SAMU - Online Forms

Student Health & Wellness!mystudentplan is a benefits plan for students and can provide coverage for prescription drugs, vision care, dental care, mental health counseling, and more. The plan is designed to supplement provincial health insurance and provide additional access to medical services.

Online Forms

Are you covered by a comparable plan? Do you wish to cover your dependents? Or have you opted out of the plan and wish to be re-enrolled? Eligible Students may submit their online forms.

Submitting Online Forms

Before submitting your online forms, please review the eligibility criteria and read the Terms and Conditions.

The winterwinter term deadline to submit online forms is January 31^st, 2024was January 31^st, 2024.

Opt-Out Application

Withdraw from the student benefits plan If you have coverage from a comparable Health and Dental Plan and do not wish to coordinate benefits.

Opt-Out Eligibility

Flex your Plan Application

Suit your Health and Dental needs by choosing one of the three flex plan options at no additional charge. All eligible students are automatically enrolled in the Balanced Plan.

Flex your Plan Eligibility

Family Add-On Application

Extend your student benefits plan to your dependents by purchasing coverage to provide them with the same Health and Dental benefits.

Family Add-On Eligibility

Re-enroll Application

Re-enroll in the student benefits plan if you previously opted out or lost your comparable insurance coverage and are still eligible for the plan.

Re-enroll Form

Online Forms Deadline
Submit your online Family Add-On, Opt-Out, or Opt-In applications by January 31^st, 2024

Plan Card Generator
Generate your Plan Card and use it where direct billing to Canada Life is available.

Prescription Search Tool
Find out if your prescription drugs are covered by the student plan.

Plan Claims
Learn more about submitting online or manual claims to Canada Life to get your refund.

SAMU Benefits Plan Office

Email: macewanplan@mystudentplan.ca
Phone: 780-497-4675
Address: 10850 - 104 Avenue NW
SAMU Building - SA-109A
Edmonton, AB. T5H 0S5

General Inquiries Line

Monday to Friday from 6:00am to 5:00pm MST

Phone: 1-877-746-5566 Ext. 7249

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