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myBenefits

Please try searching by your key words for the benefit or information you want to know.




myBenefits at a Glance

The highlights below are provided as general information. Coverage for eligible costs are based on the contract detail. Reasonable and customary rates will be applied. Select the benefit for additional coverage details.

Ambulance:
Reimbursed at 100% to a daily maximum of $100.
( please click Supplemental Health for details)

Prescription Drugs:
Reimbursed at 80% to a maximum of $5,000 per benefit year.
Reimbursement will be made for the cost of the lowest priced equivalent drug.
( please click Prescription Drugs for details)

Vision:
Reimbursed at 100% to a maximum of $60, for one eye exam based on reasonable and customary charges every 24 months from the date of service. Glasses or contact lenses, maximum of $100 every 24 months from the first date of purchase.
(please click Vision for details.)

Health Practitioners:
The services of paramedical practitioners must be registered and licensed in their field of practice.

Medical Equipment & Supplies:
Reimbursed at 100%. A physician's prescription is required. Pre-authorization is suggested.
( please click Supplemental Health for details)

Dental Coverage:
Exams covered at 80% once per benefit year. Overall plan maximum of $750 per benefit year.
( please click Dental for details)

Dental Accident:
Reimbursed at 100% to a maximum of reasonable and customary charges per accident.
(services must be performed within 12 months of accident; authorization required)
( please click Supplemental Health for details)

Travel Insurance:
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 outside your province or territory of residence. Your coverage period is 60 days per trip.

In addition, this insurance provides coverage for the following benefits:
• to $5,000 per insured person, per trip for trip cancellation; and
• to $2,000 per insured person, per trip, for trip interruption.

( please click Travel Insurance for complete details)

Tutorial:
After 15 days of confinement due to illness or injury.
( please click Other Insurances for details)


NOTE: In the event of any discrepancy between the information herein and our contract with the insurer, the terms of the contract will apply.

Supplemental Health

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 - $1000 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

For Online Video Counselling you can submit your receipts online or with our paper form for reimbursement.
Medical Equipment & 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.
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.
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.
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.

BC Fair Pharmacare

PLEASE NOTE: International students or out of province students do not need to apply for BC Fair Pharmacare.  Please register directly for your myBenfits Card.  On this form instead of the BC Fair Pharmacare number, please indicate the country or province you are from.  Register for your myBenefits Card HERE.    

The Fair PharmaCare program in British Columbia is intended to provide greater financial assistance to British Columbian's for eligible prescription drugs and designated medical supplies. You must be a resident of the Province of British Columbia with an MSP number. The new approach focuses PharmaCare financial assistance to British Columbian's who need it most - the lower your income, the more assistance the government will provide for your prescription drugs.

By coordinating the benefits from BC Fair PharmaCare and the Student Health Plan, many enrolled students will enjoy lower out-of-pocket charges for their eligible prescription drugs.

Students with net income less than $15,000 in the previous taxation year, who have registered for BC Medical Services Plan (MSP) on their own, not under their family, will enjoy the greatest benefit. PharmaCare will pay 70% of eligible prescription drug charges from the first dollar charged to the student and the Student Benefits Plan will pay up to 80% of the remainder!


To register you will need to have your:
• BC Care Card number
• Net income from 2 years ago (line 236 on your tax return)
• Social insurance number
• Date of birth

You will receive your registration number immediately.

Click here for a PDF on the step-by-step process needed to completed your card registration.  

Register online HERE
Please note this link above works best using Safari or Internet Explorer. 

If you experience difficulty registering, or it states that you are already registered, or if you prefer to register over the phone please call: 604-683-7151 or 1-800-663-7100 for assistance.


Once you have your BC Fair PharmaCare number, register for your myBenefits Card HERE




Vision

Your plan covers 100% of the cost of one eye examinations, to a maximum of $60, by an ophthalmologist or optometrist in a 24 month period from the date of service. Based on reasonable and customary charges.

Your plan covers 100% of cost for the purchase of eyeglasses and/or contact lenses to a maximum of $100, once during a 24 month period from the first date of purchase. Based on reasonable and customary charges.

