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Frequently Asked Questions

Please see below some commonly asked questions about your coverage with Student VIP.



  • International Basic Plan FAQ
  • Companion Plan
  • Common Insurance Terms
  • General Coverage Questions
  • Drug Coverage
  • Dental Coverage
  • Opting In
  • Opting Out
  • On Campus Clinic Appointment Booking
  • Provincial Pharmacare
  • Submitting Claims
  • Travel Coverage
  • Claims Reimbursements
  • Contact Us

Please see below some commonly asked questions about your international health plan.
 

Am I covered?

  • All international students are automatically billed and enrolled under the SMUSA International Basic Health Plan when they begin their studies at Saint Mary's University

  • Please contact the SMUSA Health Plan Office for opt-in/out dates and deadlines.


When does my coverage begin?

Fall enrolments; September 1-August 31

Winter enrolments; January 1-August 31

Spring enrolments; May 1-August 31

How much does my coverage cost?
 

Months on Plan Single Rate

Family Rate
1 dependant

Family Rate
2 dependants
Family Rate
3 dependants
Family Rate
4  dependants
12 months (full year) $915.00 $1,830.00 $2,745.00 $3,660.00 See office for pricing
8 months $608.00 $1,215.00 $1,823.00 $2,430.00 See office for pricing
4 months $308.00 No Coverage available for Spring and Summer 

*NOTE: Family rates include single rates*

Can I enrol my family?

Family members can be added to the SMUSA International Basic Health Plan upon payment of the appropriate fee and completion of the family opt-in application. Eligible family members include spouse, common-law partner and dependent children.

Please complete a family opt-in application when your family arrives in Nova Scotia.

If you are looking for coverage for non-immediate family members (parents, siblings, grandparents, etc.) or for visiting friends, you may purchase our Visitors to Canada Plan. More information can be found here. 

 

Can I opt-out (cancel) the SMUSA international health plan?

You may be eligible to opt-out of the plan if you have MSI, private coverage from your home university (exchange students), or are a sponsored students. Specific criteria must be met in order to be opted-out. Please contact the SMUSA Health Plan Office for more details.

 

I have both the health and dental benefits and the international plan, what do they cover and what card do I use?

Click here for a roadmap explaining your plan differences. 

 

What if I miss the opt-out deadline?

Please contact the SMUSA Health Plan Office.
 

How do I confirm eligibility for a medical service?

  • You can complete THIS FORM to confirm eligibility of a service 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 to the student with approval or denial within 48-72 business hours.
     

How do I submit a claim?

  • Please present your health card at Saint Mary’s Student Health Services or the hospital to have your bills submitted to the insurance company directly. If you visit a doctor and pay up-front, please bring all receipts and paperwork to the SMUSA Health Plan Office for help completing a claim. You may also submit your CLAIM ONLINE

  • Claims must be submitted 90 days after your coverage terminates or within one year from date of service, whichever comes first.
     

Where can I find a doctor?

To find a doctor close to you click here.

Non-Emergency

Halifax- Please visit St.Mary’s Health Services in the Student Centre for all non-emergency medical care

Emergency

Halifax- Please visit the QEII hospital on Robie St. for any emergency medical care
 

Where can I find my health card? 

Please find instructions here to receive your health plan card. 

Or email healthplan.smusa@smu.ca

Or visit 

SMUSA Health Plan Office

5th Floor, Student Centre Room 522

923 Robie St., Halifax, NS  B3H 3C3

 

What is the contact information for the SMUSA Health Plan Office?

SMUSA Health Plan Office

5th Floor, Student Centre

923 Robie St., Halifax, NS  B3H 3C3

Phone: 902-496-8754

E-mail: healthplan.smusa@smu.ca


 


Group Policy # 92651


The Companion Plan is a mandatory plan that International Students will be automatically enrolled on if they opt-out of the International Student Medical Plan with Nova Scotia MSI Coverage. 


Why do I need this Coverage?

Even though you have MSI, it is only valid in Nova Scotia. This means, if you leave the province of Nova Scotia for any period of time, you would be not have coverage for medical emergencies and therefore be exposed to high costs if you were to get sick or injured while outside of Nova Scotia.


Additionally, when your provincial coverage is not in place (such as if you leave the province) the emergency travel coverage you may have through your SMUSA Health & Dental Benefits or through any other extended health plan will not be in effect as these plans require that provincial health care (or an equivalent plan) are in place.
 

What is covered?

Students are covered for 31 days outside of the province of Nova Scotia and outside of Canada (including their home country) for medical emergencies.

Click Here to view your policy.

Click Here to view your Rack Card.

Insurance terms can be difficult to understand, but that's why we're here to break them down for you.

View the International Glossary Booklet for additional International Basic Health Plan terms.

COMMON INSURANCE TERMS


ANESTHESIA

Medical Anesthesia is a field of anesthesia that includes local, sedation and general anesthesia. These are forms of medicine that freeze a spot on the body that requires medical attention to help relieve pain. General and sedation are typically a medical gas that give you the feeling of being asleep before a medical procedure is done so you do not feel pain.

