Menumenu button

myBenefits

For Flex benefits information, please click myBenefits at a Glance for details.



myBenefits at a Glance

The Student Benefits Flex Plan allows you to choose coverage to suit your needs. Below is a summary of the coverage options available. You have one opportunity each year during your enrolment period or on the anniversary of your first enrolment period to Flex your benefits however please note certain restrictions apply. Please see the Terms and Conditions section.

To Flex your benefits you must complete the FLEXible Enrolment or Re-Enrolment form and submit it prior to the applicable deadline. All eligible students are automatically enrolled in the Balanced Plan.

Click Here to select your FLEXible Benefits Plan option.

More questions about your FLEXible Benefits Plan see the FAQ's section

Please Note: Below is a summary of benefits. Click here for complete details.

Please scroll the table if the table content can not be seen


Balanced
Plan
FLEXible Drug & Parameds FLEXible Vision & Parameds FLEXible Dental 
Prescription Drugs 80% coverage
$3,000/benefit year
90% coverage
$3,000/benefit year
70% coverage
$3,000/benefit year
70% coverage
$3,000/benefit year
Vision
100% coverage
Eye Exams $60 / 24 months
Glasses / Contacts $100 / 24 months no coverage $150 / 24 months no coverage
Parameds 80% coverage
$20/visit
$300 / benefit year
80% coverage
$35/visit
$400 / benefit year 
 80% coverage
$50/visit
$500 / benefit year
 80% coverage
$20/visit
$300 / benefit year
Psychologist or Social Worker no per-visit limit
$300 / benefit year
no per-visit limit
$400 / benefit year
no per-visit limit
$500 / benefit year
no per-visit limit
$300 / benefit year
Dental $750 / benefit year $500 / benefit year $750 / benefit year $1,000/benefit year
Diagnostic & Preventative 80% coverage
12 month recall
80% coverage
6 month recall 
Minor Restorative 70% coverage 50% coverage 60% coverage 80% coverage
Oral Surgery 50% coverage 30% coverage 30% coverage 80% coverage
Periodontic 15% coverage
Endodontic 20% coverage
Included in All Options
Supplemental Health 80% coverage
Ambulance $250 per trip
Dental Accident $1000 per accident
Medical Service & Supplies Based on reasonable and customary
Emergency Travel $2,000,000 lifetime maximum
AD&D $5,000 for loss of life
Critical Illness $5,000 upon diagnosis of a covered illness or injury
Tutorial $15 / hour up to $2,000 / benefit year

Supplemental Health

Please Note: Below is information for the Balanced Plan. If you have chosen a Flex Plan option, please click myBenefits at a Glance button for details.





Ambulance
Your plan covers of 80% for licensed ground ambulance or emergency air service that transports the patient to the nearest hospital equipped to provide the required treatment when the physical condition of the patient prevents the use of another means of transportation. If the patient requires the services of a registered nurse during the flight, the services and return airfare for a registered nurse are covered.
Practitioners
Student benefits are payable after any Provincial Health Care benefits have been exhausted. This plan does not cover user fees. Student specific rates are available for some of the indicated services, information can be found in Select Savings. Practitioners must be registered and licensed in their field of practice.

The services of the following practitioners are covered at 80% up to $20 per visit to a maximum of $300 based on reasonable and customary charges, per practitioner, per benefit year.

• chiropractor, including one x-ray examination per benefit year
• registered massage therapist*
• naturopath
• osteopath, including one x-ray examination per benefit year
• physiotherapist*
• speech therapist*
• psychologist* or social worker*

*physician’s prescription/referral required for indicated services

Medical Equipment & Supplies
It is recommended that an application for pre-approval be submitted to the insurer for any item that would be claimed under the Medical Services & Supplies benefit.

Medical Equipment
Your plan covers 80% of reasonable and customary charges for eligible equipment when prescribed by a physician. Eligible durable equipment includes, but is not limited to, items such as:

• wheel chairs
• wheel chair repairs
• walkers
• hospital beds
• traction kits

Trusses, Crutches, Splints, and Braces
Your plan covers 80% of reasonable and customary charges when prescribed by a physician and are not solely for athletic use for braces, crutches, splints, and trusses.

Prosthesis
Your plan covers 80% of reasonable and customary charges when prescribed by a physician for artificial limbs or other prosthetic appliances.

Orthopaedics*
Your plan covers 80% up to a maximum of $150 per benefit year for custom-made orthopaedic shoes, repairs and modifications when required for the correction of deformity of the bones and muscles. Provided the orthopaedics are not solely for athletic use and are prescribed by a physician, podiatrist, chiropodist, or chiropractor.

