GSS Health & Dental Plans
**Note: The September 30 Health Plan opt out deadline has passed and the online opt out has closed***
Contents
Important health and dental info
Just a reminder that during September black out period, students will have to save receipts for submission in October. This is because until registration is finalized and the opt out/opt in period is closed, we don’t know which students are continuing on the plan. it is wise for students currently on the plan who have regular or expensive prescriptions to fill their September prescription at the end of August.
Note that claims for spending by those currently on to the plan up to August 31 2011 will still be processed during September’s black out period.
The GSS encourages members to create an on-line Blue Cross account with Caresnet, where you can print temporary cards, view your spending to date, check when items with annual maximums renew to the maximum amount again. Info on Caresnet is here.
Please notify the GSS if you are having problems with your account.
Grad Student Claim forms are available at the PBC website.
Please be aware, this is not the undergraduate plan, alumni plan, or UVIC staff plan. If you are NOT doing a Masters or PhD, please go here.
The Health and Dental Plan Coordinator is Ms. Mary Shi. She can be reached by phone: 250-721-8816 or by email: gsoc[at]uvic.ca.
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Form & booklet downloads
Who is assessed the fees?
All graduate students who are:
Registered in 3.0 or more ON-CAMPUS units in September or January
Registered as co-op students
Registered in an ON-CAMPUS thesis or dissertation
You will be assessed once per academic year (the academic year runs September-August). Students are not assessed in the Summer term, so students starting their program May-August are not assessed or covered by the plan until the following September.
Graduate students who live outside the Victoria area are usually registered in an OFF-CAMPUS section. Normally these sections are numbered 50 and 55.
OFF-CAMPUS (distance) students are not automatically included in the extended health or dental plans. If you have questions or concerns about the registration process, contact the Graduate Admissions and Records Office at (250) 472-4657.
Opting Out
Only students with alternate coverage may opt out of the health or dental plan.
The deadline to opt out depends on when you start your program each year. If you start in September, you are charged for the plan in September and your opt out deadline is September 30. If you start in January (or are charged in January because you were part time or off campus in the fall) your opt out deadline is January 31.
To be exempted from one or both of the GSS Extended Health and Dental plans, please visit the GSS General Office and provide us with proof of your equivalent alternative extended health and/or dental 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.
Your opt-out must be renewed each September.
Can’t make it to our office by the deadline?
From September 1 to 30 each year there is online opt out. You will need your plan information and your student number (V#) to fill out the form.
Family and Distance Student opt in
For students starting in September, the family or distance student opt in period is September 1 to 30. For students starting in January, the family or distance opt in period is January 1 – 31. Students renew their opt in each September.
Please fill out the GSS Family Health and Dental Opt In Form or the 2011-Distance student enrollment form(also available at the GSS General Office). Payment (cash or cheque) must accompany your form. Coverage expires each August 31, therefore must be renewed each year by the deadline. Monthly installment option is available, please consult the office.
Opt-in deadlines for Family and Distance students are:
September 30th for September-start students
January 31st for January-start students
Come see us within a month of registering in cases of late enrolment or within a month of any changes in your situation requiring late enrolment.
Pay for your opt in with monthly instalments
You may pay in monthly installments by automatic debit from your bank account. Payments are made on the 15th of each month, with a first payment being equivalent to two months fees (for September and October fees) withdrawn October 15, and each additional payment being 1/12 of the full annual cost withdrawn on the fifteenth of each month with a final payment August 15. Please contact the GSS Health Plan coordinator for details and exact pricing for your situation. Health-& Dental fees by Monthly instalments (form pdf).
Extended Health and Dental Plan Fees
Students pay health plan fees only once per school year, either in September or January, and this provides coverage until the next August 31. No fees are assessed in May–students beginning their program in May are not covered by the plan until they are assessed the following September.
September fees for the 2011-12 year:
Single (student) Fees in September (covering Sept 1, 2011 to August 31, 2012):
These fees are charged with your tuition.
