School Logo Image
Forms & Documents

Please find below some useful forms & documents related to your Health & Dental Benefits.



  • Claim Forms
  • Info Brochures
  • Registration Forms
  • Other Benefit Forms

For instructions on how to Make a Claim, please go HERE.


Health Claim Form   ENGLISH   |  FRENCH

Use this form to claim for Drug, Extended Heath & Vision claims.

 

Dental Claim Form  ENGLISH   |   FRENCH

Take this form to your dentist for completion before submission.  Note that we recommend students show their dentist their Health Benefits Card and have the dental office submit their claim electronically, or request a "Standard Dental Claim Form" in lieu of using this form.

Accident Claim Form

If you have been involved in an accident and need to claim under the Accident Policy of your coverage, please email info@studentvip.ca

Health & Dental Benefits Brochure  2024-2025  | 2023-2024 

Find all the details for your Health & Dental Benefits listed in this document.
 

Travel Brochure   2024-2025  | 2023-2024

Find the details of your 365-day travel coverage here.

 

Full benefit details can be found on the Blue Cross Portal

Students are encouraged to use the Online Opt-In to add family to their benefits during the term in which they begin their studies.


Students who need to opt-in for Single Coverage must visit the BUSU Health Plan Office.


 

Special Authorization Request Form

This form is used for students requesting special authorization for a specific drug to be covered under their benefits. For students requesting a CNS Cap Removal, or Monitored Medication Request, please contact Student VIP directly. Note that submission of this form does not guarantee your request will be granted.


Submit exception requests by sending as an "e-Claim" on the Blue Cross Member portal, or by mailing it to Medavie Blue Cross™ at 644 Main St., PO Box 220, Moncton, NB E1C 8L3 or by fax to 1-844-661-2640.


Outbound Travel (Proof of Travel Coverage leaving Canada)

If you require a Proof of Coverage letter for outbound travel for either a travel visa, applications for government programs or proof for other reasons, please email info@studentvip.ca to request this.

live chat