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Click here to download the CSA & GSA Health & Dental Plan coverage leaflet for the 2021-2022 Benefit Year.

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.

Reimbursed at 100% based on reasonable and customary charges.
(Please click Supplemental Health for details)

Prescription Drugs:
Reimbursed at 100% to a maximum of $5,000 per benefit year.
Based on the National Formulary with a generic rider.
Dispensing fees are not covered.
(Please click Prescription Drug for details)

Reimbursed at 100% to a combined maximum of $100 for eye exam, glasses and/or contact lenses, every 24 months.
(Please click Vision for details)

Health Practitioners:
The services of paramedical practitioners are reimbursed at 80% with combined maximums in place. Practitioners must be registered and licensed in their field of practice.
(Please click Supplemental Health for details)

Medical Equipment & Supplies:
Reimbursed at 80% or 100%. A physician's prescription is required. Pre-authorization is suggested.
(Please click Supplemental Health for details)

Dental Coverage:
Exams covered at 100% once per benefit year. Overall plan maximum of $600 per benefit year.
(Please click Dental for details)

Dental Accident:
Reimbursed at 100% to a maximum of $1,000 per accident.
(services must be performed within 12 months of accident; pre-authorization required)
(Please click Supplemental Health for details)

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

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.  

Diaphrams, Cervical Caps, Intrauterine Devices
Your plan covers 100% of reasonable and customary charges for diaphrams, cervical caps, intrauterine devices. Insertion fees are not covered.

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 practitioner is covered at 80% to a maximum of $750 based on reasonable and customary charges, per benefit year.
• psychologist and/or social worker and/or registered psychotherapist

The services of the following practitioners are covered at 80% to a combined maximum of $500 based on reasonable and customary charges, per benefit year.
• chiropractor, including one x-ray examination per benefit year
• naturopath
• physiotherapist*

*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 Services & 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.

Braces, Crutches, Splints and Trusses
Your plan covers 80% of reasonable and customary charges up to $450 when prescribed by a physician and are not solely for athletic use for braces, crutches, splints, and trusses.

Your plan covers 100% of reasonable and customary charges when prescribed by a physician for artificial limbs or other prosthetic appliances.

Your plan covers 80% up to a maximum of $300 per pair, every 24 months for custom-made foot orthotics when required for the correction of deformity of the bones and muscles provided they 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.

*IMPORTANT It is strongly recommended that a pre-determination/estimate be submitted to Canada Life to ensure that the guidelines set out by Canada Life 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 $1,000 per benefit year.

Treatment must be completed within 12 months of the impact. If treatment is scheduled to occur more than 90 days after the impact, a treatment plan must be submitted to the insurer before the end of the 90 day period.
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.

Prescription Drug

Your drug plan covers 100% of the cost of most medications legally requiring a prescription to a maximum of $5,000 per benefit year. Dispensing fees are not covered.

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

Please Note:
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. 

IMPORTANT! Advise your doctor and pharmacist that you are on the National Formulary and the Ontario provincial formulary.

The National Formulary is a specific list of drugs that are eligible for reimbursement under your drug benefit. Formularies are developed to ensure that prescription drugs are available on a cost-effective basis. It covers approximately 85% of the most frequently prescribed drugs. Formularies are reviewed regularly and as a result, updates are made on an ongoing basis.

Exception Process: In the event that the drugs covered by the Formulary are not effective in treating the condition, an exception process is in place. To be eligible for an exception, you must have tried one alternative drug listed on the Formulary. An exception drug request form is available below or from your Benefits Plan Office and must be completed by your physician. Completed forms may be returned to your Benefits Plan Office or can be faxed directly to the insurance company.

Request for Coverage of Exception Status Drug form


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 $100 in a 24 month period for a cost that is considered reasonable and customary.


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 $300.

Your plan covers up to a maximum of $600 per benefit year.