Note: The following will not be covered: prescription sunglasses.

Prescription Drugs

Your drug plan covers 80% of the cost of most medications legally requiring a prescription to a maximum of $5,000 per benefit year. HPV Vaccines are covered at 65% and are included in the total drug maximum for the year.

The maximum amount payable to an eligible brand name drug will be limited to the lowest priced item in the appropriate generic category.

vision

Your plan covers 100% the cost of one eye examination, eyeglasses or contact lenses by an ophthalmologist or optometrist, limited to a combined maximum of $125 in a 24 month period for a cost that is considered reasonable and customary.

Dental

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.

IMPORTANT! Please submit a pre-determination/pre-authorization to the insurance carrier prior to treatment of specialist services and any treatment plan exceeding $500.

Your plan covers up to a maximum of $750 per benefit year.



Oral Surgery
Your plan covers 75% for services associated with surgical extractions, including:
• extractions of teeth and/or residual roots
• general anaesthesia, deep sedation, and intravenous sedation in conjunction with eligible oral surgery only

Diagnostic & Preventative
Your plan covers 80% of diagnostic and preventative procedures including:
• complete oral examinations once every 3 years
• emergency and specific oral examinations
• full series X-rays and panoramic X-rays once every 3 years
• bitewing X-rays once per benefit year
• recall examinations once per benefit year
• cleaning of teeth (up to 1 unit of polishing plus up to 1 unit of scaling) once per recall period
• topical application of fluoride twice per benefit year for covered persons 19 years of age and
under
• oral hygiene instruction once per lifetime
• denture cleaning once per recall period
• pit and fissure sealants on molars only, for covered persons 16 years of age and under
• space maintainers
• mouth guards once every 12 months
Minor Restorative
Your plan covers 75% for services associated with dental health restoration, including:
• amalgam, tooth coloured filling restorations, and temporary sedative fillings
• inlay restorations - these are considered basic restorations and will be paid to the equivalent non-bonded amalgam
Major Resortative
Your plan covers 10% for major restorative including:
• Standard onlays or crown restorations (paid to full metal on molar) to restore diseased or accidentally injured natural teeth, once every 5 years
• Standard bridges, including pontics, abutment retainers/crowns (paid to full metal on molar) on natural teeth, once every 5 years
• Standard dentures including complete, immediate, transitional, and partial dentures, once every 5 years
• Standard repair or recementing of crowns, onlays and bridge work on natural teeth

Standard denture services:
• denture repairs and/or tooth/teeth additions
• standard relining and rebasing of dentures, once every 3 benefit years, only after 6 months have elapsed from the installation of a denture
• denture adjustments and remount and equilibration procedures, only after 3 months have elapsed from the installation of a denture
• soft tissue conditioning linings for the gums to promote healing
• remake of a partial denture using existing framework, once every 5 years

Comprehensive oral surgery:
• surgical exposure, repositioning, transplantation or enucleation of teeth
• remodeling and recontouring - shaping or restructuring of bone or gum
• excision - removal of cysts and tumors
• incision - drainage and/or exploration of soft or hard tissue
• fractures including the treatment of the dislocation and/or fracture of the lower or upper jaw and repair of soft tissue lacerations
• maxilofacial deformities - frenectomy - surgery on the fold of the tissue connecting the lip to the gum or the tongue to the floor of the mouth
Endodontic
Your plan covers 10% for endodontic services including:
• root canal therapy
• pulpotomy (removal of the pulp from the crown portion of the tooth)
• pulpectomy (removal of the pulp from the crown and root portion of the tooth)
• apexification (assistance of root tip closure)
• apical curettage, root resections and retrograde fillings (cleaning and removing diseased tissue of
the root tip)
• root amputation and hemisection
• bleaching of non-vital tooth/teeth
• emergency procedures including opening or draining of the gum/tooth
Periodontic
Your plan covers 10% for periodontic services (excluding periodontal scaling for 80% coverage) including:
• periodontal scaling and/or root planing 1 time unit per benefit year
• occlusal equilibration - selective grinding of tooth surfaces to adjust a bite 4 time units per benefit year
The fees for periodontal treatment are based on units of time (15 minutes per unit) and/or number of teeth in a surgical site in accordance with the General Practitioners Fee Guide.
• bruxism appliance once every 2 benefit years

Travel Insurance

Group Out-of-Province/Canada Travel Medical Emergency Insurance

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 outside your province or territory of residence. Your coverage period is 60 days per trip.