 

BENEFICIARY

A person who may receive payment from your health benefits if you die while covered under an insurance policy.

 

BENEFIT PERIOD

The period of time that an Insured Person is insured (covered) under the insurance policy. Starting from 12:01 a.m. on the effective date of coverage and ending at 12:00 midnight on the termination date.

 

CALENDAR YEAR

The 12-consecutive-month period that begins on January 1 and ends on December 31. Sometimes your insurance policy will indicate that some benefits are in force per calendar year versus policy year.

 

CANASSISTANCE

The emergency assistance provider for the Student VIP Travel Benefits and Student VIP International Student Health Plan. CanAssistance provides travel assistance such as if you are sick and need to find a doctor.

 

CERTIFICATE ID or ID NUMBER

A certification ID or your ID number is your personal identification number for the insurance company to find you under your group policy. Under a Student VIP / Student VIP International plan, a certificate ID and ID number are the same.

 

CLAIM

A claim is when you have paid out of pocket for a service and must submit your expenses to the insurance company to see if they are eligible. A claim can be for medication, dental services, doctor visits, etc. Making a claim does not mean the service will be reimbursed (paid).

 

CO-INSURANCE

If you are covered by another health insurance plan in addition to your Student Benefits (e.g. through a parent's or spouse's employer, or your own employer), you may coordinate the benefits in order to increase your overall coverage, up to 100%.

 

COMMON CARRIER VS CARRIER

Carrier means the insurance provider responsible for processing and paying your claims.

Common Carrier means a method of transportation such as airplane, bus, train, etc.

 

COORDINATION OF BENEFITS

If you are covered by other extended benefits in addition to your Student Benefits (ex. through a parent's or spouse's employer, or your own employer), you may coordinate the benefits in order to increase your overall coverage, up to 100%.

 

CO-PAY

You pay a portion of the cost of your prescriptions by paying either the same amount each time (e.g. $5) or a percentage of the total cost (e.g. 20%). If you’re paying a percentage, then you’re encouraged to shop around for the best available dispensing fees and ingredient costs.

DEDUCTIBLE

A deductible is an amount you pay for health care services before your health policy begins to pay.

 

DENIAL OF CLAIM

When the service that you have obtained is not eligible (covered) under your insurance policy. This may be because the service is not included in the coverage, you have reached the maximum amount payable for that service, or it relates to a pre-existing condition.

 

DEPENDENT

A person/family member that can be included on the student's health benefits. On the Student VIP benefits, an eligible dependent (family member) is a spouse (husband/wife), common-law partner (live-in partner for at least 2 years), or children.

 

DIAGNOSTIC TEST

A diagnostic test can include an x-ray, a blood test, or other bodily fluid samples. It is an examination to identify a person's area of weakness and strength to determine a condition, illness or even disease. This follows the report of symptoms or other medical test results.

 

DIRECT BILLING

When a practitioner, pharmacy, dental office, doctor office, or hospital sends the bill to the health insurance company for payment. This means the student does not have to pay up front and file a claim for reimbursement.

 

EMERGENCY

Unexpected and unforeseen sickness or injury that requires immediate medical treatment for the relief of pain or suffering which cannot be delayed.

 

EMERGENT CARE CENTRE (also known as an ER)

An emergent care centre is a 24 hour/7 day a week service that is at a hospital. It has all of the necessary tools for assessment and care. Emergent care means services provided for a person that, if not provided, would likely result in the need for crisis intervention or hospital evaluation.

 

ENROLMENT

Enrolment means that you have been signed up for the health insurance benefits either by your school automatically, or having purchased the health benefits on your own.

 

EXCLUSION

A service or expense that is not covered under the insurance policy.

 

EXCURSION

Any type of travel outside of the province that you are attending school. An excursion can be for academic purposes such as study abroad or leisure such as a trip during reading week.

 

EXPLANATION OF BENEFITS (EOB)

An explanation of benefits (commonly referred to as an EOB) is a statement sent by a health insurance company to covered individuals explaining what medical treatments and/or services were paid for on their behalf. The EOB is not a bill. It simply explains how your benefits were applied to that particular claim. It includes the date you received the service, the amount billed, the amount covered, the amount that the insurance company paid, and any balance you’re responsible for paying the provider.

 

EXTENDED HEALTH BENEFITS

A type of benefit included in health insurance benefits. Extended health benefits usually include paramedical practitioners, medical equipment and supplies, ambulance and more.

 

HEALTH BENEFITS CARD

The card you must show when visiting the pharmacy, dental office, doctor office, or hospital. This card usually has your name and ID on it and the insurance company information so health care providers can directly bill the insurance company.

 

HOME COUNTRY

Home Country means the country that you maintain your permanent residence. For example, if you are a student that has come to Canada from China to study, your home country would be considered China.

 

HOSPITAL vs ON CAMPUS CLINIC vs WALK-IN CLINIC

Hospital - Is an institution that provides medical and surgical treatment and nursing care for sick or injured people. It has enhanced capabilities and can treat illnesses and injuries. They have diagnostic tools and an emergency care centre that you can go to in very serious situations 24/7. Hospital should only be used when care is emergent and cannot wait for an appointment.

