School Logo Image
Your Coverage
  1. The details below are a summary of benefits, limitations, and exclusions that apply.
  2. Full benefit details can be found on the Medavie Blue Cross™ Portal.
  3. In the event of a discrepancy between the website and the benefit booklet, the benefit booklet will be taken as true.
  4. Overall Drug, Extended Health & Vision Maximum: $10,000/benefit year. 
  5. The termination age for ACSA Health & Dental Benefits is 70.


Did you know that as a Domestic Manitoba resident, you have access to Prescription Drug coverage through Manitoba Pharmacare, as well as your ACSA Health Benefits? (Not applicable for International Students)

Drug, Extended Health, Vision, and Dental coverage is valid in Canada only. Travel coverage is valid worldwide. Please review your policy for full details.
 

Understand Your Coverage

Know all benefits, limitations, and exclusions that apply.

Coverage valid in Canada only.

Policy Year: September 1, 2024 - August 31, 2025

 
 

Drug Coverage

Overall Drug Maximum $3,000/Benefit Year

Preferred Pharmacies

100% Coverage for Generic Drugs

80% Coverage for Brand Drugs

Dispensing Fee: 100% of any amount up to $7

*Preferred Pharmacy Online ONLY

Description of Image 1

*Preferred Pharmacy in Brandon ONLY

*Preferred Pharmacy in Dauphin ONLY

All Other Pharmacies

80% Coverage for Generic Drugs

60% Coverage for Brand Drugs

Dispensing Fee: 100% of any amount up to $4

Lifestyle Medications 80%, up to a lifetime max of $300

Fertility Drugs/Treatment

Smoking Cessation Aid/Remedies

Anti-Obesity Drugs/Products

Erectile Dysfunction Drugs

Gardasil

Drug Benefit Also Includes

Standard Preventive Vaccines* (80% coverage, $200/benefit year)

Contraceptives, includes oral, IUD’s, Injectable (IUD/Non-hormonal $200/benefit year {1 per 5 plan years})

Diabetic Supplies (test strips & needles) - glucometers may be covered under your Extended Health coverage

Hepatitis C Medications ($1,500/lifetime)

Biologic Agents ($1,000/benefit year)

Standard Preventive Vaccines

Mandatory Generic Product Selection

Brand name drugs will be covered up to the amounts listed above up to the cost of the lowest-priced generic equivalent

Only those drugs which legally require a prescription and are eligible under the benefits will be covered

Eligible Drug Search Tool

* Vaccines are on a cost-reimbursement basis. Students pay upfront & submit a Health Claim Form for reimbursement. Vaccines must be administered by a licensed retail pharmacy to be eligible for coverage.

**CNS Simulants are medications used to increase physical activity, mental alertness and attention span. They are often used in the treatment of Attention Deficit Disorder and/or Hyperactivity Disorder (i.e. Adderall, Concerta, Vyvanse, Ritalin and their generic versions).

 

Dental Coverage

50% to 80% Coverage, up to an Annual Combined Maximum of $750/ benefit year

Predetermination: It is strongly recommended to obtain a predetermination for extensive dental procedures to prevent unexpected costs.

Have your dentist send a quote/predetermination electronically to Medavie Blue Cross® at fax: 506-867-4651. If your claim is the result of a Dental Accident please go to the Accident Coverage section for more information.

Examinations (80%): Complete Oral Examination (once every 5 benefit years) / Limited and Recall examinations (once every 12 months)

Radiographs (80%): Complete series Periapical or Panoramic (once per 3 years) / Bitewing (2 images every 12 months)

Preventative Services (80%): Dental polishing (1x 15-minute unit every 12 months) / Scaling (2x 15-minute units every 12 months)

Minor Restorative (50%): Fillings

Extractions (50%): Includes Wisdom Tooth Extractions

Anesthesia (50%): When in conjunction with surgical services

Other Dental Coverage (50%): Endodontics/Periodontics/ Denture Services
 

*Limitations and Exclusions may apply. Reimbursement based on the Current Dental Fee Guide. Note that specialist fees will be paid at General Practitioner rates.

Students can check to see if the dental code on their predetermination is eligible on the plan. Login to the Blue Cross Member Portal to find out! Note: This does not say how much is eligible, just if the code itself is eligible under your benefits or not.

Blue Cross Member Portal
 

Vision Coverage

100% Vision Coverage

Eye Examinations, Frames, Lenses & Contact Lenses- $200 combined maximum every 24 months

Use Code: VPSTVIP8 for 8% off at Vision Pros
 

This coverage excludes expenses incurred for non-corrective sunglasses and safety glasses. Please make sure to include your prescription (no more than 2 years old) along with your receipt when submitting claims for reimbursement.

