Extended Health Coverage
Your extended health coverage runs for as long as you remain an enrolled and eligible student at the University of Calgary The plan is provided by the University of Calgary Students' Union. Download the Extended Health & Dental Plan coverage leaflet for the 2022-2023 academic year.
Your myBenefits Card allows you direct billing with pharmacies. 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.
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.
|
| Vision |
100% |
- $50 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.
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 to a maximum of $20 per visit and an overall plan maximum $300 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
*physician's prescription/referral required for indicated services.
|
| Psychologist or social worker |
80% |
$20 per visit up to $300 based on reasonable and customary charge per benefit year. * Physician's prescription/referral required.
|
| 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.
Eligible durable equipment includes, but is not limited to, items such as:
- Wheelchairs and wheelchair repairs (lifetime maximum of $250)
- Walkers
- Hospital beds
- Traction kits
- Braces, Crutches, Splints and Trusses
- Orthopaedics:
Maximum of $150 per foot, per benefit year for Custom-Made Orthopaedic shoes when they are 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. Modifications, repairs and adjustments to custom-made orthopaedic shoes are covered without a prescription.
- Prosthesis:
The plan covers reasonable and customary charges for artificial limbs or other prosthetic appliances.
|
| Diabetic Supplies |
100% |
The plan covers 100% to a maximum of $150 during a 5 year period for blood glucose monitors.
|
| Hearing Aids |
100% |
The plan covers 100% to a maximum of $500 during a 5 year period for hearing aids and repairs, excluding batteries.
|
| Ambulance |
80% |
Maximum of $250 per occurrence 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.
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| Other Insurances |
- |
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.
The plan provides coverage for Tuition Insurance and covers a student who has left school and medically cannot continue studies, as a result of death or severe and prolonged disability. The student must be enrolled in the Health Plan and must be under the continuous care of an appropriate specialist for a period of at least 60 days prior to applying for this benefit. The student will receive a benefit up to a lifetime maximum of $10,000 in accordance with any tuition, and ancillary fees paid by said student to cover:
- Tuition for courses the student was unable to complete
- Mandatory, non-negotiable/non-refundable fees, which will be amortized to the point of disability
- Book allowance of up to $1,000 (receipts required)
Please contact the Student Benefits 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.
The 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.
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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 is ordinarily a resident 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 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 smoking cessation aids;
- Expenses for drugs if they are used for the treatment of infertility;
- Expenses for the services of a registered nursing assistant (R.N.A.), licensed practical nurse (L.P.N.) or 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 and Twinrix will be covered, except for Recombivax HB preservative free - DIN 02245976 & DIN 02245977); or
- Any other exclusion identified in the policy contract.
Dental Coverage
Your dental coverage runs for as long as you remain an enrolled and eligible student at the University of Calgary The plan is provided by the University of Calgary Students' Union. Download the Extended Health & Dental Plan coverage leaflet for the 2022-2023 academic year.
In order to receive dental coverage for eligible services, students on the Undergraduate Student Dental Plan must visit one of the indicated dental service providers. Managed Dental Providers are experienced practitioners who provide quality dental care to students at a preferred rate. Please confirm you are enrolled on the plan prior to contacting the Managed Dental Centre. The dental benefits provided under the Managed Dental Plan are provided through a specific network of dental centres.
The managed dental program is provided to ensure students can maintain their basic dental health, without having to incur the increasing dental fees associated with dental care.
Managed Dental Service Providers Listing by Dental Choice
If you cannot keep your appointment you must provide adequate notice of cancellation. Missed appointments are time lost during which other students could have received treatment. The dental office's cancellation policy and penalties apply if adequate notice of a cancellation is not provided.
Services are covered at rates outlined in the 1997 Alberta Dental Association Fee Guide for General Practitioners, plus inflationary adjustments as determined by the insurance carrier. Should your dentist charge fees in excess of the fee guide, the additional costs are not covered.
Northland Dental Choice
Phone: (403) 247-1807
308, 4600 Crowchild Trail NW
Calgary, AB
(Northland Professional Building)
Stephen Avenue Dental Choice
Phone: (403) 261-3895
Suite 380, 225-7th Ave SW
Calgary, AB
(between the Bay and TD downtown)
MacLeod Dental Choice
Phone: (403) 262-3035
435, 9737 Macleod Trail SW
Calgary, AB
(Southland Crossing Shopping Centre)
University Dental Choice
Phone: (403) 261-4777
360, 2500 University Drive
Calgary, AB
(U of C MacEwan Student Centre)
17th Ave Dental Choice
Phone: (403) 265-4400
1301-17th Ave SW
Calgary, AB
(parking at back of building)
Mount Royal Dental Choice
Phone: (403) 685-3210
Z006, Wyckham House - Lower Level
4835 Mount Royal Gate SW
Calgary, AB
Jasper Dental Choice
Phone: (780) 441-1941
10160 - 109 Street NW
Edmonton, AB
The Dental Plan covers up a maximum of $750 per benefit year. Please submit an estimate/pre-authorization prior to any dental treatment plan exceeding $500.
The following is the coverage for your Dental Plan:
| Dental Benefits |
Coverage |
| Diagnostic & Preventative |
100% |
- Examination, 1 per benefit year
- Bitewings, not more than 4 films per benefit year
- Polishing, 1 unit per benefit year
- Scaling, 2 units per benefit year
- Fluoride, under 15 years of age, 1 treatment per benefit year
- Additional or elected treatments or services may not included
|
| 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 24 months
- Pit and fissure sealants
under 16 years of age, 1 replacement per tooth, per lifetime, on permanent molars
|
| Other Restorative |
50% |
- Denture adjustments and repairs
- Denture relining, rebasing and tissue conditioning, 1 treatment in any period of 36 months
- Recementation of fixed prosthesis
|
| Oral Surgery |
50% |
- Wisdom teeth, limited to 2 teeth per patient, per benefit year
- Periapical x-rays
- General anaesthesia, eligible when done in conjunction with Oral Surgery
- Panoramic, 1 in any period of 36 months
|
| Endodontic & Periodontic |
50% |
- Root canal therapy
- Additional scaling and/or root planing, maximum 2 units per benefit year
|
| 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 less than 5 years before the replacement.
|
| 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.
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 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:
- When a covered person receives dental treatment from a dentist not on the Dental Plan Network;
- 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;
- Any 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 dysfunction;
- Expenses for crowns placed on a tooth not functionally impaired by incisal angle or cuspal damage;
- Expenses for orthodontic treatment (ie. dental braces);
- Any services or supplies for implantology, including tooth implantation and surgical insertion of fabricated implants;
- Any dental procedure which is not listed in the descriptions of dental benefits indicated herein;
- Where coverage for services is provided under any government plan;
- Where services would be provided without charge in the absence of this plan; or
- >Any other exclusions identified in the policy contract.