Campus Health Clinic - Provides care to students right on campus. Similar to a walk-in clinic with designated hours of operation. Some clinics can provide mental and physical health care. If there are doctors on site, they can prescribe medication and treatments. Check if your campus clinic is appointment-based or walk-in. You can visit one when you are feeling unwell or need a check-up. They are also there to help answer questions related to your health. Services are confidential.

Walk-In Clinic - Accepts patients on a walk-in basis and with no appointment required. You can get advice, assessment and treatment for minor illnesses and injuries. They provide services including diagnosis, prescriptions and referrals. Use a walk-in clinic in a non-urgent situation. Walk-in clinics are not open 24/7.

 

INJURY

Harm or damage to your body.

 

INSURANCE

Coverage that may pay for drug, dental, vision, medical, surgical expenses. Health and Dental benefits are subject to maximums, conditions and limitations and should be reviewed in full before use.

 

INSURANCE PROVIDER

The company responsible for processing and or paying claims, managing the contact centre for coverage questions and claims assistance. The insurance provider is sometimes known as the plan administrator. 

 

INSURED PERSON

The person who is listed as having active coverage under an insurance policy.

 

INVOICE

A document issued by the health care provider that indicates the services you received. This document is needed by the insurance company to review and process claims.

 

MANDATORY PRODUCT SELECTION

MPS, quite simply, pays for the cost of a prescription up to the equivalent generic price.

 

MEDICALLY NECESSARY

Services or supplies provided by a Hospital or Physician, licensed Dentist or another licensed provider that are required to identify or treat an Insured Person’s Sickness or Injury.

 

MENTAL HEALTH

A person's condition in terms of psychological, social and emotional well-being. It affects how we think, feel and act. It also helps determine how we handle scenarios, relationships and other feelings or situations.

 

MONITORED MEDICATION

A Monitored Medication, or controlled substance, is generally a drug or chemical whose manufacture, possession, or use is regulated by a government, such as illicitly used drugs or prescription medications that are designated a Controlled Drug by the Controlled Drug and Substance Act. Examples include Dilaudid, Methadone, Demerol, OxyContin, Percocet, Morphine, Opium, Codeine, Amphetamine (Dexedrine, Adderall), and Methamphetamine. Schedule III – These are substances that can still lead to moderate or low physical dependence and high psychological dependence.

 

MSW

A Master of Social Work - a Master's Degree in the field of Social Work. A provider who has an MSW provides mental health care to individuals such as counselling.

 

OPT-IN

To sign up, register, or enrol in an insurance policy.

 

OPT-OUT

To cancel, withdraw, or leave a health insurance policy. At your school, you are required to have insurance. You may be able to cancel if you have other insurance already in place that is comparable to the school provided insurance before you can cancel.

 

ORIENTATION

It is a session or event where information is provided to students regarding their health benefits, benefits package, service and coverage details. Orientations can be held at different times of the year and students should attend.

 

PARAMEDICAL PRACTITIONER

A type of health care provider that offers care such as a physiotherapist, chiropractor, massage therapist, naturopath, chiropodist, nutritionist, etc.

 

PLAN ADMINISTRATOR

The person that manages or takes care of the health and dental benefits for students. The administrator works with the plan provider (Student VIP International) to make sure the plan meets all the rules. Students can go to their health plan administrator with questions regarding their health coverage.

 

POLICY NUMBER or GROUP NUMBER

A policy number or group number is a way to identify what health insurance policy you are covered under. A policy number is assigned to each insurance policy. Under a Student VIP / Student VIP International plan, a policy number and group number are the same.

 

PRACTITIONER

An individual licensed under Canadian law to provide health services to individuals. Examples include a physician, psychiatrist, dentist, nurse, etc.

 

PRE-EXISTING CONDITION

Any condition known or unknown for which you have already received medical advice or treatment before enrolment on the health insurance benefits. Common pre-existing conditions include diabetes, a heart condition, a broken bone for which you need follow up treatment, etc.

 

PRE-DETERMINATION-MEDICAL

A medical pre-determination is used when you want to confirm if the medical procedure you need to get is covered by your insurance. You have to complete a form and submit it to the insurance company. They will review the form and your policy and send you a letter to confirm if you have coverage for the procedure or not. It is important to do a pre-determination before expensive medical procedures such as surgery, x-rays or if you know you need to be admitted to the hospital.

 

PREFERRED PROVIDER

A health care provider that is part of our network that usually offers a discount for services or direct billing to the insurance company so you do not have to pay the full cost out of pocket.

 

PREMIUM

The price that you pay for your health insurance.

 

PRESCRIPTION

A formal written document issued by a medical professional for a patient to be provided medicine or treatment. A drug prescription is used to get medication from a pharmacy. A prescription is not needed for over-the-counter health aids.

 

PROVINCIAL HEALTH CARE or GOVERNMENT HEALTH INSURANCE PLAN

The health care coverage Canadians automatically qualify for, to cover visits to the doctor or hospital. International students may qualify for this coverage if certain eligibility is met.

