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Forms & Documents

Please find below some useful forms & documents related to your Health & Dental Benefits, as well as the International Student Medical and Wellness plan.



  • Claim Forms
  • Brochures
  • Request Forms

Health and dental plan
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. Note that 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 durham@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, for more information on the Health and Dental Plan travel coverage please click here.
For more information on the International Student Medical and Wellness Plan, please click here


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


International Student Medical and Wellness Plan
If you have paid up front for medical services, you will need to submit a claim for review for reimbursement. Please click here to access the Cowan Portal. 

 

* All International Student Medical and Wellness Plan claims must be submitted within one year, otherwise the claim will not be considered valid and will be denied.
* You are responsible for all fees charged for any supporting documentation.
* Failure to complete and sign this form in its entirety or submit supporting documentation will delay claim processing.

 

Health and Dental Benefits

Health & Dental Benefits 2025-2026 | 2024-2025
Find all the details for your Health and Dental Benefits listed in this document.


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


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


International Student Medical and Wellness Plan
International Student Medical and Wellness Plan Brochures 2025-2026
 | 2024-2025


Special Authorization Request Form
This form is used for student 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.


Inbound Travel (Proof of International Student Medical Insurance coming to Canada)
If you require a Proof of Coverage letter as an international student arriving to Canada for their visa, immigration or proof for other reasons, please email info@studentvip.ca to request this.

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