Health: $ 328
Dental: $ 214
Additional Fees to opt in Family in September (in addition to single fees), or for Distance Students who are not charged with tuition to opt in to the plan:
These fees can be paid at the GSS office by September 30 if the student wishes to add their family. These fees include all family members.
Health $ 333
Dental $ 219
Single (student) Fees in January (charged with tuition)
January 2012 fees for January start students only:
These fees are charged with tuition for students who start in January.
Health: $ 219
Dental: $ 143
Additional Fees for Family in January, also in addition to single fees (and January-start Distance students only):
These fees can be paid at the GSS office by January 31 if the student wishes and ONLY if the student started in January.
Health $ 224
Dental $ 148
About the GSS health and dental coverage
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/.
What about travel?
The GSS Extended Health Plan includes 60 days of out of country emergency medical coverage. If you are travelling for the purposes of study, and the travel will extend beyond 60 days, please contact the GSS to learn about other free options for coverage. If you are travelling for pleasure (or non-school related travel) beyond 60 days, the GSS has negotiated a 20% discount on Blue Cross travel insurance packages for our members. Ask at the GSS office for details.
Practitioner Service Reasonable and Customary Limit
(For services rendered in 2011)
- Accupuncture: $100 (all visits)
- Chiropractor Services: initial visit $60, subsequent visit $45
- Massage therapy: $100.80 (all visits, effective Mar 1)
- Naturopath services: initial visit $240, subsequent visit $180
- Physiotherapy services: initial visit $74, subsequent visit $64
- Podiatry: $100 (all visits)
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.
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.
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.
I am already covered by BC MSP, isn’t this enough?
All BC residents (including international students) must be covered by BC Medical Services Plan and have a care card. Provincial MSP covers your visits to the doctor and emergency treatment in hospital. Students from out of province may opt to stay on their home province medical plan. We encourage all students to apply for premium assistance to lower their MSP premiums (fees).
Provincial medical coverage does NOT cover dental work, vision or pharmaceuticals, and is not considered alternative coverage for those wishing to opt out of the GSS plan.
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I moved here from another province and am on my home province medical
I am from out of Province … what about my home province medical coverage?
Students studying out of province can remain on their home province medical plan for the duration of their studies. Students are usually required to contact their provincial medical plan office and notify them of their plan to study out of province. Not all coverage is the same between provinces, and some services are not provided.
Information from:
[Alberta ] [Saskachewan ] [Manitoba] [Ontario] [ Quebec ] [New Brunswick ] [Nova Scotia] [ Newfoundland & Labrador ] [PEI] [ NWT ] [Yukon] [Nunavut]
Coverage on most out of province medical plan is subject to a reciprocal billing agreement between provinces. The Reciprocal Billing Agreement allows students to use their home province medical card at the doctor or hospital out of province. Quebec is not a signatory to the reciprocal billing agreement.
Some coverage provided at home may not be provided outside the province and the student will have to pay up front. In some cases these services can be reimbursed bythe home province. Information on coverage under reciprocal billing is difficult to find. Students are advised to ask their home province health isurance program if they have concerns. the Canadian Institute for Health Information provides the following summary of excluded coverage as of 2007:
“Services Excluded Under the Interprovincial
Reciprocal Billing Agreement
The following list of services were excluded under the interprovincial agreements
for the reciprocal processing of out-of-jurisdiction medical claims, effective April 1, 1988:
• Surgery for alteration of appearance (cosmetic surgery).
• Sex-reassignment surgery.
• Surgery for reversal of sterilization, contraception and sterilization procedures.
• Therapeutic abortions.
• Routine periodic health examinations.
• In-vitro fertilization, artificial insemination.
• Acupuncture, acupressure, transcutaneous electro-nerve stimulation (TENS),
moxibustion, biofeedback, hypnotherapy.
• Services to persons covered by other agencies: RCMP, Armed Forces, Workers’
Compensation Board, Department of Veterans Affairs, Correctional Services of Canada
(Federal penitentiaries).
