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McMaster Student Health and Dental Plan Accident Benefits for All Plans Travel for All Plans Student Wellness Programs for All Plans $600 Maximum Basic & Preventative Services
Minor Restorative
Extractions and Oral Surgery
Other
N/A |
McMaster Student Health and Dental Plan Accident Benefits for All Plans Travel for All Plans Student Wellness Programs for All Plans
N/A |
Part Time Opt In
Student Opt-In
Part Time/Graduate Student Opt-In
Choose Your Plan
Dependent Opt In
Family Opt In
Opt Out
80% co-insurance
Maximum: $2,500
Basic and Preventative: 80%
Minor Restorative: 50%
Extractions and Oral Surgery: 50%
Major Restorative: 10%
Maximum: $600
Paramedical Practitioners: 80%
Maximum: $300
One general eye exam during any 24 consecutive months
- $2,500 maximum
- Coverage Details:
- 80% coverage
- Drugs Covered:
- Most prescription drugs or medicines
- Insulin
- Insulin supplies under pseudo din #910333
- Allergy serums
- Preventative vaccines (excluding Hep B);
- Oral contraceptives and the patch (birth control);
- Nuva Ring (contraceptive), subject to a maximum of $178.00 per insured, per policy year;
- Mirena, Jaydess, Kyleena (IUD’s), subject to a maximum of $300.00 per Insured, per policy year;
- Over the counter drugs: Creams relating to yeast infections such as Canesten, Monistat, Gynecure; allergy medications such as Claritin, Reactine, Hismanal, Seldate
- These claims will be covered under the plan when submitted using a prescription drug claim form with all original receipts and a written or itemized receipt from a pharmacy.
- AIDS coverage
- The plan will pay up to $5,000.00 with respect to drug treatment for HIV positive or AIDS affected students. (Special authorization required)
- $600 Maximum
- Basic & Preventative Services
- 80% of one examination and consultation, including any necessary x-rays and diagnostic services at time of exam, during each policy year.
- 80% of one cleaning and one unit of polishing; includes up to 4 units of scaling (above the gum line)
- Fluoride treatments will be limited to one per policy year.
- Minor Restorative
- 50% of the cost of amalgam, silicate, composite or tooth-coloured fillings and space maintainers.
- Extractions and Oral Surgery
- 50% coverage of extractions and residual root removal including wisdom teeth(limit of two per policy year).
- Other
- Endodontics, Periodontics, and Major Restorative are covered at 10%.
- All benefits are covered at 80%, unless otherwise indicated
- Paramedical Practitioners
- 80% per treatment to a maximum of $300.00 each policy year for each type of practitioner listed below:
- Combined services a clinical psychologist, psychotherapist or speech therapist;
- Combined services of a naturopath or a chiropractor;
- Combined services of a podiatrist or chiropodist;
- Services of a registered dietician;
- Services of an osteopath;
- Services of an athletic therapist;
- Services of a physiotherapist, if recommended by a physician; Eff. Sept 1/19, this benefit will be a combined benefit that includes an occupational therapist, if recommended by a physician.
- Services of a massage therapist, if recommended by a physician;
- Services of an acupuncturist: Practitioners must be registered with: Transitional Council of the College of Traditional Chinese Medicine Practitioners and Acupuncturists of Ontario.
- Orthopedic Supplies
- Charges for molded arch supports, orthopedic supplies and custom made orthopedic shoes are covered at 80% to a maximum of $200.00, if recommended by a physician, podiatrist or chiropodist;
- Orthopedic supplies as noted above must be dispensed by one of the following providers: othotist, pedorthist, podiatrist or chiropodist.
- Orthopedic supplies must be dispensed by a different provider than the prescriber.
- Orthopedic supplies prescribed or dispensed by a chiropractor are not eligible.
- *When submitting your claim be sure to include the following: Your major medical expense claim form, referral pre-dating treatment, original paid in full invoice, gait analysis or biomechanical exam, a description of the raw materials used in the construction of the orthotic
- Ambulance
- Air or land ambulance service to the nearest hospital when an emergency requires immediate attention.
- Prosthetic Appliances
- Artificial limbs - lost, repair, and replacement
- Artificial eyes - one polishing or one re-making each year
- Casts, splints, trusses, braces or crutches, including replacements when medically necessary to a maximum of $300
- External breast prosthesis to a maximum of $200
- Medical Supplies
- Compound serums, colostomy supplies, injectable drugs and varicose vein injections, if medically necessary.
- Equipment Rental
- Charges for wheelchairs, walkers, hospital beds, traction kits which are rented for temporary therapeutic use. If, due to extended illness or disability, the need for these items will be long term, the Company, at its sole discretion, may approve the purchase of these items. Repair to a wheelchair will be included up to a lifetime maximum of $250.00.
- Other
- Oxygen, blood or blood products and the equipment required for its administration
- Treatment of a sickness by the use of radiotherapy or coagulotherapy
- Laboratory tests done in a commercial laboratory for diagnosis of a sickness but excluding any tests performed in a physician's office or a pharmacy.
- One eye exam every 24 consecutive month
- $100.00 maximum towards prescribed lenses and frames OR contact lenses every 24 consecutive months
- $200.00 should you be prescribed contact lenses for severe corneal astigmatism, severe corneal scarring, Keratoconus (Conical Cornea) or Aphakia. Please refer to your Student Health Plan booklet for further details.
- There is no provision for worldwide coverage for the Vision benefit as this plan only allows Canadian vision care providers
- Life Insurance
- A death occurring as a result of an accident will pay $7500.
- Accidental Medical Expense*
- Hospital charges
- Services of a nurse
- Services of a physiotherapist or chiropractor when recommended by a physician
- Services of a chiropodist, podiatrist, osteopath or speech therapist
- Transportation by an ambulance
- Medical equipment
- X-rays
- Miscellaneous expenses for crutches, casts, splints, trusses and braces (does not include dental braces, or expense of a brace or similar device used for non therapeutic purposes or used solely for the purpose of participation in sports or other leisure activities)
- *Refer to booklet for coverage maximums per expense
- Accidental Dental Expense
- Injury coverage to a maximum of $2,000.
- Emergency Taxi
- Licensed taxi covered to a maximum of $50.
- Rehabilitation
- Training for special occupation covered to a maximum of $5000.
- Repatriation
- Transportation of the body of the deceased to the city of residence, covered to a maximum of $2,000.
- Tutorial
- Tutorial services at $20/hour up to $2,000.
- Eyeglasses & Contact Lenses
- Eyeglasses and contact lenses repair, replacement and purchase to a maximum of $200.
- Home Modification & Vehicle Modification
- Alterations and modifications to your home and vehicle are covered to a maximum of $10,000.
- Hearing Aids
- Covered to a maximum of $3000.
- Wigs/Hairpieces
- Wig and hairpieces as a result of alopecia, radiation and/or chemotherapy are covered up to a maximum of $1,000.00 in total per policy year.
- Completed claim form must be filed directly to Industrial Alliance Insurance and Financial Services Inc. within 90 days from the date of the accident, and no later than 1 year.
- Travelling Outside of Canada
- When travelling outside of Canada you have Accident coverage limited to $10,000.00 as the result of any one accident:
- services and supplies rendered by a hospital while the Insured is confirmed as a resident in-patient in standard ward or semi-private accommodation
- services of a physician or anesthetist
- services of a nurse
- diagnostic x-ray examination by a physician
- transportation by a licensed ambulance: rental of crutches, splints, trusses or braces (excluding the expense of brace or similar device used for non-therapeutic purposes or used solely for the purpose of participating in sports or other leisure activities).
- Reimbursement under this provision shall not duplicate payment provided by any other part of the policy. Insurance commences on the date of departure of an Insured from the province of residence and terminates upon the date of return to the province of residence.
- Travelling Within Canada
- Emergency Taxi
- When injury necessitates immediate medical attention, the Company will pay the reasonable expense incurred for a licensed taxi to transport the Insured to either a physician’s office or the nearest hospital, subject to the maximum amount of $50.00 as the result of any one accident.
- Special Treatment Travel Expense
- If injury necessitates special medical treatment recommended by the attending physician and which cannot be obtained within a radius of 160 kilometers of the Insured's residence, the Company will pay the reasonable and necessary travel expenses actually incurred to obtain such treatment. Should the age of the Insured necessitate accompaniment by an escort, the Company will pay reasonable and necessary travel expenses actually incurred for the person who accompanies the Insured, plus ordinary living expenses up to $40.00 per day. The maximum amount payable under this provision is $1,000.00 for all such expenses.
- Supplemental Transportation Expense
- If, as a result of an injury, it is deemed necessary for the Insured to be transported to his regular scheduled classes and his residence by means of transportation other than that which would have normally been used by the Insured, had such injury not occurred, the Company will reimburse the Insured for the additional cost of such alternate transportation, subject to a maximum of $15.00 per day and payable up to 60 scheduled class days.
- STUDENT ASSISTANCE PROGRAM (SAP)
- The importance of self-care and a healthy balance in mental and physical well-being for students is extremely important today, especially for those arriving to join a new community, experience different environments and meet new peers. It often means facing challenges and dealing with new pressures. With this program, you are not alone. There are resources to find clinical support and assistance on your campus and in your community as well as coaching, tips, and tools available.
- Starting September 01 2024, the WeConnect Student Assistance Program (SAP) provides mental health and wellness services to students through our virtual platform (powered by Dialogue), available via the web or a mobile application.
- How do I access?
- Follow this link: https://app.dialogue.co/ or download the Dialogue application from the app store.
- Call 1-855-853-0565
- Services include:
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- Access is available 24/7 by phone or virtual resources, worldwide.
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- Care is immediate by connecting with the intake team and payment for counselling is not required
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- Time management and organization
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- Career development
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- Student-life balance
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- Personal growth and development
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- Dependent Care
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- Legal and Financial Support
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- Daily Living / Life Coaching
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- Mindfulness / Wellness Coaching