Frames, Lenses and Contact Lenses must be purchased from a Canadian provider to be considered eligible under the benefits.

Frames are only eligible if purchased in conjunction with prescription lenses.

Lasik or Laser Eye Surgery are NOT covered under the benefits.
 

 

Extended Health Coverage

Practitioner Coverage: 100% Coverage

$30 per visit maximum, up to $300 per practitioner per benefit year

Acupuncturist

Chiropractor

Podiatrist/Chiropodist

Naturopath

Osteopath

Physiotherapist*

Registered Massage Therapist*

Dietitian

*Physician's Prescription must accompany first RMT/Physiotherapist claim each benefit year. If prescription is less than 12 months from date of issue, it can be used in subsequent benefit years.

$800 combined maximum per benefit year

Speech Language Pathologist**

Psychologist**

Psychotherapist**

Social Worker (MSW)**

Psychiatric Nurse**

**Mental health practitioners who do not meet the above criteria will not be considered eligible for coverage under the benefits.

**Psychotherapists must be in good standing with the college in their province, as well as registered as a provider with Medavie Blue Cross and be issued a provider number.

Other Medical Coverage – 100% Coverage, coverage is to maximum indicated, unless otherwise stated:

Custom Orthotic Shoes & Orthopedic Appliances ($250/benefit year)*** **** *****

Medical Equipment & Supplies (Reasonable & Customary)*** *****

Diabetic Equipment ($200/benefit year)*** *****

Ambulance to nearest treating hospital ($1,000/benefit year - Reasonable & Customary)

***Prescribed by a medical doctor, an orthopedic surgeon or podiatrist.

****Must be obtained from one of the following eligible providers: podiatrist, chiropodist, pedorthist, orthoptist, or chiropractor (with an orthotic agreement on file).

*****For a full listing of eligible expenses, please see the benefit booklet

 

Travel Coverage

Up to 365 Days per Trip, $2,000,000 Maximum

Coverage Includes, but is not limited to:

Emergency medical assistance

Repatriation of mortal remains (maximum $7,500)

Airfare in the event of:

  1. Missed return flight due to illness of you or travelling companion
  2. Medically required attendant to accompany insured home
  3. Cost of airfare for spouse or close relative if confined outside province for at least 7 days
  4. Cost of airfare to return unsupervised children under the age of 15 home when only available supervising guardian is hospitalized

Cost of return of patient's vehicle when patient or family is unable to do so (maximum $1,000)

Costs incurred by family (when patient is detained in hospital) for meals and accommodation {maximum $150/day up to 20 days} ($3,000 Maximum/incident)

Trip cancellation ($5,000 Maximum)

Lost luggage coverage ($500 Maximum)

International students will have 30 days of coverage in their home country for emergency services if provincial or equivalent coverage is extended as well

Psychological Coverage abroad- If you seek services abroad, you may claim your visits upon return to Canada and may be eligible for a refund. All claims are adjudicated in accordance with policy wording and eligible claims are refunded in Canadian dollars

Exclusions

Expenses incurred for injuries and/or illness as a result of the insured’s reckless behavior while on a trip, including international non-compliance with a prescribed treatment or therapy, or intentional misuse of medication or reckless disregard for their own health or safety while engaging in activities or treatment thereof, or accidents relating thereto.

Have you returned from your trip and need to make a claim?

For medical claims abroad (doctor visits, hospital visits, x-rays, lab work, etc.), please complete the Travel Claim Form Request and your claim form will be emailed to you

Travel Claim Form Request

For trip cancellation or interruption please complete below form

Trip Cancellation Form

The attending physician form found here must also be completed if your trip cancellation or interruption is due to medical reasons

Attending Physician Form

For baggage claims, please complete this form and submit it to the Travel Claims Department

Baggage Claims Form

To speak to an agent dial 1-833-564-4444, select prompt 1 for English

Still need assistance? Please email info@studentvip.ca or Live Chat with us by heading to the home page of this site and clicking the "Live Chat" button

Important Reminders

All claims must be accompanied by original receipts and the original claim form

Time Limit to Submit a Claim: Blue Cross must receive proof of claim within 4 months of the date the expense was incurred to be eligible for maximum reimbursement under the benefit. Blue Cross will accept claims up to 12 months from the date the expense was incurred However, the claim may be subject to reductions

Please take copies or scans of ALL documents and receipts before submitting your claim

 

Learn More About your Travel Coverage

Travel Advisories

Students planning to travel to countries with travel advisories issued to them should check to ensure coverage will be enforced while abroad, even if not planning to travel to an affected area

