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 Benefits Card and have the dental office submit their claim electronically, or request a "Standard Dental Claim Form" in lieu of using this form.
Use this form to set up direct deposit and receive your drug, extended health, and vision claim reimbursements faster. Please email your completed form to lethbridge@medavie.bluecross.ca or mail it in to one of the addresses listed on the 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
If you have returned home from your trip and need to make a claim, please click here for more information.
Find all the details for your Health & Dental Benefits listed in this document. Travel Brochure Find the details of your 365 day travel coverage here.
Full benefit details can be found on the Blue Cross Portal
Use this form to enroll yourself and/or your family onto the ULSU Health & Dental benefits for the 2024-25 Year. Completed forms can be emailed to the ULSU Health Plan Office for processing.
This form is used for students requesting special authorization for a specific drug to be covered under the benefits. For students requesting a CNS Cap Removal, or Monitored Medication Request, please contact Student VIP directly. *Note that submission of this form does not guarantee your request will be granted.
Submit exception requests by sending as an "e-Claim" on the Blue Cross Member portal, or by mailing it to Medavie Blue Cross™ at 644 Main St., PO Box 220, Moncton, NB E1C 8L3 or by fax to 1-844-661-2640.
If you require a Proof of Coverage letter for outbound travel for either a travel visa, applications for government programs or proof for other reasons, please email info@studentvip.ca to request this.