Overall Drug Maximum $2,500/Benefit Year
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100% Coverage
80% Coverage
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Generic Drugs
Brand Drugs
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Dispensing Fee: 100% of any amount up to $7
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Generic drugs will be covered up to 100% up to the cost of the lowest-priced generic equivalent
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Only those drugs which legally require a prescription and are eligible under the benefits will be covered
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Standard Preventative Vaccines* ($200/benefit year)
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Contraceptives - Oral, IUDs, Injectable ($200/benefit year)
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Diabetic Supplies (test strips & needles, glucometers) {$200/benefit year}
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Hepatitis C Medications ($1,500/Lifetime)
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Smoking Cessation Products (Maximum of $500/Lifetime)
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Fertility Products (Maximum of $10,000/Lifetime)
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CNS Stimulants** (Maximum of $600/Benefit Year)
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Biologic Agents (Maximum of $1,000/Benefit Year)
Want to know if your drug is eligible for coverage? Visit the Member Website and the My Benefits App and use the Alberta Blue Cross® Drug Look-Up Tool or our Eligible Drug Search tool to search by DIN or Drug name.
* Vaccines are on a cost-reimbursement basis. Students pay upfront & submit a Health Claim Form for reimbursement. Vaccines must be administered by a licensed retail pharmacy to be eligible for coverage
**CNS Simulants are medications used to increase physical activity, mental alertness and attention span. They are often used in the treatment of Attention Deficit Disorder and/or hyperactivity Disorder (i.e. Adderall, Concerta, Vyvanse, Ritalin and their generic versions).
Maximum of $200 per practitioner per benefit year, $20 per visit maximum:
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Acupuncturist
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Chiropractor
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Podiatrist/Chiropodist
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Naturopath
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Osteopath
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Physiotherapist*
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Registered Massage Therapist*
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Dietitian/Nutritionist
*Prescription required for first RMT and physiotherapy claim each benefit year. If prescription is less than 12 months from date of issue, it can be used in subsequent benefit years.
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Speech Language Pathologist
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Psychologist**
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Psychotherapist
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Social Worker (MSW)**
**Clinical Counsellors and other mental health practitioners who do not meet the above criteria will not be considered eligible for coverage under these benefits.
Coverage is to maximum indicated, unless otherwise stated:
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Custom Orthotic Shoes & Orthopedic Appliances ($250/benefit year)***
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Medical Equipment & Supplies (Reasonable & Customary)*** ****
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Ambulance to nearest treating hospital ($500/benefit year - Reasonable & Customary)
***Prescribed by a medical doctor, chiropodist or podiatrist
****For a full listing of eligible expenses, please see the benefits booklet
Predetermination: It is strongly recommended to obtain a predetermination for extensive dental procedures to prevent unexpected costs. Have your dentist send a predetermination electronically to Alberta Blue Cross®
Students can check to see if the dental code on their predetermination is eligible for coverage. Note: This does not say how much is eligible, just if the code itself is eligible on your benefits.
If your claim is the result of a Dental Accident please go to the Accident Coverage section for more information.
Annual combined maximum of $500.00/year/insured Reimbursement based on Current Dental Fee Guide less one year. Note that specialist fees will be paid at General Practitioner rates.
Complete Oral Examination (once every 5 years) / Limited and Recall examinations (once every 12 months)
Complete series Periapical or Panoramic (once per 2 years) / Bitewing (2 images every 12 months)
Dental polishing (1x 15-minute unit every 12 months) / Scaling (12x 15-minute units every 12 months)
Fillings
Includes Wisdom Tooth Extractions
Endodontics / Periodontics
Limitations and Exclusions may apply.
An accident means an occurrence due to external, violent, sudden, fortuitous causes beyond the insured’s control, which must occur while the student is insured under this policy.
Payment of a stipulated sum for loss of life or limb through accidental means, provided such loss occurs within 365 days after the date of accident causing such loss
Injury to whole and sound teeth, and within 30 days from the day of the accident obtains treatment in Canada from a qualified dentist. Reimbursement will only be provided on expenses which are: incurred in Canada, incurred within 52 weeks of the date of the accident causing injury, incurred only for therapeutic and not elective or aesthetic treatment, and supported by an original standard dental claim form.
If within 30 days from the accident causing injury, the insured obtains medical treatment in Canada may be reimbursed for the following reasonable and necessary expenses to the specified maximum per Insured for all injuries resulting from any one accident:
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Duty nurse ($50/hour, $5,000 maximum)
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Ambulance ($5,000)
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Semi-private hospital room ($5,000)
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Wheelchair rental (Reasonable & Customary)
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Fee for services of a licensed physiotherapist ($500)
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Hearing aids, crutches, splints, casts, trusses and braces, excluding replacement (Reasonable & Customary)
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HIV Post-Exposure Prophylaxis (PEP) for bodily injuries sustained in the performance of duties required by your program of study
Expenses must be incurred in Canada, within 52 weeks of the date of the accident causing injury, incurred for only therapeutic and not elective treatment, and supported by original receipts.
If insured suffers injury resulting in hospital or medically necessary bed rest and is confined for at least 15 consecutive school days, as determined by a physician, the insurer will pay for the private tutorial services of a qualified teacher.
If injury causing loss of life occurs more than 50 kilometers from insured’s permanent city of residence and within 365 days of the date of the accident causing injury, the insurer shall pay the actual expenses incurred for preparing the deceased insured for burial or cremation and shipment of the body to the city of residence of the deceased insured.
If the Insured sustains an Injury that results in payment being made for loss of life. The Insurer will pay the reasonable and necessary day care expenses incurred for any dependent Child 12 years of age and under. Child must be enrolled in a legally licensed day care centre on the date of accident or within 365 days following the date of accident.