birth Control are covered at 100%.

Vaccinations are covered at 80% based on reasonable and customary charges. Administration costs associated with providing the injection are not covered.

The following diabetic supplies are covered to a maximum of $200 per benefit year

  • Insulin syringes
  • disposable needles for use with non-disposable insulin injection devices
  • lancets and test strips

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 -
  • $60 for one eye examination. The exam must be by an ophthalmologist or optometrist.
  • $80 for eyeglasses or contact lenses.
  • $200 for 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 vision coverage renews every 24 months from the initial date of service. Coverage is based on reasonable and customary charges.

Sunglasses, safety glasses or eyeglasses provided for cosmetic or aesthetic purposes are not covered by the plan.

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 $300 based on reasonable and customary charges, per practitioner, per benefit year.

Practitioners must be registered and licensed in their field of practice.

Psychologist, Master of Social Work - MSW, Psychotherapist, Speech Therapist 100% Combined maximum of $500 per year.
Orthotics, Orthopaedics Shoes 80%
  • Maximum of $200 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
  • Prescription & pre-authorization may be required. not solely for athletic use
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.

Ambulance 80%

To a maximum of $250 per occurrence based on reasonable and customary charges.. 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 100%

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.

Policy Number: SRG 9429071

You are eligible for this travel coverage when you are:

  • an active member of the health plan,
  • under the age of seventy (70), and
  • are covered under a hospitalization and medical plan of a Canadian province or territory or equivalent.

Spouse and Dependent Children of a person eligible for this coverage who are, under the age of seventy and covered under a hospitalization and medical plan of a Canadian province or territory or equivalent, are eligible if the additional family health coverage was purchases for the current benefit period.

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.

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.

Dental Coverage

Your dental coverage runs for as long as you remain an enrolled and eligible student at Ontario Tech University. For more information about enrollment and eligibility, please visit the Plan Enrollment section.

Plan Leaflet

Get a summary of eligible expenses and maximum reimbursements of your Health and Dental Plan.

Plan Card

Your Plan Card allows you direct billing with pharmacies and dental offices.

Select Savings

Get a student discount and save money on certain eligible services by visiting one of our members.

The following is the coverage for your Dental Plan:

The Dental Plan covers up a maximum of $500 per benefit year. Please submit an estimate/pre-authorization prior to any dental treatment plan exceeding $300.

Dental Benefits Coverage
Diagnostic & Preventative 80%
  • 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
Minor Restorative 60%
  • 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.

Oral Surgery 60%
  • 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.
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
Major Restorative 10%

Most of the services listed below will be replaced only if the existing appliance is at least 5 years old, if the appliance is temporary and being replaced with a permanent appliance within 12 months of the installation of the temporary appliance, or if the appliance was necessary due to the extraction of one natural tooth.

  • 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.
  • 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.
Periodontic & Other Oral Surgery 20%
  • 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 that 4 units in any benefit year)
  • Other oral surgery
Dental Accident 100%

Limited to $2000 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.

No benefits are paid for:

  • Accidental damage to dentures
  • Dental treatment completed more than 12 months after the accident
  • Orthodontic diagnostic services or treatment

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 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 Health Plan. it's important to review and understand exclusions to the plan before using your benefits.

OTSU Benefits Plan Office

Email: ontariotech@mystudentplan.ca
Phone: 905-721-8668 Extension 6345
Address: 40 Founders Drive, Lower Level SHA 023.
Oshawa, Ontario.
L1H 7K4

General Inquiries Line

Monday to Friday from 8:00am to 7:00pm EST

Phone: 1-877-746-5566 Ext. 7249