 

PSYCHIATRY/PSYCHIATRIC CARE

A medical specialty for mental health. This medical practice is to diagnose, prevent and treat mental health conditions, illnesses or disorders This includes trouble with mood, behaviour, and perception. Psychiatric care can include medical evaluations, care or treatment by a professional.

 

REASONABLE AND CUSTOMARY

Reasonable & Customary limits are the range of usual fees for comparable medical services in a geographical area. Like other benefit providers, Medavie Blue Cross™ uses these limits to determine the maximum eligible amounts for health care services and supplies covered by your benefits. We review reasonable and customary limits on a continual basis and make changes periodically to ensure our allowed amounts are representative of the current standard charges in the health care environment.

 

REIMBURSEMENT

When the claim you or a provider submits for services you have obtained is approved and paid.

 

REPATRIATION

The return of an insured student to their own country or province if they are sick, injured or have died while covered under an insurance policy.

 

SICKNESS

Sudden and unforeseen (unexpected) presence of an illness or disease.

 

STABLE

An existing medical condition that is not worsening and there has been no change in any medication or dosage or usage for the medical condition, and there has been no change in the medical treatment.

 

STUDENT VIP INTERNATIONAL HEALTH PLAN vs. PROVINCIAL HEALTH CARE (GHIP)

The Student VIP International Health Plan and Provincial Health plans provide coverage for physician-related services such as doctor visits, hospital visits, diagnostic testing, etc. The coverages are NOT the same.

 

URGENT CARE CENTRE

An urgent care centre is not designated to receive patients who arrive in an ambulance. It can be located in a hospital facility or a building on its own. Some urgent care centres have designated hours of operations. Urgent care is provided for illnesses or injuries which require immediate attention but are not of such seriousness as to require the services of an emergency room/ hospital.

 

DRUG TERMS

BRAND VS GENERIC

Brand - It is a prescription drug that is marketed with a specific brand name by the company that makes it. Brand name drugs are typically more expensive than generic drugs.

Generic - Contain the same active medicinal ingredients as the brand name alternative, and are therefore considered therapeutic equivalents. However, the ingredients that actually combine the active ingredients may differ. For the most part, generic products will perform the same as their brand name counterparts, cost less and can reduce the costs of your health benefits.

 

DISPENSING FEES

A dispensing fee represents the charge for the professional services provided by a pharmacist when dispensing a prescription. The dispensing fee differs from pharmacy to pharmacy. Student VIP is able to offer you student-friendly dispensing fees through some of our partners.

 

DRUG IDENTIFICATION NUMBER (DIN)

A DIN is a number assigned to a specific dosage or drug that tells you if the product has been approved for use and can legally be manufactured and sold in Canada.

 

MONITORED MEDICATION

A Monitored Medication, or controlled substance, is generally a drug or chemical whose manufacture, possession, or use is regulated by a government, such as illicitly used drugs or prescription medications that are designated a Controlled Drug by the Controlled Drug and Substance Act. Examples include Dilaudid, Methadone, Demerol, OxyContin, Percocet, Morphine, Opium, Codeine, Amphetamine (Dexedrine, Adderall), and Methamphetamine. Schedule III – These are substances that can still lead to moderate or low physical dependence and high psychological dependence.

 

OVER-THE-COUNTER MEDICATION

Also known as (OTC) are health aids or medicine that do not need a prescription. They can be purchased at places like a pharmacy. OTC's can include items like Advil, Tylenol, cold medicine, cough drops, etc.

 

PHARMACY RECEIPT VS STORE RECEIPT

 

A STORE RECEIPT is a slip of paper given in person or sent online that is used to provide a record of sale.

A PHARMACY RECEIPT is a record of sale slip that includes the pharmacy details, prescriber's name (doctor), and the name of the drug or treatment that was prescribed. It can allow you in some cases to claim a reimbursement or see the details of the drug benefits payment details.

 

DENTAL TERMS

ANESTHESIA

Dental Anesthesia is a field of anesthesia that includes not only local anesthetics but sedation and general anesthesia. Local anesthetic freezes the mouth before a procedure is done to help with pain relief.

 

COMPLETE VS RECALL EXAM

A Complete Exam consists of the dentist looking inside your mouth for things that can affect your oral – and overall – health. The complete exam can catch problems early before you see or feel them and when they are easier and less expensive to treat. Some of the problems that dentists can identify include deteriorating fillings, early signs of gum disease or oral cancer, etc.

A Recall Exam is a maintenance exam performed once a year following the initial oral examination. This exam helps to prevent tooth decay, gum disease, and other dental disorders that may have developed during the year. A recall visit typically includes an exam, as well and polishing and scaling.

 

ENDODONTIC

An Endodontist is a dentist who specializes in maintaining teeth through endodontic therapy – procedures, involving the soft inner tissue of the teeth, called the pulp. Endodontists perform a variety of procedures including root canal therapy, endodontic retreatment, treating cracked teeth, and treating dental trauma. Root canal therapy is one of the most common procedures performed by Endodontists.

