Student Health and Wellness

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Student Health and Wellness! mystudentplan provides health, prescriptions, dental, mental health care plus additional benefits for eligible students.

Eligibility Criteria

All domestic, indigenous, government-sponsored and international students who meet the following criteria are automatically enrolled in the Student Benefits Plan and do not need to apply for coverage.

Students who are members of the TMGSU - Toronto Metropolitan Graduate Students' Union and meet the following eligibility criteria are automatically assessed the TMGSU Health Plan Fall GS on their tuition.

You are eligible if:

You are admitted to an eligible full-time graduate program at Toronto Metropolitan University; and

You reside in Canada and study in person or online.

Eligible students who are 70 years old or over do not qualify for the Accidental Death and Dismemberment Insurance.

Enrollment Confirmation

Review your student account statement and search for TMGSU Health Plan Fall GS to confirm you are covered by the Student Benefits Plan.

How to find the fees

Please note: Depending on your eligibility, you will see this charge either in your Fall or Winter Term tuition fee.

Still unsure if you are eligible and enrolled? Contact the Benefits Plan Office at healthplan@tmgsu.ca before any applicable deadlines.

Opting-In to the Plan

Part-time graduate students are not automatically enrolled in the plan but may elect to opt-in to the Student Benefits Plan. if you are a part-time graduate student and wish to be enrolled, you must apply to opt-in before the applicable term deadline.

Opt-In Information

Student Benefits Plan

The Student Benefits Plan covers supplementary health and dental services not covered by Provincial Health Care and Medical Travel Insurance.

There are additional coverages included in your Student Benefits Plan such as Emergency Travel Assistance, Dental Accident, Tutorial Insurance and Accidental Death and Dismemberment.

If you opt out of the Health Plan, you will also opt out of the additional coverages.

Coverage Period

Coverage begins the first day of the month in which your program begins. You cannot carry forward any unused coverage.

Period Details

The following is the period during which the Student Benefits Plan protects you.

Term/Semester	Effective Date	Termination Date
Fall	September 1^st	August 31^st
Winter	January 1^st	August 31^st

Fall Students: If you change your eligibility status from the fall to the winter semester, the coverage period ends on December 31^st.

Termination Date

Coverage ends on Agust 31^st. You can submit online claims for receipts up to and including this date.

Validation Period

There is a 45-day validation period from the start of the term for new enrollments. During this time, you pay out of pocket for all eligible expenses and keep the receipts to submit your claims once the validation period is complete.

Mandatory Fees

The TMGSU Health Plan Fall GS is automatically assessed to all eligible students. A student referendum approved the Student Benefits Plan fees which are an admission requirement.

Consult the Toronto Metropolitan University's fees

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Coordination of Benefits

If you are an eligible student on the Student Benefits Plan and are covered by another benefits plan under your parents, spouse, government, job, or band, you can make these plans work together to obtain up to 100% of coverage.

There are two scenarios where coordination of benefits comes into effect. In each case, one plan pays first (the primary payor), and one plan pays second (the secondary payer).

Scenario 1: You are covered under a parent's or spouse's plan as a dependent. The primary payor is the Student Benefits Plan and the second payor is the other benefits plan.
Scenario 2: You are covered under your employer, government or band's benefits plan. The primary payor is the one you have had the longest.

Send your claim to the first plan on the list (primary payor). After your claim has been processed, if there are any unpaid amounts, submit a claim to the next plan on the list (secondary).

Learn more!

How to identify your primary insurance

If a student is eligible for the Student Health and Dental plan and the student is covered by another plan under a parent's or spouse's as a dependent, the primary insurance is the Student Health and Dental Plan.

Example:

Students who have Health or Dental coverage through their school: these plans will always pay before any plan where the student is covered as a dependent.

The Student Health and Dental plan pays first.

If a student is eligible for the Student Health and Dental plan and the student is covered by another plan under job, government, or band the primary insurance is the one you have had the longest.

Example:

Students who have Health and Dental coverage through their employer: the student needs to confirm the effective date of all insurances to determine which plan has been in effect the longest.

The plan you have had the longest pays first.

Submitting Claims

After you have identified which is your primary and secondary insurance, submit the claim to your primary insurance first. Once you receive the Explanation of Benefits, you can then submit the remaining unpaid portion to your secondary insurance.

Examples:

Student Health and Dental Plan as Primary Insurance.

Submit the claim to your Student Benefits Plan (GSC Everywhere App). Once processed, submit any portion that remains unpaid to your secondary insurance plan.

Student Health and Dental Plan as Secondary Insurance.

If you have an alternative insurance plan that you are also the primary holder of, and that has been in effect longer than your Student Benefits Plan, all eligible claims will be submitted to your alternative plan first. Once the claim is processed, submit any portion that remains unpaid to your Student Benefits Plan.

Submitting Claims for Your Spouse (if applicable).

Submit the claim to your spouse's primary plan first. Next, any unpaid portion can be submitted to your Student Benefits Plan.

Submitting Claims for a Dependent Child (if applicable).

Submit the claim to the parent's plan whose birthday falls first in the year (this is their primary benefit plan). Next, any unpaid portion can be submitted to the parent's plan whose birthday falls second in the year.

Important notes:

Take a copy of your original receipt before you send it to your primary plan as you will need to send a copy to the secondary plan.
Include a copy of the Explanation of Benefits statement received from the first claim submission (primary plan), as well as a photocopy of the originally submitted receipt when you submit to your secondary plan.

Non-Eligible Students

My personal insurance solutions fit the needs of students who are not eligible for the Student Benefits Plan and need Health and Dental benefits. You can find options at cost-effective rates, including options that do not require medical questionnaires or exams to qualify for coverage.

There are three scenarios where you can consider purchasing personal insurance solutions:

I don't qualify for the Student Benefits Plan: I am not eligible for the Student Benefits Plan and want information on purchasing personal insurance. This option also applies to students who missed the applicable re-enroll or opt-in deadline.
I am losing my Student Benefits Plan: I am graduating or leaving school and want information on purchasing personal insurance.
I want to cover my dependents: I missed the deadline to add family members to my Student Benefits Plan and want information on purchasing personal insurance for my family.

The personal insurance solutions are offered in partnership with Canada Life through their Freedom to Choose™ individual insurance products.

Let's get started!

Winter Deadline
Submit your online Family Add-On, Opt-Out, or Opt-In applications by February 7^th, 2025

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

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

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Benefits Plan Office

Email: healthplan@tmgsu.ca
Address: 55 Gould Street, Student Centre (SCC) lobby.
Toronto, Ontario M5B 1E9, CA

General Inquiries Line

Monday to Friday
from 8:00am to 8:00pm EST
Phone: 1-877-746-5566