Use this form to claim for Drug, Extended Heath & Vision claims.
Take this form to your dentist for completion before submission. Note that we recommend students show their dentist their Health Plan Card and have the dental office submit their claim electronically, or request a "Standard Dental Claim Form" in lieu of using this form.
Claim forms change depending on your province of residence. Once you return from your travels, please complete a Travel Claim Form Request or call 1-800-667-4511 to have the proper travel claim form sent directly to you.
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
Use this form to claim for International Medical and Drug claims.
Find the details of your 365-day travel coverage and a removable emergency travel card here.
Full benefit details can be found on the Medavie Blue Cross Member Website.
This form can be completed to confirm eligibility of of claim under the ASU International Medical Plan 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 with approval or denial within 48-72 business day hours.
This form is used for students requesting special authorization for a specific drug to be covered under the plan. *Note that submission of this form does not guarantee your request will be granted.
Submit exception requests by mailing it to Medavie Blue Cross®.
This form is used for students requesting proof of coverage for either a travel visa, applications for government programs or proof for other reasons. *Note that students traveling to Cuba do NOT require a travel letter, your provincial health coverage is sufficient for entering the country.