Diagnostic & Preventative
Your plan covers 100% of diagnostic and preventative procedures including:
• 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
Your plan covers 80% for services associated with dental health restoration, including:
• 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
Your plan covers 75% for services associated with surgical extractions, including:
• wisdom teeth removal
• residual root removal
• General anaesthesia, eligible when done in conjunction with oral surgical procedures
Endodontic, Periodontic and Other Oral Surgery
Your plan covers 15% of endodontic, periodontic and other oral surgery including:
• root canal therapy
• occlusal equilibration, not more than 4 units per benefit year
• periodontal appliances, not more than 1 appliance per arch in any period of 24 months
• periodontal appliance repairs, maintenance and adjustments, not more than 4 adjustments per benefit year
• other oral surgical services
• additional scaling and/or root planing, maximum of 2 units per benefit year
Major Restorative
Your plan covers 15% of major restorative services including:
• crowns
• bridges

Replacement of an existing crown or bridge is an eligible expense if the replacement is required to
replace an existing crown or bridge, which was installed 5 years before the replacement.

Other Insurances

Your plan covers 80% 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.

Travel Insurance

Emergency Out of Country Travel Insurance

Your plan covers 100% up to a maximum of $2 million per lifetime of medical expenses incurred as a result of a medical emergency arising while you are traveling outside Canada for vacation, business or education purposes. To qualify for benefits, you must be covered by the government health plan in your home province. For additional details on this benefit download your Travel Assist Brochure.

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.


Limitations and Exclusions to Extended Health Benefits
No benefit is payable for:
1) expenses for which benefits are payable under a Workers' Compensation Act or a similar statute;
2) expenses incurred due to intentionally self-inflicted injuries;
3) expenses incurred due to civil disorder or war, whether or not war was declared;
4) 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;
5) expenses for which benefits are payable under a government plan;
6) expenses for benefits which are legally prohibited by the government from coverage;
7) Any services or supplies received by an insured person in their home country if their home country is not Canada;
8) out-of-province expenses for medical treatment or surgery;
9) expenses for drugs which, in the insurer's opinion, are experimental;
10) expenses for dietary supplements, vitamins and infant foods;
11) expenses for smoking cessation aids;
12) expenses for drugs if they are used for the treatment of infertility;
13) expenses for the services of a homemaker;
14) dental expenses, except those specifically provided under eligible expenses for treatment of accidental injuries to natural teeth;
15) utilization fees which are imposed by the Provincial Health Care Plan for the use of a service;
16)  immunizations and vaccines other than Hepatitis (click here for more details) and rabies vaccine IMOVAX for OVC only; or
17) any other exclusion identified in the policy contract.

Limitations and Exclusions to Dental Benefits
No benefit is payable for:
1) any cause for which the insured may apply for and receive protection, exemption or compensation under any Workers' Compensation Act;
2) self-inflicted injury while sane or insane;
3) war, insurrection or hostilities of any kind, whether or not the insured was a participant in such actions;
4) participation in any riot or civil commotion;
5) services or supplies received outside of Canada;
6) committing or attempting to commit a criminal offence or provoking an assault;
7) any group or policyholder sponsored dental care or treatment;
8) any dental care, treatment or supplies primarily for cosmetic purposes;
9) failing to keep scheduled appointments;
10) file transfers, the completion of claim forms or other documentation;
11) any dental treatment for the correction of temporomandibular joint dysfunction;
12) replacement of mislaid, lost or stolen appliances;
13) 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;
14) any services or supplies for implantology, including tooth implantation and surgical insertion of fabricated implants;
15) any dental procedure which is not listed in the descriptions of dental benefits indicated herein;
16) charges that are in excess of the fees stated in the Ontario Dental Association General Dentist Fee Guide applicable to this benefit;
17) where coverage for services is provided under any government plan;
18) where services would be provided without charge in the absence of this policy; or
19) any other exclusions identified in the policy contract.

BC Fair Pharmacare

The Fair PharmaCare program in British Columbia is intended to provide greater financial assistance to British Columbians 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 Columbians 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!


Have ready your:
• BC Care Card number
• net income from 2 years ago
• social insurance number
• birthdate

You will receive your registration number immediately.

Register online HERE

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.

Please note: if you are not a permanent resident of BC you must still fill out the registration form providing your home province or country in place of the Fair Pharmacare registration number.