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Group Policy #09510a International Group Policy #09510a
Forms and Brochures

Below you will find important form and documents relating to your international health plan. If a form you need is not here, please contact Student VIP International at info@studentvip.ca
  • BROCHURES
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  • FORMS
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Claim Form

If you have paid up front for medical services, you will need to submit a claim for review for reimbursement. Please find the claim form below:

Opt-Out Forms

Click here to access an MSI Opt-Out form. 
Click here to access a Home Country Opt-Out form. 


Opt-In Forms

Click here to access a Family Opt-In form. 


Pre-Determination Authorization Form

This form can be completed to confirm eligibility of a claim prior to a student seeking the service. This form can be completed and sent in to studentvip@medavie.bluecross.ca. The claims team will review and respond to the student with approval or denial within 48-72 business hours.

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