| Prescription Drugs |
80% |
Maximum of $5000 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.
HPV Vaccines are covered at 65%.
Birth control is covered at 100% and the Cooper IUD is covered to a maximum of $75 per benefit year and are included in the total drug maximum for the year.
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| Vision |
100% |
- $75 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.
Prescription sunglasses are not covered by the plan.
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| Doctors' Notes |
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$25 per note up to $100 per benefit year.
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| Paramedical Practitioners |
100% |
Student benefits are payable after any Provincial Health Care benefits have been exhausted. This plan does not cover user fees.
Practitioners must be registered and licensed in their field of practice.
Practitioners:
| Practitioner |
Coverage |
| Chiropractor |
$15 per visit up to 20 visits per benefit year; plus 1 x-ray 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 |
| 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 |
| Doctors Notes |
$25 per note up to $100 per benefit year |
*physician's prescription/referral required for indicated services.
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| Mental Health Practitioners |
100% |
The services of a psychologist, counsellor/social Worker, master of social work or psychotherapist are covered to a maximum of $1000 based on reasonable and customary charges per benefit year.
Practitioners must be registered and licensed in their field of practice.
Holistic Nutritional Consultant Included in the overall combined maximum of $1,000 per benefit year for Psychologist, Social Worker/Counsellor, Master of Social Work or Psychotherapist.
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| Ambulance |
100% |
To a maximum of $100 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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| Private Duty Nursing in the Home |
100% |
To a maximum of $25,000 per benefit year. 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.
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| Medical Equipment & Supplies |
100% |
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.
Eligible durable equipment includes, but is not limited to, items such as:
- Compression Stockings - $50 per benefit year
- Wigs - $500 per lifetime
- Wheelchair/Scooter modifications/ repairs - $250 per lifetime
- Wheelchair Ramp (portable) - $2,000 per lifetime
- Patient Lift - 1 every 5 benefit years up to $2,000
- TENS Unit - $700 per lifetime
- Myo-electric arm - $10,000 per prosthesis
- External Breast Prosthesis - 1 per benefit year
- Blood Glucose Meter - $150 every 5 benefit years
- Contraceptives devices - $75 per benefit year
- Mobility aids, such as canes, crutches, walkers
- Braces, Crutches, Splints and Trusses. Not solely for athletic use.
- Prosthesis: The plan covers reasonable and customary charges for standard prosthetics, such as an arm, hand, leg, foot, breast, eye and larynx.
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| Custom-Made Shoes - Orthopaedics |
80% |
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.
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| 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 9429070
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.
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| 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.
You may become eligible for a Tuition Benefit if a disability exclusively prevents you from being able to carry on your usual studies for at least 60 consecutive days and you receive continuous treatment by a physician or specialist during that time. Benefits are payable only for the current academic period.
If, before you became insured for this benefit, you obtained medical care for the disease or injury causing your disability, you will not be eligible for the benefit unless:
- You become disabled after you have been continuously insured under this benefit for one year, or
- you did not obtain medical care for the disease or injury for a continuous period of 90 days ending on or after the date you became insured for this benefit.
Please contact the Student Benefits Plan Office regarding Tuition Insurance Claims as it falls within a specific category of claims which involve specialized claim forms that will be supplied to you.
Your plan covers 100% up to $15/hour to a maximum of $1,000 per benefit year for private tutorial service if the student is confined to home or hospital for a minimum of 15 consecutive school days.
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