Extended Health Coverage
Your extended health coverage runs for as long as you remain an enrolled and eligible student at the University of Guelph. The plan is provided by the Central Student Association or Graduate Students' Association. Download the Extended Health & Dental Plan coverage leaflet for the 2022-2023 academic year.
Your myBenefits Card allows you direct billing with pharmacies and dental offices. To access direct billing at paramedical practitioners or vision care services, you must register on the my.canadalife.ca and update your 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 |
100% |
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. Dispensing fees are not covered.
- Hepatitis B vaccines has been added to the policy on an exception basis.
- The cost of Concerta is covered, up to the cost of the generic substitute with the lowest price only.
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. Must have tried one alternative drug that is on the formulary.
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| Vision |
- |
$120 for one eye examination, eyeglasses or contact lenses. The exam must be by an ophthalmologist or optometrist.
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 combined covered up to a maximum of $500 based on reasonable and customary charges, per benefit year.
- Chiropractor
- Naturopath
- Physiotherapist*
* Physician's prescription/referral required.
Practitioners must be registered and licensed in their field of practice.
|
| Psychologist, Social Worker or Registered Psychotherapist |
80% |
Maximum $750 based on reasonable and customary charge per benefit year.
|
| Medical Equipment & Supplies |
80% |
Prescription and pre-authorization may be required.
Eligible durable equipment includes, but is not limited to, items such as:
- Braces, Crutches, Splints and Trusses. Maximum of $450 when prescribed by a physician and are not solely for athletic use
- Orthopaedics:
- Maximum of $300 every 24 months for custom-made foot orthotics when they are required for the correction of deformity of the bones and muscles.
- Custom-made foot orthotics are not solely for athletic use and are prescribed by a physician, podiatrist or chiropodist.
- Modifications, repairs and adjustments to custom-made foot orthotics are covered without a prescription.
- Prosthesis: Your plan covers 100% of reasonable and customary charges when prescribed by a physician for artificial limbs or other prosthetic appliances.
- Wigs and Hairpieces: Your plan covers 100% up to a maximum of $500 in a 24 month period for wigs and hairpieces required as a result of Alopecia Universalis, chemotherapy, or radiation therapy.
|
| Diaphrams, Cervical Caps, Intrauterine Devices |
100% |
Your plan covers 100% of reasonable and customary charges for diaphrams, cervical caps, intrauterine devices. Insertion fees are not covered.
|
| Ambulance |
100% |
Your plan covers of 100% (after the provincial maximum has been paid out) 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. Please note: only services in Ontario are covered under the ambulance benefit.
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| Tutorial |
100% |
Your plan covers 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 Tutorial benefits.
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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 smoking cessation aids;
- Expenses for drugs if they are used for the treatment of infertility;
- Expenses for the services of a homemaker;
- 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;
- Immunizations and vaccines other than Hepatitis and rabies vaccine IMOVAX for Ontario Veterinary College (OVC) students only; 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 Guelph. The plan is provided by the Central Student Association or Graduate Students' Association. Download the Extended Health & Dental Plan coverage leaflet for the 2022-2023 academic year.
Your myBenefits Card allows you direct billing with pharmacies and dental offices. To access direct billing at paramedical practitioners or vision care services, you must register on the my.canadalife.ca and update your address on your profile.
Students can save money on certain eligible services if they visit one of our select savings members.
The Dental Plan covers up to a maximum of $600 per benefit year. Please submit an estimate/pre-authorization prior to any dental treatment plan exceeding $300.
The following is the coverage for your Dental Plan:
| Dental Benefits |
Coverage |
| Diagnostic & Preventative |
100% |
- Recall examination
1 per benefit year
- Complete oral examination
1 per dentist in a lifetime
- Emergency or specific examination
- Consultation
once per benefit year
- Bitewings
not more than 4 films per benefit year
- Panoramic
1 in any 36 month period
- Occlusal radiographs
(no more than 4 films in any benefit year)
- Periapical
(no more than 16 films in any 36 consecutive months)
- Polishing
1 unit per benefit year
- Scaling
2 units per benefit year
- Fluoride
1 treatment per benefit year
|
| Minor Restorative |
80% |
- Space maintainers and maintenance
under 15 years of age
- Amalgam (silver) fillings
1 per tooth in any period of 24 months
- Composite resin (tooth colored) fillings
1 per tooth in any period of 24 months, limited to once every two years on the same tooth surfaces
- Silicate fillings
1 per tooth in any period of 24 months
|
| Oral Surgery - Surgical extractions |
75% |
- wisdom teeth removal
- residual root removal
- General anaesthesia, eligible when done in conjunction with oral surgical procedures
|
| 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 than 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 Dental Plan. It's important to review and understand exclusions to the plan before using your benefits.
No benefit is payable for:
- Any cause for which the insured may apply for and receive protection, exemption or compensation under any Workers' Compensation Act;
- Self-inflicted injury 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 group or policyholder sponsored dental care or treatment;
- 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;
- Replacement of mislaid, lost or stolen appliances;
- Expenses for full mouth reconstructions for vertical dimension correction or to repair or restore teeth damaged or worn due to attrition or vertical wear or to restore occlusion;
- 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;
- Charges that are in excess of the fees stated in the Ontario Dental Association General Dentist Fee Guide applicable to this benefit;
- Where coverage for services is provided under any government plan;
- Where services would be provided without charge in the absence of this policy; or
- Any other exclusions identified in the policy contract.