In addition, this insurance provides coverage of up to $5,000 per insured person, per trip, for trip cancellation benefits and up to $2,000 per insured person, per trip, for trip interruption benefits.

To qualify for this insurance coverage, you must be covered by the government health plan in your home province or territory of residence and have your permanent residence in Canada if you are a domestic student. If you are an international student, you must be covered by the health insurance plan provided by Ryerson University and you must reside in Canada.

This insurance product is underwritten by Royal & Sun Alliance Insurance Company of Canada. Coverage is subject to the terms and conditions in the Benefits Booklet. For complete benefit details, click here to see your travel Benefits Booklet.

Click here for your travel benefits card.

Please note the policy number has changed from 28556323 to 1167965.

This information found on this webpage is intended for promotional purposes and is not an insurance policy. It is not an offer of insurance. It contains some information about coverages offered by Royal & Sun Alliance Insurance Company of Canada but it does not list all of the conditions and exclusions that apply to the described coverages. The actual wording of the policy governs all situations. The product described is subject to change without notice at any time.

©2018 Royal & Sun Alliance Insurance Company of Canada. All rights reserved. ® RSA, RSA & Design and related words and logos are trademarks and the property of RSA Insurance Group plc, licensed for use by Royal & Sun Alliance Insurance Company of Canada. This insurance is underwritten by Royal & Sun Alliance Insurance Company of Canada. RSA is a registered tradename of Royal & Sun Alliance Insurance Company of Canada.

Other Insurances

Accidental Death & 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 $5,000. For further details on this benefit please see the Accidental Death & Dismemberment brochure.

Tutorial*

Your plan covers 100% up to $15 per hour to a maximum of $1,000 per disability for private tutorial service if the student is confined to home or hospital for a minimum of 15 consecutive school days.

*Applicable to the Student only. Family members are not eligible for reimbursement of Accidental Death & Dismemberment and Tutorial benefits.

Personal Health Risk Assessment

The Personal Health Risk Assessment can be used to create a health profile, build an action plan to support your health and wellness needs and track progress.

Watch a short video about Personal Health Risk Assessment.

Exclusions

Limitations and Exclusions to Prescription Drug Benefits
1) Smoking cessation products and drugs for the treatment of obesity, erectile dysfunction and infertility;
2) Vitamins, other than injectable;
3) Contraceptives, other than oral;
4) Products which may lawfully be sold or offered for sale other than through retail pharmacies, and which are not normally considered by practitioners as medicines for which a prescription is necessary or required;
5) Ingredients or products which have not been approved by Health Canada for the treatment of a medical condition or disease and are deemed to be experimental in nature and/or may be in the testing stage; or
6) Mixtures, compounded by a pharmacist, that do not conform to GSC's current Compound Policy.