The Foreign Affairs and International Trade Canada website includes Travel Warnings and Advisories for specific countries experiencing civil unrest. Their website is www.travel.gc.ca and the information is updated regularly. We recommend that you check this website prior to leaving Canada for essential travel information

We encourage you to review your Travel Right brochure. If you have any questions, contact us at 1-833-564-4444

When a Travel Warning or Advisory has been issued for a country that you are travelling to, it is important for you to be aware of the impact this may have on your Out-of-Canada Emergency Medical benefit with Travel Right.
Although your coverage itself may be allowed, expenses incurred while travelling in a country (or specific region of a country) for which there is a Government of Canada travel warning to avoid all travel or non-essential travel, when such travel warning was issued before the departure date and the loss or expense is related to the reason for which the travel warning was issued; or participation in a criminal act or attempt to commit a criminal act, regardless of whether charges are laid or a conviction is obtained; insurrection, war (declared or not), the hostile action of the armed forces of any country or participation in any riot or civil commotion, may not be eligible for coverage depending on the nature of the claim. All other benefit exclusions apply




Travel Right Brochure

Emergency Assistance

Are you currently travelling and need to contact your travel provider?

  1. Within Canada (not your home province) and the United States: 1-800-563-4444
  2. Anywhere else in the world, call collect: 1-506-854-2222

Please have the following information ready:

1. Personal Information

  1. Your name and Student ID
  2. Your Policy Number 0091932000

2. Travel Information

  1. Travel dates: departure date and return date (from/to) the home province
  2. Travel destination: City, State/Province (when applicable), Country
  3. Travel purpose

3. Medical Information

  1. Description of the medical emergency or need (symptoms, circumstances, etc.)
  2. Date of medical emergency or first onset of symptoms

Provincial Coverage & Travel

Those with a valid provincial health plan card may still have partial coverage for some emergency services while travelling abroad. For more information please visit the Ministry of Health website for the province your coverage is with

Travel coverage offered through the plan is only valid if your provincial health care is in force for the entire duration of your travel. Please contact your provincial Ministry of Health office or download the appropriate travel flyer for more information

Before You Depart

Travel coverage cannot be extended past August 31 each policy year. If your travel duration exceeds August 31, please contact your health plan office or Student VIP for more information

365 days of coverage may not be valid for international students. Please contact the health plan office or Student VIP for confirmation before you leave the province



Download Manitoba Travel Flyer

Visa & Travel Letter Requests

Students requiring proof of coverage for their Visa application may complete the Visa & Travel Letter Request Form, your request will be reviewed and the letter e-mailed to you in 3-5 business days

Students only require a travel letter if the country they are travelling to requires a letter for entry into the country, or if they have to apply for a travel visa

Domestic students travelling to Cuba do not require a travel letter, your provincial health coverage should be sufficient for entry into Cuba




Visa & Travel Letter Request Form

J1 Visas

Applicants for a J1 Visa require specific levels of coverage in order to obtain the visa. We have provided an enhancement to the travel coverage to meet all requirements. If you are J1 visa applicant, please contact us at info@studentvip.ca and we can assist with upgrading your coverage

Frequently Asked Questions

Have questions about your travel coverage?

Download the FAQ Info sheet for some answers to commonly asked questions.




Download FAQ Infosheet
 

Accident Coverage

Please email info@studentvip.ca for any claims regarding Accident Coverage.

What is an Accident?

An accident means an occurrence due to external, violent, sudden, fortuitous causes beyond the insured’s control, which must occur while the student is insured under this policy

Coverage Maximum $1,000 to $2,500

Seat Belt Indemnity ($1,500)

Accidental Dental Expense ($2,500)

Funeral Expense ($2,500)

Hospital Indemnity ($2,500)

Coverage Maximum $5,000

Death, Accident

Death, Natural Causes

Death, Suicide

Bereavement Expense

Brain Death Indemnity

Cosmetic Disfigurement Indemnity

Day-Care Indemnity

Bereavement Expense

Tutorial Fees Expense (Education Indemnity)

Coverage Maximum $10,000

Accident Reimbursement Expense

Home Alteration and/or Vehicle Modification Expense

Coverage Maximum $15,000

Family Transportation Expense

Occupational Training Expense

Rehabilitation Expense

Coverage Maximum $20,000

Repatriation Expense

Coverage Maximum $50,000

Death, Accident

Brain Death Indemnity

Cosmetic Disfigurement Indemnity

Accident Policy Brochure

 

Preferred Provider

Please use our provider search tool to find contact information for Preferred Providers offering discounts of up to 19%. Remember to present your Student VIP card to access these savings.



live chat