 

MAJOR RESTORATIVE

Major Restorative Dental Services typically include procedures and treatments that are relatively more complex in nature. Major Restorative Services can include Dental Crowns, Dentures, Bridges, etc.

 

MINOR RESTORATIVE

Minor Restorative Dental Services typically include types of treatments and procedures that are relatively straightforward in nature. Minor Restorative Services can include Composite Fillings, Recementing Dental Crowns, Stainless Steel Crowns, etc.

 

PERIODONTICS

Periodontic dental care ranges from routine treatment of gums to assisting those diagnosed with gum disease, and can include the removal of calcium deposits (plaque, tartar, calculus, and stone) from around the tooth above and below the gum.

 

PRE-DETERMINATION-DENTAL

A dental pre-determination is an estimate of what your dental benefits will cover and what you will be responsible for. Your dental office can submit an outline of the proposed treatment to Medavie Blue Cross™ prior to proceeding with treatment. The predetermination is only an estimate, and does not guarantee the final costs you will be responsible for paying.

 

RADIOGRAPHS

A radiograph (x-ray) helps dentists diagnose and treat dental problems, including cavities, gum disease, infections, and more. Radiographs allow dentists to see inside a tooth and beneath the gums to assess the health of the bone and supporting tissues that hold teeth in place.

 

SCALING

Scaling teeth is part of a routine professional cleaning, and it involves scaling teeth and the gum line to remove plaque and tartar. This is done to keep your teeth and gums healthy.
 

Who is eligible for coverage?
The following students are automatically covered by the SMUSA Health & Dental Benefits:
 
  • All students taking at least one academic credit are automatically billed and enrolled for this plan. This includes Graduate students in continuation.
  • Please note there are eligibility exceptions. Exceptions for 2023/2024 include:
                         -  AST – Diploma students only (historically have never been on the plan)
                         - Graduate students (FGSR) in the following programs: EMBA and MMCCU
                         - The Language Centre – University Bridging (UBP) students from Doshisha University only
 
 
How much do the benefits cost?

Fall Full Time Student 2023 Fees 

Policy Period: September - August
Single: Health $250.00 / Dental $120.00
Family (1 Dependant): Health $520.00 / Dental $240.00
Family (2 Dependants): Health $560.00 / Dental $280.00
Family (3 Dependants) Health $600.00/ Dental $320.00

 
 
Winter Full Time Student 2024 Fees 
 
Policy Period: January - August
Single: Health $166.00 / Dental $80.00
Family (1 Dependant): Health $346.00 / Dental $160.00
Family (2 Dependants): Health $376.00 / Dental $190.00
Family (3 Dependants) Health $406.00/ Dental $220.00


*NOTE: Family Rates include Single Rates.
Students must enrolled with Single Coverage to be eligible for family coverage.

 
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Spring/Summer Full Time Student 2024 Fees - International Students ONLY
 
Policy Period: May - August / July - August
Single (4 months): $84.00 (Health Only)
Family (1 Dependant): Health
 Only $175.00
Family (2 Dependants): Health Only $195.00 
Family (3 Dependants) Health Only $215.00
 
Single (2 months): $42.00 (Health Only)
Family (1 Dependant): Health Only $88.00
Family (2 Dependants): Health
 Only $98.00
Family (3 Dependants) Health Only $108.00

*NOTE: Family Rates include Single Rates.
Students must enrolled with Single Coverage to be eligible for family coverage.

 


How can I see an outline of my coverage?

You can find an outline of all of your coverage in the Benefits Brochure, or see an outline of coverage broken down by Drug, Extended Health, Vision, Dental, Travel and Accident coverage by clicking here.


How do I know if I am covered by the extended health and dental benefits?

Check the breakdown of your annual general fees; if they include the health and dental fees, you are automatically enrolled in the benefits. In order to confirm that your coverage is in-force and to confirm the period of coverage you can contact us at: 1-888-918-5056.  If your annual general fees do not include the health and dental fees, you can enroll yourself during the month of your annual registration.

What are my coverage effective dates?

The 2023-2024 policy year will run from September 1, 2023 - August 31, 2024.

For Fall enrolments, coverage begins September 1, 2023. For Winter enrolments, coverage begins January 1, 2024 and for Spring enrolments, coverage begins May 1, 2024.  All students on the plan will have the same termination date of August 31, 2024.

Where can I access my Benefits Card?

You can download a printable copy of your benefits card here, or visit your health plan office for a plastic card.

Where can I find Discounted Service Providers?

Student VIP offers a wide variety of discounted providers. You can use a VIP Preferred Practitioner to save up to 20% on eligible services near your campus or home. To access the full network listing, please utilize our Provider Search Tool. Enter an address, select the type of practitioner, and the area you would like to search. The results will display, with any discount providers highlighted at the top of the search results. To set up an appointment, simply give them a call.
 
If your health service provider is not on the network, please ask them to 
Contact Us!

Can I still use Student VIP Perks, even if I opt-out of the plan?

