Coverage begins on September 1st of the current year and goes until August 31st of the following year.

If you are a full-time student, enrolled in 3.0 credits or more for the academic year (September to April) by the fall deadline, you will automatically qualify and be assessed the fees for Extended Health ($115) and Dental ($90) as part of your tuition. 

You must also be coverered by OHIP or an equivalent plan, such as UHIP (for international students).

Benefit cards can be picked up at the BUSU Health & Dental Plan Office.  Please be sure to have your Student ID with you.  The drug cards will not be activated until mid-October, after the Opt-Out process is completed.

RETURNING STUDENTS: Use same card from prior year.

Prescription Drugs and Extended Health Care combined maximum of $5,000/year per insured.

Emergency Out-of-Province/Canada coverage for a period of 60 days or less and a maximum of $1,000,000. 

Accident coverage - Maximum reimbursement of $10,000 for eligible medical expenses, $250 for air ambulance and $1,000 for dental expenses incurred resulting from one accident.

What is an accident?

"Accident" means an occurrence due to external, violent, sudden, fortuitous causes beyond the insured student's or dependent's control, which must occur while the student or dependent is insured under this policy.

You have two choices:

1.  By coordinating your benefits with another plan, you may increase your allowable maximum. Example: BUSU maximum allowable for Chiropractor - $200. Parental plan maximum allowable for Chiropractor - $300. Total annual allowable is now $500.   When coordinating your benefits using two plans you can, in most circumstances, increase your entitlement to 100% coverage.   Please note the BUSU Student Plan is the primary payor.

2.  If after reviewing your other plan and this plan, you feel that you do not wish to benefit by increasing your coverages you may opt-out by the yearly published deadline.  Please note: you may only opt-out if you have other equivalent coverage.  If you have equivalent coverage, you can choose to opt-out of either Health only, Dental only or Health & Dental.   If you do not opt-out by the yearly published deadline, then you will remain on the Health & Dental plans for the policy year.

For prescription drug claims, you simply present your Drug ID Card to your pharmacist. You will be responsible for 10% of the cost of the prescription. The pharmacist will deal directly with Green Shield Canada for the remaining 90%. Should the pharmacist encounter any problems when submitting a claim to Green Shield, ask the pharmacist to call Green Shield directly at 1-888-711-1119 for confirmation.

"BLACK-OUT" PERIOD":  The benefit cards are not active from September 1st until enrollment in the plan is confirmed.  This usually happens by mid-October, or when opt-outs are done being processed.  During this time, any prescription receipts should be submitted manually using the Claim for Health Benefits Form and brought to the Health & Dental Plan Office for reimbursement.  Also, any dental claims must be submitted manually.  For any dental appointments you have, please obtain a Standard Dental Claim Form from your dentist's office and submit it to the Health & Dental Plan Office for manual reimbursement.

Accidental Claims will be paid on a reimbursement basis and are to be sent through the Health & Dental Plan Co-ordinator's office. 

All other extended health claims (ie. chiropractor, massage therapy, etc.) must be submitted to the Health & Dental Plan Co-ordinator's office with a Claim for Health Benefits Form. Please ensure that your Student ID number and date of birth are shown on the claim form.

 IMPORTANT: To speed up claim service, you must attach ALL original receipts and ensure that the claim forms are completed in full. All claims must be submitted within 90 days of your termination date.

Manual Claims:

To make a manual dental claim, obtain a completed Standard Dental Claim Form from your dentist's office and submit it to the Health and Dental Plan Office.  Please be sure you sign in the appropriate spots and provide your policy information (found below).

Electronic Claims:

Your dentist can also send your dental claim electronically to:

RWAM Insurance Administrators Inc. (Carrier ID#610616)

Group Policy Number: 490007

Division Number: 001

Certificate Number: your Student ID #.

Yes.  You will be required to complete a Family Coverage Application and pay an additional fee/fees.  You can enroll your spouse/common-law and dependent children at the Health & Dental Plan Co-ordinator's Office.

The final date for enrolling in the family plan is September 19, 2008 for September enrolments and January 23, 2009 for 2nd term enrolments.

The fees for Health ($115) and Dental ($90) must be paid separately for accounting purposes. 

When an insured student applies for dependant coverage, special benefit cards will be printed with the insured students' name and dependants names on the back.  These take a little while to print and will be mailed out to the insured student once they are ready. 

Please note: Your dependents must be enrolled in the same plans as you are.  For example:  If you are enrolled in both the Health & Dental plans, then your dependents must be enrolled in both as well. 