Limitations and Exclusions to Extended Health Benefits Eligible benefits do not include and reimbursement will not be made for:
1) Services or supplies received as a result of disease, illness or injury due to:
(a) intentionally self-inflicted injury while sane or insane;
(b) an act of war, declared or undeclared;
(c) participation in a riot or civil commotion; or
(d) committing a criminal offence;
2) Services or supplies provided while serving in the armed forces of any country;
3) Failure to keep a scheduled appointment with a legally qualified medical or dental practitioner;
4) The completion of any claim forms and/or insurance reports;
5) Any specific treatment or drug which:
(a) does not meet accepted standards of medical, dental or ophthalmic practice, including charges; for services or supplies which are experimental in nature, or is not considered to be effective (either medically or from a cost perspective, based on Health Canada's approved indication for use);
(b) is an adjunctive drug prescribed in connection with any treatment or drug that is not an eligible service;
(c) is administered in a hospital or is required to be administered in a hospital in accordance with
Health Canada's approved indication for use;
(d) is not dispensed by the pharmacist in accordance with the payment method shown under the Prescription Drugs benefit; or
(e) is not being used and/or administered in accordance with Health Canada's approved indication for use, even though such drug or procedure may customarily be used in the treatment of other illnesses or injuries; or
6. Services or supplies that:
(a) are not recommended, provided by or approved by the attending legally qualified (in the opinion of GSC) medical practitioner or dental practitioner as permitted by law;
(b) are legally prohibited by the government from coverage;
(c) you are not obligated to pay for or for which no charge would be made in the absence of benefit coverage or for which payment is made on your behalf by a not-for-profit prepayment association, insurance carrier, third party administrator, like agency or a party other than GSC, your plan sponsor or you;
(d) are provided by a health practitioner whose license by the relevant provincial regulatory and/or professional association has been suspended or revoked;
(e) are not provided by a designated provider of service in response to a prescription issued by a legally qualified health practitioner;
(f) are used solely for recreational or sporting activities and which are not medically necessary for regular activities;
(g) are primarily for cosmetic or aesthetic purposes, or are to correct congenital malformations;
h) are provided by an immediate family member related to you by birth, adoption, or by marriage and/or a practitioner who normally resides in your home. An immediate family member includes a parent, spouse, child or sibling;
i) are provided by your plan sponsor and/or a practitioner employed by your plan sponsor, other than as part of an employee assistance plan;
j) are a replacement of lost, missing or stolen items, or items that are damaged due to negligence (replacements are eligible when required due to natural wear, growth or relevant change in your medical condition but only when the equipment/prostheses cannot be adjusted or repaired at a lesser cost and the item is still medically required);
k) are video instructional kits, informational manuals or pamphlets;
l) are for medical or surgical audio and visual treatment;
m) are special or unusual procedures such as, but not limited to, orthoptics, vision training, subnormal vision aids and aniseikonic lenses;
n) are delivery and transportation charges;
o) are for Insulin pumps and supplies (unless otherwise covered under the plan);
p) are for medical examinations, audiometric examinations or hearing aid evaluation tests;
q) are batteries, unless specifically included as an eligible benefit;
r) are a duplicate prosthetic device or appliance;
s) are from any governmental agency which are obtained without cost by compliance with laws or regulations enacted by a federal, provincial, municipal or other governmental body;
t) would normally be paid through any provincial health insurance plan, Workplace Safety and Insurance Board or tribunal, the Assistive Devices Program or any other government agency, or which would have been payable under such a plan had proper application for coverage been made, or had proper and timely claims submission been made;
u) were previously provided or paid for by any governmental body or agency, but which have been modified, suspended or discontinued as a result of changes in provincial health plan legislation or de-listing of any provincial health plan services or supplies;
v) may include but are not limited to, drugs, laboratory services, diagnostic testing or any other service which is provided by and/or administered in any public or private health care clinic or like facility, medical practitioner's office or residence, where the treatment or drug does not meet the accepted standards or is not considered to be effective (either medically or from a cost perspective, based on Health Canada's approved indication for use);
w) are provided by a medical practitioner who has opted out of any provincial health insurance plan and the provincial health insurance plan would have otherwise paid for such eligible service;
x) relates to treatment of injuries arising from a motor vehicle accident;
Note: Payment of benefits for claims relating to automobile accidents for which coverage is available under a motor vehicle liability policy providing no-fault benefits will be considered only if:
i) the service or supplies being claimed is not eligible; or
ii) the financial commitment is complete (a letter from your automobile insurance carrier will be required); or
y) are cognitive or administrative services or other fees charged by a provider of service for services other than those directly relating to the delivery of the service or supply.

Limitations and Exclusions to Dental Benefits
Eligible benefits do not include and reimbursement will not be made for:
1) Services or supplies received as a result of disease, illness or injury due to:
(a) intentionally self-inflicted injury while sane or insane;
(b) an act of war, declared or undeclared;
(c) participation in a riot or civil commotion; or
(d) committing a criminal offence;
2) Services or supplies provided while serving in the armed forces of any country;
3) Failure to keep a scheduled appointment with a legally qualified dental practitioner;
4) The completion of any claim forms and/or insurance reports;
5) Any dental service that is not contained in the procedure codes developed and maintained by the Canadian Dental Association, adopted by the provincial or territorial dental association of the province or territory in which the service is provided (or your province of residence if any dental service is provided outside Canada) and in effect at the time the service is provided;
6) Implants and related services;
7) Restorations necessary for wear, acid erosion, vertical dimension and/or restoring occlusion;
8) Appliances related to treatment of myofacial pain syndrome including all diagnostic models, gnathological determinants, maintenance, adjustments, repairs and relines;
9) Posterior cantilever pontics/teeth and extra pontics/teeth to fill in diastemas/spaces;
10) Service and charges for sleep dentistry;
11) Diagnostic and/or intraoral repositioning appliances including maintenance, adjustments, repairs and relines related to treatment of temporomandibular joint dysfunction;
12) Any specific treatment or drug which:
(a) does not meet accepted standards of medical, dental or ophthalmic practice, including charges for services or supplies which are experimental in nature, or is not considered to be effective (either medically or from a cost perspective, based on Health Canada's approved indication for use);
(b) is an adjunctive drug prescribed in connection with any treatment or drug that is not an eligible service;
(c) will be administered in a hospital;
(d) is not dispensed by the pharmacist in accordance with the payment method shown under the Health Benefit Plan Prescription Drugs benefit; or
(e) is not being used and/or administered in accordance with Health Canada's approved indication for use, even though such drug or procedure may customarily be used in the treatment of other illnesses or injuries; or
13. Services or supplies that:
(a) are not recommended, provided by or approved by the attending legally qualified (in the opinion
of GSC) medical practitioner or dental practitioner as permitted by law;
(b) are legally prohibited by the government from coverage;
(c) you are not obligated to pay for or for which no charge would be made in the absence of benefit
coverage; or for which payment is made on your behalf by a not-for-profit prepayment
association, insurance carrier, third party administrator, like agency or a party other than GSC, your plan sponsor or you;
(d) are provided by a health practitioner whose license by the relevant provincial regulatory and/or professional association has been suspended or revoked;
(e) are not provided by a designated provider of service in response to a prescription issued by a legally qualified health practitioner;
(f) are used solely for recreational or sporting activities and which are not medically necessary for regular activities;
(g) are primarily for cosmetic or aesthetic purposes, or are to correct congenital malformations;
(h) are provided by an immediate family member related to you by birth, adoption, or by marriage and/or a practitioner who normally resides in your home. An immediate family member includes a parent, spouse, child or sibling;
(i) are provided by your plan sponsor and/or a practitioner employed by your plan sponsor, other than as part of an employee assistance plan;
(j) are a replacement of lost, missing or stolen items, or items that are damaged due to negligence (replacements are eligible when required due to natural wear, growth or relevant change in your medical condition but only when the equipment/prostheses cannot be adjusted or repaired at a lesser cost and the item is still medically required);
(k) are video instructional kits, informational manuals or pamphlets;
(l) are delivery and transportation charges;
(m) are a duplicate prosthetic device or appliance;
(n) are from any governmental agency which are obtained without cost by compliance with laws or regulations enacted by a federal, provincial, municipal or other governmental body;
(o) would normally be paid through any provincial health insurance plan, Workplace Safety and Insurance Board or tribunal, or any other government agency, or which would have been payable under such a plan had proper application for coverage been made, or had proper and timely claims submission been made;
(p) relates to treatment of injuries arising from a motor vehicle accident;
Note: Payment of benefits for claims relating to automobile accidents for which coverage is available under a motor vehicle liability policy providing no-fault benefits will be considered only if:
i) the service or supplies being claimed is not eligible; or
ii) the financial commitment is complete (a letter from your automobile insurance carrier will be required); or
(q) are cognitive or administrative services or other fees charged by a provider of service for services other than those directly relating to the delivery of the service or supply.

myBenefits Booklet

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