*IMPORTANT It is strongly recommended that a pre-determination/estimate be submitted to Great-West Life to ensure that the guidelines set out by Great-West Life for the payment of Orthopaedics are met and to confirm that your claim would be eligible.
Dental Accident
IMPORTANT! Dental Accident Pre-determination: An estimate for all dental accident services MUST be submitted to the health plan insurer. If you go ahead with treatment without a pre-determination being approved, you are doing so at the risk of the expenses being yours.

The plan covers 80% of the cost of the services of a dental surgeon, limited to the fees provided in the current General Practitioners fee guide, including dental prosthesis, required for the treatment of a fractured jaw or accidental injuries to natural teeth or jaw if caused by external, violent and accidental means. Services must be performed within 12 months of the accident. Dental Accident benefits are payable through the Health plan and limited to $1,000 per accident.

Treatment must be completed within 12 months of the impact. If treatment is scheduled to occur more than 90 days after the impact, a treatment plan must be submitted to the insurer before the end of the 90 day period.

Prescription Drug

Please Note: Below is information for the Balanced Plan. If you have chosen a Flex Plan option, please click myBenefits at a Glance button for details.



Your drug plan covers 80% of the cost of most medications legally requiring a prescription to a maximum of $3,000 per benefit year.

The maximum amount payable to an eligible brand name drug will be limited to the lowest priced item in the appropriate generic category.

IMPORTANT! Advise your doctor and pharmacist that you are on the National Formulary.

The National Formulary is a specific list of drugs that are eligible for reimbursement under your drug benefit. Formularies are developed to ensure that prescription drugs are available on a cost-effective basis. It covers approximately 85% of the most frequently prescribed drugs. Formularies are reviewed regularly and as a result, updates are made on an ongoing basis.

Exception Process: In the event that the drugs covered are not effective in treating your condition, an exception process is in place. To be eligible for an exception, you must have tried one alternative drug listed on the Formulary. An exception drug request form is available below or from your Benefits Plan Office and must be completed by your physician. Completed forms may be returned to your Benefits Plan Office or can be faxed directly to the insurance company.

Request for Coverage of Exception Status Drug form

Vision

Please Note: Below is information for the Balanced Plan. If you have chosen a Flex Plan option, please click myBenefits at a Glance button for details.



Your plan covers 100% of the cost of eye examinations by an ophthalmologist or optometrist limited to one examination, in a 24 month period to a maximum of $60, based on reasonable and customary charges.

Your plan covers 100% of cost for the purchase of eyeglasses and/or contact lenses to a maximum of $100, once during a 24 month period, based on reasonable and customary charges.

Dental

Payment of dental benefits is based on the General Practitioners Dental Association suggested fee guide or the Insurance Reimbursement Rate set by the Canadian Life and Health Insurance Association Inc. (CLHIA) when a fee guide is not available. For services provided by a dental specialist, payment is based upon the General Practitioners Dental Association suggested fee guide.

Alternate Benefit - When there are two or more courses of treatment available to adequately correct a dental condition, reimbursement may be based on the cost of the least expensive treatment, which provides adequate care to the Insured.

IMPORTANT! Please submit a pre-determination/pre-authorization to the insurance carrier prior to treatment of specialist services and any treatment plan exceeding $500.

Please Note: Below is information for the Balanced Plan. If you have chosen a Flex Plan option, please click myBenefits at a Glance button for details.



Your plan covers up to a maximum of $750 per benefit year.



Diagnostic & Preventative
Your plan covers 80% of diagnostic and preventative procedures including:
• recall examination, 1 per benefit year
• initial or complete examination, once per dentist in a lifetime
• complete series of x-rays (not eligible for dependants under 12), up to 16 films including bitewings, 1 in any period of 36 months
• bitewings, not more than 4 films per benefit year
• panoramic, 1 in any period of 36 months
• polishing, 1 unit per benefit year
• scaling, 2 units per benefit year
• fluoride, under 19 years of age, 1 treatment per benefit year
• oral hygiene instruction, 1 treatment per lifetime
• pit and fissure sealants, under 19 years of age, 1 per molar in any period of 36 months
• anaesthesia, eligible when done in conjunction with a covered dental procedure
Minor Restorative
Your plan covers 70% for services associated with dental health restoration, including:
• space maintainers and maintenance, under 15 years of age
• amalgam and tooth coloured fillings, 1 per tooth in any period of 24 months
• stainless steel and plastic full coverage restorations, under 15 years of age, 1 per tooth in any period of 36 months
• recementation of existing restorations
• denture adjustments and repairs
• relining, rebasing and tissue conditioning, one treatment in any period of 36 months
Oral Surgery
Your plan covers 50% for services associated with surgical extractions, including:
• extractions, not more than 2 wisdom teeth per benefit year
• anaesthesia, eligible when done in conjunction with oral surgical procedures
Endodontic
Your plan covers 20% for endodontic services including:
• root canal therapy

