The Health & Dental Plan

Health and Dental Cards

Students beginning in September can get their cards as soon as the cards arrive at the GSS general office, usually mid- to late- October. Your coverage begins September 1st, but claims cannot be made until the enrolment list is final, so hang on to your receipts! Students starting in January can pick up their cards in mid February.

Contact the GSS by email: gsoc[at]uvic.ca or by phone: (250) 721-8816 for inquiries about enrolment, benefit coverage or claims problems.

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Opting Out

Only students with comparable alternate coverage may opt out of the health or dental plan.

 

The deadline to opt out depends on when you start your program. Students have until the last day of their first month of registration into a program to opt out of the extended health and dental plans. Following the first year of entry in a program, opt-outs need to be renewed every September until graduation.

Students who sign up with UVIC Accounting Services to pay their tuition in monthly installments need to opt out before September 15 to ensure their monthly tuition installments are calculated correctly.

Please visit the GSS General Office to fill an opt-out form and submit proof of having comparable alternate insurance coverage. Examples include:

  • Extended health and dental plan cards provided by your insurance company.
  • A letter from your insurance company on letterhead, explaining both Extended Health and Dental plans and including all relevant policy, group, or certificate numbers.

 

A letter from your employer on a company letterhead, outlining both Extended Health and Dental coverage, including the name of the insurance company and all relevant policy, group, or certificate numbers.

If you can’t make it to our office during business hours, in September an online opt-out option is available. You will need your plan information and your student number (V#) to fill out the form.

There is no online opt out option available for January start students.

Opt-outs are permitted within 30 days of a change of status. If you acquire new comparable alternate coverage at any point during the school year, come see us within 30 days of that change.

 

Family and Distance Student (Off Campus Student) Opt-In

Full-time distance students may opt-in to the plans during their first month of registration into a program (usually September, except for those starting in January).

All students who are covered by the plans may also add their family during this same opt-in period.

Distance students who wish to enrol both themselves and their families must complete both a distance opt-in AND a family opt-in.

Please visit our General Office to fill the Distance Student Opt-In Form and/or Family Opt-In Form, as appropriate, and pay the insurance premiums directly to the GSS.

 

Pacific Blue Cross

You may find more member information and download claim forms from the Pacific Blue Cross website. Check Blue Advantage for discounts on vision care and medical purchases and CARESnet for on-line access to claims and benefit information. For more information, see the Pacific Blue Cross frequently asked questions.

PBC recently expand on electronic claims submission funtionality and service providers can electronically bill PBC on behalf of their patients. 

I am an international student

As MSP has three-month waiting period, UVIC has endorsed AON Reed Stenhouse Inc. (AON) as the provider for emergency medical coverage (emergency is defined as an unexpected sickness or injury that requires immediate medical treatment to relieve existing danger to life or health) for international students during the BC MSP three-month waiting period. For detailed information, please click here.

For more information please see Tia’s advice on the importance of health insurance from the UVic Global Community Newsletter.

 

Students may file an appeal in regards to an opt-in, opt-out, or fee assessment related to the GSS health and dental insurance.  The Appeals Committee assess the validity of appeals on the basis of two criteria: administrative unfairness and/or extenuating personal circumstances.

Terms of Reference of the GSS Health and Dental Appeals Committee can be found in the GSS policy manual, section 20.9, page 38.

Guidelines for decisions of the Health and Dental Appeal Committee can be found here [PDF].

 

A student referendum directed the Graduate Students’ Society to establish an Extended Health and Dental Plan in 1999. Successive referendums have established the price and benefit levels of the plans. The plans are currently carried by Pacific Blue Cross, a non-profit insurance company. The benefit year is 12 months long, beginning September 1st each year and running through to August 31st. For new students beginning in January, a special pro-rated benefit year of 8 months is assessed. PLEASE NOTE: Just as with an employer provided plan, benefits roll over on the calendar year (December 31st). (For example, plan maximum of $250 for chiropractic services runs January 1st to December 31st).

For the best access to information on where your coverage stands, set up an account with CARESnet here: http://www.pac.bluecross.ca/members/member.html This will show you how much you and any dependents you have enrolled are eligible to claim today, when the benefit renews. You can also set up automatic deposit to your bank for claims that require mailing in receipts and access forms, print replacement cards and more.

Full coverage details are available via CARESnet. You can also pick up a benefit booklet, available at the GSS office.

The Extended Health Plan is tailored to meet the needs of graduate students. Beyond the basic health coverage of your provincial Medical Services Plan (MSP), your extended health plan provides coverage for many services including help with prescription drug costs, 60 days of out-of-country emergency medical coverage, vision and coverage for each eligible paramedical service (including physiotherapy, massage therapies, naturopathy, clinical psychology, and other services).

The Extended Health Plan does not replace the provincial MSP, nor do your GSS premiums cover your provincial MSP premiums. More information on BC MSP can be found at the BC MSP website. Further assistance with prescription drug costs may be available through the Pharmacare program, and the GSS recommends all students register for premium assistance and Fair Pharmacare to ensure you have maximum coverage. More information is available at https://pharmacare.moh.hnet.bc.ca/.

Insurance covers services of paramedical practitioners (i.e. massage, physio, chiropractor, accupuncture, etc) up to the reasonable and customary limit. The reasonably and customary limit is based on the current fee schedule for practitioners in BC, and indicates the maximum reimbursement you can expect from Blue Cross. The GSS strives to keep this list up to date. Current list of reasonable and customary limits is always available at http://www.pbchbs.com/pdf-bin/100/RCParamedTable.pdf.

In addition, currently, Pacific Blue Cross limits members to a 100-day supply of blood glucose test strips. Within that supply, members can order an unlimited number of test strips.

On January 1, 2015, Pacific Blue Cross will introduce a Reasonable and Customary Limit of 3,000 test strips per member per calendar year. Members who can prove medical necessity will be granted a larger supply.

Starting from January 1, 2015, Pacific Blue Cross is applying Reasonable and Customary Limits to certain high-cost specialty drugs where alternative government and/or patient assistance programs exist. Plan members will not be asked to pay out of pocket for these drugs. Costs will be offset by applicable assistance programs.

For example, if a pharmacy charges more than the Reasonable and Customary Limit for one of these drugs, it can either absorb the difference or obtain funding form the applicable assitance program. Members prescribed high-cost speciality drugs can also ask their physicians about supplemental coverage options.

Pacific BlueCross has launched pay-direct biling for extended health care providers in BC. Pay-direct makes it more convenient for members to claim for chiropractic, physiotherapy, acupuncture, naturopathy, podiatry, psychology, massage theory and vision care services. For detailed information, please refer to: http://www.pac.bluecross.ca/pdf-bin/benefitinsider/bi_SpringSummer2015.pdf

The Dental Plan provides 70% reimbursement on preventative and minor restorative dental services to a maximum of $750 per calendar year (Starting 2011 September). Please refer to the policy brochure (at the bottom of this page) for more details. We recommend that you seek pre-authorization before receiving any dental treatment valued at over $200.00.

Dental costs covered are also subject to the standard fee schedule. Please note that not all dentists charge the same rates. If cost is a concern, always ask your dentist if they charge according to the fee schedule and request a Pre-Approval from PBC.