Yes! Many Student VIP Perks are available to all SMUSA Students, regardless of whether or not they are currently covered under the Student Health and Dental benefits.

Do I need to submit a prescription with my claim?

 Drug Claims & Vision Appliances 

Always require a prescription


Registered Massage Therapy (RMT) 

Requires a physician's prescription on your first claim submission, each policy year.


Orthotics & Orthopedics

Must be prescribed by an attending physician, orthopedic surgeon, physiatrist, rheumatologist or Chiropodist/Podiatrist.


Hearing Aids

Must be prescribed by an otorhinolaryngologist or otologist or recommended by an audiologist.

 

Travel

Some travel expenses may require copies of receipts or prescriptions depending on the claim.  For more information on this please contact Blue Cross directly at 1-833-867-3468 or saintmarys@medavie.bluecross.ca

 

Do students at different campuses have the same coverage?

Yes, students at all campuses will have the same coverage. 

I am a mature student, at what age will my coverage terminate?

The current age cap on your SMUSA Health & Dental benefits is Age 99 for Drug, Extended Health, Dental & Travel Coverage & Age 70 for Accident coverage.

I'm graduating this year, how can I get coverage after graduation?

If you're graduating this year, you're about to lose the health and dental coverage available to you as a student. If you've already graduated, you may have found provincial government health benefits do not fully cover the cost of many health care services, leaving you vulnerable. Grad Perks offers supplemental health and dental benefits that can help to fill those gaps and provide you with the protection you need. Click here for more information.
 

How can I see if my medication is covered under my benefits?

If you want to know if your drug is eligible for coverage, check out the Eligible Drug Search tool. Just enter in the name of the drug or DIN (drug identification number) and you'll find out if it's eligible under the benefits and for Direct2U Prescriptions, as well as if it's a Brand or Generic drug. 

What if the only medication that works isn't covered?

In the event that the therapeutic alternatives, which are eligible under the benefits, prove to be ineffective for treating your particular condition, it is possible to have a special care approval for your medication.  These approvals are done on a case-by-case basis.  You must complete the Special Authorization Request Form.  You will be notified in writing if your application has been approved or not.


What is the turn-around time for Special Authorization Drug Requests?

Your request will be confidentially reviewed by a health care professional according to the payment criteria established.  When all the required information is received by Blue Cross, the standard turn-around time for Special Authorization decisions is 7 to 10 working days.

What is Direct2U Prescriptions?

Direct2U Prescriptions is a prescription delivery service available to SMUSA Health Benefits members. This service offers up to 100% coverage for Generic Medications and 80% for Brand Name Medications. For more information please click here.


How do I get a quote for dental work?

If you'd like to see exactly what will be covered for specific dental procedure(s), have your dentist submit a pre-determination, along with your name and student ID #, to Medavie Blue Cross™ via fax at 506-867-4651. Pre-determinations are strongly recommended for extensive dental procedures such as wisdom teeth extractions, crowns, and other major services. 

How can I check to see if a dental code is covered?

You can check to see if a dental code on your pre-determination is eligible on the benefits. 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.

Orthodontic Coverage

Unfortunately the Health & Dental benefits do not cover Orthodontic services or supplies. Braces, Invisalign and services related to these items would not be eligible for coverage.

I'm a full-time student, do I need to opt-in?

 

No. All students are automatically billed and enrolled on the Extended Health and Dental plan. International students are also enrolled and billed for the International Basic Health plan.
 
These charges should appear on your student account (in Banner) during the academic term in which you begin your studies for that academic year. (ex. if you begin you studies in September, the health plan fees should appear in your Fall term charges).

If you don’t see the charges, please contact the Health Plan Office at healthplan.smusa@smu.ca
 
I'm a part-time student, do I need to opt-in?

Students starting in Fall and Winter terms:
No, all students taking at least one academic credit are automatically billed and enrolled for the Extended Health and Dental plan. International students are also automatically billed and enrolled for the Basic Health plan.

Students starting in Spring and Summer terms:
No, all students taking at least one academic credit are automatically billed and enrolled for the Extended Health plan. International students are also automatically billed and enrolled for the Basic Health plan. There is no dental coverage available for new students beginning in May or July. 

Questions? Contact the SMUSA Health Plan Office at healthplan.smusa@smu.ca 

Can I add family onto my benefits?

Yes, students may enrol their spouse and/or dependent children onto the benefits for an additional fee during the opt-in period in which they begin their studies. The following are considered eligible dependents:

Spouse/Common-Law:
The legal spouse of the insured student provided there is no legal separation in effect, or an individual of the same or opposite sex who has been residing with the insured student for a period of at least one (1) year and who has been designated as the spouse/common-law partner of the insured student in the policyholders records for insurance purposes, and is a resident of Canada and has provincial health coverage (or equivalent coverage).

Dependent Child(ren):
Any natural child, step-child or legally adopted child of the insured student, who is under 21 years of age, unmarried and receives full support and maintenance from the insured student, or those over 21, but under 25 years of age, unmarried and receives full support and maintenance from the insured student for reason of full-time attendance at an accredited institute, college, or university in Canada, or receives full support and maintenance from the insured student by reason of mental or physical infirmity, and is a resident of Canada and has provincial health coverage (or equivalent coverage).