Periodontic
Your plan covers 15% for periodontic services including:
• occlusal equilibration, not more than 4 units per benefit year
• periodontal appliances, not more than 1 appliance per arch in any period of 24 months
• periodontal appliance repairs, maintenance and adjustments, not more than 4 adjustments per benefit year
• oral surgical procedures
• anaesthesia, eligible when done in conjunction with oral surgical procedures

Other Insurances

Accidental Death & Dismemberment*
Your plan provides coverage for the loss of life or limb and for paralysis caused by an accident. The amount of your life benefit is $5,000. Please contact health and dental plan office for a complete schedule of losses.

Critical Illness*
Your plan provides coverage for a Critical Illness benefit of up to $5,000 which is paid upon diagnosis of a covered illness or injury and survival after 30 days, 365 days for paralysis and a 90 day waiting period for Cancer applies. This benefit is limited to students who are under age 65. For further details on this benefit, download your Critical Illness Brochure.

Tutorial*
Your plan covers 80% up to $15 per hour to a maximum of $2,000 per benefit year for private tutorial service if the student is confined to home or hospital for a minimum of 15 consecutive school days.

*Applicable to the Student only. Family members are not eligible for reimbursement of Accidental Death & Dismemberment, Critical Illness and Tutorial benefits.

Travel Insurance

Emergency Out of Country Travel Insurance
Your plan covers 100% up to a maximum of $2,000,000 per lifetime of medical expenses incurred as a result of a medical emergency arising while you are travelling outside Canada for vacation, business or education purposes. To qualify for benefits, you must be covered by the government health plan in your home province. For additional details on this benefit download your Global Medical Assistance Brochure.

Personal Health Risk Assessment

The Personal Health Risk Assessment can be used to create a health profile, build an action plan to support your health and wellness needs and track progress.
Watch a short video about Personal Health Risk Assessment.

Exclusions

Limitations and Exclusions to Extended Health Benefits
No benefit is payable for:
1) expenses for which benefits are payable under a Workers' Compensation Act or a similar statute;
2) expenses incurred due to intentionally self-inflicted injuries;
3) expenses incurred due to civil disorder or war, whether or not war was declared;
4) expenses for services and products, rendered or prescribed by a person who is ordinarily a resident in the patient's home or who is related to the patient by blood or marriage;
5) expenses for which benefits are payable under a government plan;
6) expenses for benefits which are legally prohibited by the government from coverage;
7) out-of-province expenses for medical treatment or surgery;
8) expenses for drugs which, in the insurer's opinion, are experimental;
9) expenses for dietary supplements, vitamins and infant foods;
10) expenses for contraceptives (other than oral);
11) expenses for smoking cessation aids;
12) expenses for drugs if they are used for the treatment of infertility;
13) expenses for the services of a homemaker;
14) expenses for items purchased solely for athletic use;
15) dental expenses, except those specifically provided under eligible expenses for treatment of accidental injuries to natural teeth;
16) utilization fees which are imposed by the Provincial Health Care Plan for the use of a service;
17) immunizations and vaccines (except Hepatitis B - DIN 749486 and DIN 1919431); or
18) any other exclusion identified in the policy contract.

Limitations and Exclusions to Dental Benefits
No benefit is payable for:
1) any cause for which the insured may apply for and receive protection, exemption or compensation under any Workers' Compensation Act;
2) self-inflicted injuries while sane or insane;
3) war, insurrection or hostilities of any kind, whether or not the insured was a participant in such actions;
4) participation in any riot or civil commotion;
5) committing or attempting to commit a criminal offence or provoking an assault;
6) any group or policyholder sponsored dental care or treatment;
7) any dental care, treatment or supplies primarily for cosmetic purposes;
8) failing to keep scheduled appointments;
9) file transfers, the completion of claim forms or other documentation;
10) any dental treatment for the correction of temporomandibular joint dysfunction;
11) expenses for treatment of root canal therapy started prior to becoming an insured member/dependant under this plan;
12) replacement of mislaid, lost or stolen appliances;
13) expenses for full mouth reconstructions for vertical dimension correction or to repair or restore teeth damaged or worn due to attrition or vertical wear or to restore occlusion;
14) any services or supplies for implantology, including tooth implantation and surgical insertion of fabricated implants;
15) any dental procedure which is not listed in the descriptions of dental benefits indicated herein;
16) charges that are in excess of the fees stated in the Dental Association General Dentist Fee Guide applicable to this benefit;
17) where coverage for services is provided under any government plan;
18) where services would be provided without charge in the absence of this policy; or
19) any other exclusions identified in the policy contract.

Service Members


Find a Practitioner