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Basic Plan Coverage

The details below are a summary of benefits, limitations, and exclusions that apply.
 

  1. Full benefit details can be found in the Benefit Booklet on the Simply Benefits App or Portal.
  2. In the event of a discrepancy between the website and the benefit booklet, the benefit booklet will be taken as true.
  3. The termination age for the SOGS Health & Dental Benefits is 70.


Drug, Extended Health, Vision and Dental coverage is valid in Canada only. Travel coverage is valid worldwide. Please review your policy for full details.

Understand Your Coverage

Know all benefits, limitations, and exclusions that apply.

Coverage valid in Canada only.

Policy Year: September 1, 2024 - August 31, 2025.

 
 

Drug Coverage - 80% Coverage

Overall Drug Maximum $3,500/Benefit Year

All Other Pharmacies

80% Coverage for Generic Drugs and Brand Name Drugs*

Dispensing Fee: 100% Up to Any Amount
 

Rexall + Telus


80% Coverage for Generic Drugs and Brand Name Drugs

Dispensing Fee: 100% Up to Any Amount

Drug Benefits also Include:

Vaccines**

Fertility Drugs (50% coinsurance / $1,500 lifetime max.)
 

Drug Benefits do NOT Include:

✔ All forms of Cannabis
✔ Hair Growth Stimulants
✔ Varicose vein injections
✔ Smoking Cessation Aids/Remedies
✔ Anti-Obesity drugs/Products
✔ Erectile Dysfunction Drugs

Brand-Name Medications

Your Plan will cover the cost of the generic version of your medication. If you are on a brand-name medication that cannot be changed, you can submit a note from your doctor indicating the need for your brand-name drug. The letter must include the below details or your request will be delayed.


  1. Patient Name
  2. Medical Practitioner Name & Contact Info
  3. Medication Name/DIN
  4. Dosage
  1. Details to support the need for the brand name medication versus a generic substitution
  2. Date the note is written

*Special authorizations: Some medications require special authorization for coverage through the plan. Please contact Simply Benefits and they will be able to provide assistance regarding your coverage eligibility.

**Vaccinations must be administered by a licensed retail pharmacy to be eligible for coverage.

NOTE: Only those drugs which legally require a prescription and are eligible under your benefits will be covered.

 

Dental Coverage

50% Coverage, up to an Annual Combined Maximum of $500/ benefit year


Preventative Services: Recall, Exams, Cleanings, X-Rays, Scaling

Extractions: Extraction of Impacted Teeth

Basic Services: Fillings, Endodontics, Periodontics
 

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

 

Extended Health Coverage

Practitioner Coverage - 70% Coverage

$500 Annual Maximum

Acupuncturists

Chiropractors*

Dietitians

Speech Therapists
 

*Please note that you need a referral by a medical doctor to be covered.

Practitioner Coverage - 70% Coverage

 $500 Annual Maximum

Psychologists/Psychotherapists/Social Worker (Registered Clinical Counsellors) (Combined)

Physiotherapists*

Naturopaths

Osteopaths/Chiropodists/Podiatrists (Combined)

*Please note that you need a referral by a medical doctor to be covered.

Hospitalization - 100% Coverage

Hospital Room (Semi-Private Accommodation) (In Province)

Other Medical Coverage

Coverage is to maximum indicated, unless otherwise stated

Ambulance to Nearest Treating Hospital (Reasonable & Customary)

Cardiac Rehabilitation ($500/ lifetime maximum)

Glucose Monitoring Systems ($3,000/Benefit year)*

Hearing Aids ($300/ 1 every 5 Benefit Years)

Insulin Pumps ($5,000, every 5 benefit years)

Insulin Pumps Supplies ($3,500, per benefit year)

Orthotics (Inserts) and Orthotics (Shoes) ($300 per benefit year)**

Private Duty Nursing ($5,000 per calendar year)


*Glucose monitoring systems and diabetic supplies are not subject to the Overall Benefit Maximum.
*Includes sensors, receivers & transmitters - patient must be insulin dependent Type 1 diabetic supported by a physician's prescription.
*Students must pay for the service upfront and then submit a claim for reimbursement, as direct billing is not available. 
**1 pair of shoes per benefit year and 1 Pair every 2 years; or 2 Pairs every 2 years if under age 19.

 

Travel Coverage - Policy #9429934

180 Days of Coverage

Trip Cancellation/Interruption Benefits
100% Coverage

$10,000 Combined Limit

Trip Cancellation: $5,000

Repatriation of mortal remains (maximum $7,500)

Trip Interruption: $5,000

  1. Pre-Paid Expenses
  2. Transportation Expenses

Trip Interruption: $250 per day

  1. Meals & Accomodation

Exclusions

Expenses incurred for injuries and/or illness as a result of the insured’s reckless behavior while on a trip, including international non-compliance with a prescribed treatment or therapy, or intentional misuse of medication or reckless disregard for their own health or safety while engaging in activities or treatment thereof, or accidents relating thereto.

This insurance does not cover any loos or expense related in whole or in part, directly or indirectly, to pre-existing conditions of an insured person, travel companion, immediate family member or key employee.

Baggage and Personal Effects Benefits
100% Coverage

$2,000 per family per Trip

$250 Deductible Applies

Loss of or Damage to Baggage and Personal Effects: $500 per trip subject to a maximum of $500 for any one item or set of items

Delay of Baggage and Personal Effects: $400 towards the replacement of the necessary toiletries and clothing

Prescription Replacement Service: $200 for the replacement of medically necessary prescription drugs that are lost, stolen or damaged.

Replacement of Travel Document: $200 towards the replacement of one or more of the Insured Person driver's license, passport, birth certificate or travel visa
 

Emergency Medical Services

Up to $2,000,000 lifetime maximum

Medical Expenses including physician, surgeon and specialists

Emergency Room and Hospital Expenses

Repatriation

 

Accident Coverage

Please email info@studentvip.ca for any claims regarding Accident Coverage.

What is an Accident?

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

Coverage Maximum $2,000 to $3,000

Accidental Dental Expense ($2,000)

Funeral Expense ($2,500)

Hospital Indemnity ($2,500)

Seat-Belt Indemnity ($3,000)

Coverage Maximum $5,000

Bereavement Expense

Day-Care Indemnity

Tutorial Fees Expense (Education Indemnity)

Coverage Maximum $10,000

Accident Reimbursement Expense

Brain Death Indemnity

Cosmetic Disfigurement Indemnity

Home Alteration and/or Vehicle Modification Expense

Death, Accident

Death, Natural Causes

Death, Suicide

Coverage Maximum $15,000

Family Transportation Expense

Occupational Training Expense

Rehabilitation Expense

Coverage Maximum $20,000 to 50,000

Repatriation Expense ($20,000)

Identification Expense ($50,000)

Accident Policy Brochure
 

VIP Preferred Provider PLUS+

Preferred Provider Plus are providers that are offering more than 20% discount for their services. In order to access the discount, please show the practitioner your StudentVIP plan card.

Preferred Provider

Please use our provider search tool to find contact information for Preferred Providers offering discounts of up to 19%. Remember to present your Student VIP card to access these savings.

 


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