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Supplemental Health

All benefits payable through the Student Plan are based on reasonable and customary charges.

Ambulance
Your plan covers of 100% of reasonable and customary charges for a licensed ambulance or emergency 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.

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 for $20 per visit to a maximum of $400 per benefit year.

• physiotherapist
• registered massage therapist*
• speech therapist
• psychologist or social worker
• chiropractor, including 1 x-ray examination per benefit year
• osteopath, including 1 x-ray examination per benefit year
• naturopath
• licensed dietician*
• chiropodist or podiatrist, including one x-ray exam per benefit year
• athletic therapist

*physician’s prescription/referral required for indicated services

Private Duty Nursing
Your plan covers 100% to a maximum of $25,000 every 3 benefit years for the services of a Private Duty Nurse, when certified in writing as medically necessary by the attending physician. To establish the amount of coverage available under this policy, we suggest that prior to initiating home care, the student submit a pre-care assessment to the carrier.

Hospital
Your plan covers 100% of the cost of an upgrade from a public ward to a semi-private room. Other hospital charges incurred during a person's hospital stay are covered to a maximum of $25 per day, for a maximum of 30 days per period of hospitalization.

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%, based on 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
• walkers
• hospital beds
• iron lung
• respirator
• braces, crutches, splints & trusses
• artificial limbs & eyes
• other approved prosthetic devices

Diagnostic Services
Your plan covers 100%, based on reasonable and customary charges for diagnostic laboratory and x-ray procedures, including radiotherapy and coagulotherapy, performed in the student's province of residence are covered when coverage is not available under a government provincial plan.

Orthopaedics*
Your plan covers 100% to a maximum of $500 per benefit year for custom-made orthopaedic shoes, repairs and modifications when required for the correction of deformity of the bones and muscles and provided they are not solely for athletic use and are prescribed by a physician, podiatrist, chiropodist, or chiropractor.

Custom-Made Orthotics*
Your plan covers 100% to a maximum of $350 per benefit year custom-made foot orthotics, when prescribed by a physician, podiatrist, chiropodist or chiropractor.

*IMPORTANT It is strongly recommended that a pre-determination/estimate be submitted to Great-West Life to ensure that the guidelines set out by Great-West Life for the payment of Orthopaedics are met and to confirm that your claim would be eligible.

Trusses, Crutches, Splints, and Braces
Your plan covers 100% of reasonable and customary charges for braces, provided they are not solely for athletic use. It is recommended that an application for pre-approval be submitted to the insurer.

Prosthesis
Your plan covers 100% of reasonable and customary charges for artificial limbs or other prosthetic appliances. It is recommended that an application for pre-approval be submitted to the insurer.

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, 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. Provided the services are performed within 12 months of the accident but excluding services required in conjunction with such injuries due to a condition that existed before the accident. Implants and treatment related to implants are not covered. If a dental accident occurs, the health plan’s dental accident provision will pay benefits before the dental plan.

In the event of a dental accident, you must complete a Standard Dental Association claim form. When making a claim, be sure to attach all original receipts to the claim form. The claim form can be mailed directly to the insurance company, or dropped off at the On Campus Health & Dental Plan Office.

Select Health Savings
To enhance your existing coverage, select providers have agreed to help students by providing savings on certain plan eligible services. You must present your myBenefits Card at each visit. For further information on participating providers check out the Select Savings tab.

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