• Services requested by a third party.
• Routine circumcision of newborn.
• Psychoanalysis.
• Psychiatric or physiatric team conferences when patient is not present.
• Polysomnograms.
• Procedures still in the experimental/developmental phase.
• Genetic screening and other genetic investigations, including DNA probes.
• Anaesthetic services and surgical assistant services associated with all of the foregoing.
Effective April 1, 1989, the following additions and deletions were made to the above list
of excluded services:
• “Surgery for reversal of sterilization, contraception and sterilization procedures” was
changed to “Surgery for reversal of sterilization”.
• “Routine periodic health examinations” was revised to “Routine periodic health
examinations including routine eye examinations”.
• “Routine circumcision of newborn” was removed.
• “Psychoanalysis” was removed.
• “Psychiatric or physiatric team conference when patient is not present” was changed
to “Team conference(s)”.
• “Polysomnograms” was removed.
In August 1991, further additions included:
• Lithotripsy for gall bladder stones.
• The treatment of port-wine stains on other than the face or neck, regardless
of the modality of treatment.”
Source: Canadian Institute for Health Information, Reciprocal Billing Report, Canada, 2004–2005, Revised August 2007
(Ottawa: CIHI, 2007). Retreived October 12, 2011 from: http://secure.cihi.ca/cihiweb/products/RB_report_2007_e.pdf
How are the health plan fees determined?
GSS Health and Dental plan fees are established by a referendum of all voting members of the GSS, after the GSS Executive has obtained quotes for various options in coverage. Fee referendums are usually held each Spring for the Health and Dental plan and determine plan cost and priorities.
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 on the web: http://gss.uvic.ca by email: gsoc[at]uvic.ca or by phone: (250) 721-8816 for inquiries about enrolment, benefit coverage or claims problems.
Need a Doctor, Dentist, Naturopath, etc
The GSS cannot recommend doctors, dentists or other practitioners. We strongly recommend you ask other students in your department for recommendations.
Find a doctor
Find a dentist
Apply for MSP
Find a naturopath
Low cost dental options:
Camosun College Dental Hygiene Clinic
Cool Aid Society
How much should I be charged for the dentist?
The BC Dental Association publishes an annual fee guide that states the standard charges for dental work. The fee guide is available at the Greater Victoria Public Library in the reference section, but you may wish to simply ask your dentist before a first appointment if their rates are those in the fee guide–some dentists charge more. Costs in excess of the standard fee guidelines may not be covered by your insurance.
Help with costs of pharmaceuticals:
For assistance with high drug costs, BC residents can apply for the income contingent Fair PharmaCare. We encourage everyone to apply for this program.
For assistance having PharmaCare cover drugs that are normally excluded by Fair Pharmacare because they are newly developed, not a normal part of treatment for your condition, or normally excluded by the Low Cost Alternative program, apply for Special Authority.
Blue Cross Advantage
Our membership with Pacific Blue Cross gives you access to a range of discounts from subscribed providers. Discounts include everything from laser eye surgery to legal advice. Check out the Blue advantage website.
The GSS has also negotiated a 20% travel insurance discount for members–perfect for when you are about to graduate and celebrate with a vacation! Use your group and ID number when purchasing to obtain the discount.
Is this my health and dental plan?
If you are not a UVIC graduate student, this is not your health and dental plan, please do not opt out here as it will cause you (and us) many problems! Undergraduates, please visit the UVSS page here to opt out or add family to the undergraduate health and dental plan.
UVIC Staff health coverage information is here.
How do I know if I am an undergraduate or graduate student?
If you are not pursuing a Masters degree or PhD (Doctorate) you are not a graduate student.
Other exceptional circumstances
If you are a graduate student who has not been charged for the plan because you are a visiting scholar, on exchange, awaiting acceptance, or are in a non-degree program, come speak to us about your options for health & dental coverage options.