When can I add family onto my benefits?

You can enroll your dependant(s) for an additional fee during the opt-in period in which you begin your studies for that academic year.

The opt-in periods are: 

Fall Opt-In: August 15 - September 25
Winter Opt-In: December 15 - January 25
Spring Opt-In: April 15 - May 25 (no dental available)
Summer Opt-In: June 15 - July 25 (no dental available)

I’m an international student that has extended family and/or friends visiting Canada, is there any way to purchase coverage for them?

If you are looking for coverage for non-immediate family members (parents, siblings, grandparents, etc.) or for visiting friends, you may purchase our Visitors to Canada Plan. More information can be found here.


If I already have coverage, can I opt-out of my Student Health & Dental benefits?
Yes, if you have comparable alternative coverage (usually through a parent, spouse, or work) you may opt-out of the health and dental benefits during the opt-out period in which you begin your studies for that academic year (ex. Students beginning their studies in the fall term must adhere to the Fall Opt-Out period). Students wishing to opt-out with alternative coverage must also submit an opt-out application each academic year.

You will be asked to provide proof of this coverage when you submit your opt-out application which includes:
  • Name of the primary insured person (i.e. parent or spouse/common-law partner)
  • Name of the other insurer
  • Policy/Certificate number
  • Insured Person’s name and relationship to you
 
You should be aware that your SMUSA Health & Dental benefits offers benefits specifically designed for students.  You may find it advantageous to remain enrolled under these benefits and coordinate your benefits with your existing coverage.

What is the opt-out process for the Extended Health and Dental Plan?

All students taking at least one academic credit will be automatically billed and enrolled on this plan each academic year.

SMUport is no longer being used to submit opt-outs. All opt-out forms will now be available on the Student VIP website during the opt-out period.

All Students:
If you have comparable alternative coverage (through a parent, spouse, or work) you may apply to opt-out of the extended health & dental benefits. You must attach proof of coverage with your application. At minimum, your alternative insurance must provide coverage for: prescription medications, routine dental care, and extended health benefits, such as paramedical practitioners.

You should be aware that your SMUSA Health & Dental plan offers benefits specifically designed for students. You may find it advantageous to remain enrolled under these benefits and coordinate your benefits with your existing coverage.

Please carefully consider your decision to opt-out. By opting out of the Health and Dental benefits, you will not be eligible to opt back into the benefits until the next policy year begins, even if you lose your existing coverage.

Examples of losing your existing coverage:

  • If your coverage is through your parents/spouse and they lose their coverage;
  • If you reach the age of maturity as a dependent on your parent’s benefits (i.e. age 21 for some benefits, 25 for others)
Note: There are no exceptions or extensions to the opt-out deadline. Opt-outs are only granted if the Basic Health plan is unused.
 
What is the opt-out process for the International Basic Health plan?

International Students Only*:
Effective September 2019, international students who have private coverage are not eligible to opt-out of the SMUSA International Basic Health plan. Private coverage may be something you purchased on your own or have through your parents/spouse.

There are three exceptions through which specific criteria must be met to opt-out of the International Basic Health Plan. Please inform the Health Plan office (healthplan.smusa@smu.ca) if you meet one of the criteria below:
  1. A student who holds active Provincial Health Coverage (known as MSI in NS - depending on the effective/expiry dates)
  2. Exchange/Visiting students with comparable coverage from their home university
  3. Students sponsored by their home government or embassy
 
Note: There are no exceptions or extensions to the opt-out deadline. Opt-outs are only granted if the Basic Health plan is unused.

*Domestic Students are covered under their provincial health plan and are not enrolled onto the SMUSA Basic Health plan.
 

If I opted out and I lose my alternative coverage, can I opt back into the benefits?

No. Please carefully consider your decision to opt-out. By opting out of the Health and Dental benefits, you will not be eligible to opt back into the benefits until the next policy year begins, even if you lose your existing coverage. 


Examples:
  • If your coverage is through your parents/spouse and they lose their coverage;
  • If you reach the age of maturity as a dependent on your parent’s benefits (i.e. age 21 for some benefits, 25 for others)

When can I opt-out?

Students can apply to opt-out of the Extended Health and/or Dental plan, as well as the Basic Health plan during the time period in which they begin their studies for that academic year*:

  • Fall Opt-Out:       August 15 - September 25
  • Winter Opt-Out:   December 15 - January 25
  • Spring Opt-Out:   April 15 - May 25
  • Summer Opt-Out:   June 15 - July 25
*International Students opting out of the Basic Health plan using MSI must complete an opt-out on a term-by-term basis if their MSI doesn't cover them from September 1 - August 31. 

Questions? Contact the SMUSA Health Plan Office - healthplan.smusa@smu.ca 
Do I need to Opt-Out each term?
No, you only need to Opt-Out once per policy year, in the term in which you begin your studies.

