Medical Coverage

This portion of your insurance coverage is for medical expenses if you are sick or injured and require medical care. Your policy covers these expenses at 100% and there is no deductible or co-pay for you.

NOTE: These details are a summary only. Please refer to the policy for full details including limitations and exclusions.

Drug Coverage from 60% - 100% Coverage*

Overall Maximum of $2,500 per participant per benefit year. Termination when member reaches 65.

Preferred Pharmacies

100% Coverage for Generic Drugs

90% Coverage for Brand Drugs

Dispensing Fee: 100% of any amount up to $8

All Other Pharmacies

80% Coverage for Generic Drugs

60% Coverage for Brand Drugs

Dispensing Fee: 100% of any amount up to $5

Mandatory Generic Product Selection

Brand name drugs will be covered up to the amounts listed above up to the cost of the lowest-priced generic equivalent

Only those drugs which legally require a prescription and are eligible under the benefits will be covered

* 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).

Dental Coverage - 80% Coverage

Annual combined maximum of $500 /year/insured

The termination age for Dental Coverage for the SCC Health & Dental benefits is 65.

Examinations (80%): Complete Oral Examination (once every 12 months)

Radiographs (80%): X-Rays

Preventative Services (80%): Cleaning/ Scaling/ Polishing

Minor Restorative (80%): Fillings

Major Restorative (80%): Crowns

*Limitations and Exclusions may apply. Reimbursement based on Current Dental Fee Guide. Note that specialist fees will be paid at General Practitioner rates.

Students can check to see if the dental code on their predetermination is eligible on the plan. 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 or not.

Predetermination: It is strongly recommended to obtain a predetermination for extensive dental procedures to prevent unexpected costs. Have your dentist send a quote/predetermination electronically to Medavie Blue Cross®. If your claim is the result of a Dental Accident please go to the Accident Coverage section for more information.

Vision Coverage

Eye Exams: $100 / 12 months

Frames, Lenses and Contact Lenses- $150 / 24 months

This coverage excludes expenses incurred for non-corrective sunglasses and safety glasses. Please make sure to include your prescription (no more than 2 years old) along with your receipt when submitting claims for reimbursement.

Frames, Lenses and Contact Lenses must be purchased from a Canadian provider to be considered eligible under the benefits.

Frames are only eligible if purchased in conjunction with prescription lenses.

Lasik or Laser Eye Surgery are NOT covered under the benefits.

NOTE: These details are a summary only. Please refer to the policy for full details including limitations and exclusions.  

Mental Health Coverage

No matter what your mental health journey looks like, you have coverage through your plan to support your mental health care.

Visits to a psychologist or psychiatrist- 100% covered up to $10,000

Visits to a social worker – 100% covered up to $500

Hospitalization due to a mental health illness or concern such as anxiety, depression, bipolar, schizophrenia or other- 100% covered up to $60,000 (lifetime maximum)

Psychiatry fees billed separately during your time in the hospital – 100% covered up to $60,000 (lifetime maximum)

NOTE: These details are a summary only. Please refer to the policy for full details including limitations and exclusions.

Transportation

The Medical & Wellness plan also includes coverage for various transportation needs including:

Ambulance – Up to $10,000

Taxi or Uber to hospital- Up to $5,000

Repatriation (you are sick and must return home permanently) – up to $20,000

Repatriation of remains (transporting your body to your home country) – up to $20,000

Supplemental Expenses for family (i.e. accommodation, food) $150/day up to $1,500 max

Please view your International Health Policy for more information. You may contact your insurance provider for full details including limitations and exclusions.

Pregnancy & Maternity

The Medical & Wellness plan includes coverage for pregnancy, terminations (abortions), miscarriages, delivery and more.

Maternity expenses including ultrasounds, lab tests, doctor visits, delivery and well-baby care for up to 6 months post-birth - $25,000

Miscarriage – Covered under $25,000 maternity benefit

Pregnancy Termination (Medical Abortion) – 1 per policy year

Please view your International Health Policy for more information. You may contact your insurance provider for full details including limitations and exclusions.

*Charges for expenses incurred resulting from the pregnancy of a Participant commenced during the Policy Year (or within 60 days from it beginning), for a maximum period of 6 months following the birth of the child.

*Eligibility for coverage under this category is based upon the conception date of the pregnancy, whether known or unknown to the Participant, and only when coverage has been in force for the entire term of the pregnancy.

Travel Coverage

Your plan includes travel coverage across the globe!

Travel within Canada: Unlimited duration

Travel outside of Canada for leisure (fun, personal): 120 days

Travel outside of Canada for school (i.e., co-op): Up to 184 days as long as 51% of the policy year is spent in Canada

Travel to your home country: 31 days max up to $10,000 coverage

Family Travel to your bedside (if you are hospitalized for more than 7 days) - $5,000 for airfare for 2 immediate family members.

You do not need to let Student VIP know when you are travelling.

Please ensure you have your Health Plan Card with you when you travel in the event you need to contact emergency assistance and or seek medical help.

Please view your International Health Policy for more information. You may contact your insurance provider for full details including limitations and exclusions.

General Exclusions

While the medical & wellness plan is very inclusive, there are things that are not covered by the insurance.

If you are unsure if your medical or health care procedure will be covered by the plan, you can submit a pre-determination form before you receive your services or procedure.

Immigration Medical Exams including Medical Assessment fees, testing, imaging, or other services required for third-party exams.

Medical expenses for a pre-existing medical condition that was not stable for 90 days before the coverage began.

Services provided by a family member

An Illness or injury resulting from non-compliance with medical treatment or therapy that has been prescribed;

Participation in a criminal act or attempt to commit a criminal act, regardless of whether charges are laid or a conviction is obtained

Services, treatment or supplies that are:
i. not incurred as a result of an Emergency;
ii. not Medically Necessary;
iii. for cosmetic purposes only;
iv. elective in nature; or
v. experimental or investigative.

Please view your International Health Policy for more information. You may contact your insurance provider for full details including limitations and exclusions.

Coverage Questions

If you have questions about your coverage, you can contact two offices for assistance: