What does student health insurance usually cover?
The exact benefits depend on the policy.
However, a student health plan may provide coverage beyond what the provincial health plan offers.
Common benefits can include:
_ Prescription medication
_ Dental treatment
_ Vision care
_ Eye examinations
_ Physiotherapy
_ Mental-health services
_ Counseling
_ Medical supplies
_ Ambulance services
_ Emergency medical treatment
_ Specialist services
_ Travel medical coverage
Do not assume all of these are included.
Insurance policies have limits.
For example, a plan might cover prescription drugs at 80 percent rather than 100 percent.
Another policy may provide a maximum annual amount for dental care.
A third may cover emergency treatment abroad only up to a specified limit.
That is why the phrase “I have health insurance” does not tell you much by itself.
The better question is:
1. What exactly does my plan pay for, and what are the limits?
2. What is usually not covered?
Many student insurance policies have exclusions.
Depending on the plan, you may have limited or no coverage for:
* Cosmetic procedures
* Pre-existing conditions
* Certain elective treatments
* Some dental procedures
* Certain prescription medications
* Treatment obtained outside the approved network
* Travel-related expenses
* Medical care outside Canada
* Services exceeding policy limits
The exclusions differ from one policy to another.
So, Read the policy booklet before assuming that something is covered.
A common mistake is to read only the benefits page and ignore the exclusions.
The exclusions can be just as important.
Why dental care deserves special attention
Dental treatment can become an unexpected expense for students.
Public provincial health insurance generally does not function as comprehensive dental insurance for adults.
The Canadian government’s health-insurance guidance specifically identifies dental services among expenses that may not be covered by provincial health plans.
Suppose you arrive in Canada with a dental problem and assume that your provincial health card will pay for treatment.
You could be surprised.
Your school plan may provide some dental coverage, but it may have:
1. Annual limits
2. Waiting periods
3. Eligible-treatment lists
4. Percentage reimbursement
5. Student eligibility conditions
If dental coverage matters to you, check the details before you arrive.
What about prescription medication?
Prescription medication is another area where students need to read the fine print.
A provincial health card does not automatically mean your prescriptions are free.
Alberta, for example, explicitly notes that AHCIP does not cover prescription drugs as part of its basic health coverage.
A student health plan may provide prescription coverage instead.
Suppose your medication costs CAD $100 per month.
If your student plan covers 80 percent up to a certain annual maximum, your actual out-of-pocket cost will depend on those limits.
This is why students who regularly take prescription medication should check:
• Whether the medication is eligible
• Whether the plan requires a generic alternative
• The reimbursement percentage
• The annual maximum
• Whether prior authorization is needed
• Whether the medication is available in Canada
If you take medication regularly, speak with your healthcare provider before traveling.
Does health insurance cover mental-health services?
Many student plans provide some mental-health benefits, but coverage varies.
This can include:
1. Counseling
2. Psychotherapy
3. Mental-health assessments
4. Student wellness services
5. Certain prescription medications
Your university may also have free or low-cost counseling services available to students.
Do not assume that every private therapist or clinic is covered by your insurance.
Check whether the provider must be registered under a particular professional designation and whether the plan has a maximum amount per visit or per year.
What happens if you get sick before your insurance starts?
This is one of the most important questions to ask before leaving your home country.
Your provincial or school coverage may not necessarily begin the moment your plane lands.
The start date can depend on the province, school and plan.
For that reason, some students purchase temporary private medical insurance for the period between arrival and the start of their regular student coverage.
Alberta, for example, advises students who are not eligible for AHCIP to arrange other health insurance before arriving.
The exact approach depends on your destination.
Ask your school:
“What date does my student health insurance become active?”
Then ask:
“What coverage should I have between my arrival date and that start date?”
Those two questions can be more valuable than simply searching for the cheapest insurance policy.