A drug formulary is a list of eligible drugs that will be covered by the plan based on the following:

1. There is often a substantial difference in price for the same (i.e. chemically identical) drug depending on whether it is produced by the brand-name pharmaceutical company which developed the drug or by a generic manufacturer, and,

2. Within a therapeutic class (category) of drugs, there may be a number of different drugs which treat a particular medical situation. Therapeutic cross-selection serves the same function for a given medical situation at a lower cost.

Green Shield has developed the Managed Drug Formulary along with physicians and pharmacists. All medications were reviewed to determine their effectiveness and it was designed to provide the best possible care at the best possible price.

The pharmacies in your area have been notified that your plan is using the Student Managed Drug Formulary.

When you go to the pharmacy to purchase your drugs, simply present your Drug ID Card.  The pharmacist will be able to determine electronically through the Green Shield Network if the drug is covered. 

If the drug prescribed to you is not covered, the pharmacist will be able to check with your doctor, while you wait, to determine therapeutically equivalent drugs you can use that are covered.

If the drug you require is not covered and cannot be substituted, please contact the Health & Dental Plan Co-ordinator.

In the event that the therapeutic alternatives which are eligible under the Student Managed Drug Formulary prove to be ineffective for treating a particular situation, it is possible to have special case approval for a particular medication.

Please contact the Health & Dental Plan Co-ordinator's office for details of this procedure.

Yes! If you drop off your prescription at Health Services (located in Harrison Hall) by 3:00 pm, you can pick it up from 5:00 pm to 5:30 pm the same day at the Health Plan Office (located in the Alumni Students' Centre, Room 314).    

If you cannot pick it up the same day, you can pick it up on the next business day at the Health Plan Office during the same time. The service runs Monday to Friday.

Glenridge Pharmacy provides this service.  You may contact them if you have any questions about your prescription.

Contact information:

Glenridge Pharmacy

209 Glenridge Avenue

St. Catharines, ON  L2T 3J6

Neil Mendes, B.Pharm

Pharmacist / Owner

Telephone: 905-984-6345 

No! The beauty of your student health plan is that anyone, regardless of the state of your health, will allow you to have access to all the medical benefits as everyone else.

No one will be "turned away" from the opportunity to have their prescription medication covered.

The "Find a Practitioner" section on the Health & Dental Plan website (http://healthplan.busu.net) provides a list of all practitioners in the Niagara Region that will offer you discounted rates in addition to what your Health & Dental plan will reimburse you.

You can not only look up the name and address information, but review their fee schedules as well!

Note: Please remember that you are not limited to only these practitioners, you are free to go wherever you would like.

All practitioner benefits (like chiropractor, registered massage therapist, physiotherapist, etc) are paid at 80% up to $20/visit. 

The overall yearly maximum for each of the practitioner benefits is $200.

All insured students may apply for manual reimbursement for these benefits by submitting all original receipts and the completed Claim for Health Benefits Form to the Health & Dental Plan Office (location and mailing address on bottom of form).

Yes! Students that are covered under the Student Health Plan are automatically eligible for 60-Day worldwide travel benefits through GreenShield Travel Assist for coverage in Canada, the United States, and anywhere else in the world.

Please visit the Student Health Plan Office for your insurance documentation before you leave on your trip.

Please note that any vaccines that you may need (eg. Hepatitis A, Typhoid, etc) will be reimbursed from your student health plan at 90%.

You may download a copy of your Travel Assist brochure HERE.

Vision care was a benefit added to your health plan at no additional premium cost.

Vision care claims, which includes eye exam, prescription eyeglasses or contact lenses, will be reimbursed at 50% to a maximum of $100 per year.

All insured students may apply for manual reimbursement for these benefits by submitting all original receipts and the completed Claim for Health Benefits Form to the Health & Dental Plan Office (location and mailing address can be found on the bottom of the form).

You can pick up your reimbursement cheque for your health & dental claims 10 - 14 days after you have submitted your claim from the Health & Dental Plan Office.

NEW!

As the more efficient and environmentally friendly alternative, you can also apply for Electronic Deposit. 

The benefits of this option are:

• Quicker health and dental claim payouts
• Reimbursement monies are deposited right into your bank account
• Claim statements will be conveniently emailed to you
• No need to remember to pick up any cheques or paperwork

The benefit cards are not active from September 1st until enrollment in the plan is confirmed.  This usually happens by mid-October, or when opt-outs are done being processed. 

During this time, any prescription receipts should be submitted manually using the Claim for Health Benefits Form and brought to the Health & Dental Plan Office for reimbursement. 

Also, any dental claims must be submitted manually.  For any dental appointments you have, please obtain a Standard Dental Claim Form from your dentist's office and submit it to the Health & Dental Plan Office for manual reimbursement.