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Forms & Documents

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



  • Claim Forms
  • Brochures
  • Registration Forms
  • Request Forms

For instructions on how to Make a Claim, please click 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. We recommend students show their dentist their Health Benefits Card and have the dental office submit their claim electronically.


Direct Deposit Form

Use this form to set up direct deposit and receive your drug, extended health, and vision claim reimbursements faster. Please email your completed form to brock@medavie.bluecross.ca or mail it in to one of the addresses listed on the form.


Travel Claim Form

If you have returned home from your trip and need to make a claim, please click here for more information.


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  2025-2026  | 2024-2025 

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

Travel Brochure

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

 

Full benefit details can be found on the Medavie Blue Cross Portal.

Students are encouraged to use the online platform to submit any opt-in/out requests to their benefits during the term in which they begin their studies. Please visit the Frequently Asked Questions section to learn more about the opt-in/out processes.


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 Medavie Blue Cross Portal or by mailing it to Medavie Blue Cross at

Medavie Blue Cross
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.

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