-International Students Email: student.health@smu.ca or call 902-420-5611 to get your 4 digit code
- Canadian Students use first 4 digits of your health card

What is Pharmacare?

The Nova Scotia Pharmacare Programs, which are Nova Scotia’s public drug plans, helps residents with the cost of prescribed drugs and devices which are indicated as benefits in the Nova Scotia Formulary, as well as with the cost for some services to which a level of coverage applies under a particular program.


Where can I find information on provincial drug coverage?

For more information visit the Government of Nova Scotia website

Seniors’ Pharmacare Program

Details of the provincial plan are available online HERE.

Eligible participants should be sent an information package from the province 3 months prior to their 65th birthday.
 
How do I submit a claim?

The easiest and fastest way to make a claim is via the Medavie Blue Cross™ Portal or the Medavie Blue Cross™ Mobile App. For instructions on how to make a claim, click here.

What is my Group Policy Number and Identification Number?
This information is on your benefits card:

Group Policy #: 0091939000
Identification #: 000 + 6 digit student ID number + 00


(Example: If your student number is A00123456, your ID number would be: 00012345600)

How long do I have to submit a claim?

All claims must be submitted to Medavie Blue Cross™ no later than 12 months from the date the expense was incurred. In the event of termination of coverage, claims incurred prior to the termination date must be submitted to Medavie Blue Cross™ within 90 days of the termination date.


How do I register for the Medavie Blue Cross™ portal?

Click here to access the Medavie Blue Cross™ Portal.

Click on the
"Register now" link which can be found near the bottom of the log in page. When prompted, choose the card on the lower right, it should look similar to the card you have. Enter your Policy Number, Identification Number, Date of Birth, Email and Password. Once you've registered, you'll recieve an email from Medavie Blue Cross™ to activate your account. For more detailed instructions, please click here. 


Where can I find claim forms?

Please click here to access Health, Dental, Travel and Accident claim forms. 

How long does it take for my claim to be processed?

It takes 3-5 business days to process a claim, starting the first business day after submitting.

 
How can I check on the status of a claim, or obtain my claim history?

You can check the status of current claims and obtain your claim history via the Medavie Blue Cross™ Portal or Mobile App.

 

Medavie Blue Cross™ Portal:

Using the Portal, you can check your claim status by clicking the "Statements" top menu bar.  Then select a date range, insured member, line of benefit, and hit "Search". If your claim has already been processed you will also be able to see the explanation of benefits. You can print this information out using the “Print” button at the bottom of the page.

 

Medavie Blue Cross™ Mobile App: 

While using the Mobile App, you can check your claim status by simply clicking the "View my claims" top menu bar.
 

Additional Questions:

Any outstanding questions regarding claim status/history can be directed to Medavie Blue Cross™ via the contact information listed below:

Student VIP Dedicated Toll-Free Phone Number: 1-833-867-3468
 
How do I coordinate my benefits?

Students with plans through their parents or spouse can coordinate their benefits for increased coverage. To do this, submit first to Student VIP. Once you get your Explanation of Benefits (EOB) and your reimbursement, you can submit the EOB along with your receipts and claim form from your parents' benefits for further reimbursement.

Students with benefits through their employer must submit to the provider they have had the longest first, then submit to their other benefits second.


My reimbursement cheque is stale dated, what do I do?

If your cheque is stale dated within 12 months of the end of the policy period in which your claim was incurred, you can contact Medavie Blue Cross directly to have the cheque reissued. If you are requesting to reissue a stale dated cheque that is beyond 12 months from the end of the policy year in which the claim was incurred, you must contact Student VIP directly. Please note that requests made outside of this timeframe may not be honoured.


How do I get a letter confirming that I have travel coverage?

If you need a letter confirming that you have travel coverage, you can complete a Student VIP Coverage Letter Request. Your request will be reviewed and a letter emailed to you in 3-5 business days. 

Who do I contact if I need to use my travel coverage while away?

Within Canada (not your home province) and the United States: 1-800-563-4444

Anywhere else in the world, call collect: 1-506-854-2222

Please have the following information ready:

Personal Information
Your name and Student ID
Your Policy Number - 0091939000

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

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

Medavie Blue Cross will issue reimbursements in the form of a paper cheque, to the address on file, if there is no direct deposit information provided. Please note that cheques are considered stale dated after six months unless certified.

If your cheque is stale dated within 12 months of the end of the policy period in which your claim was incurred, you can
contact Medavie Blue Cross directly to have the cheque reissued. If you are requesting to reissue a stale dated cheque that is beyond 12 months from the end of the policy year in which the claim was incurred, you must contact Student VIP directly. Please note that requests made outside of this timeframe may not be honoured.

Please contact the Student VIP office with any questions regarding your health and dental benefits. If we can't help you, we'll let you know who can! Visit the Support Page here to start a Live Chat or see who else you can speak to.

NOTE: Our Student VIP Representatives will make every effort to assist with specific coverage and eligibility questions. Ultimately, the policy document is the only true indicator of coverage. Please access your policy document in your Blue Cross portal for more information.


 

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