Health and Dental Plan
Frequently Asked Questions (FAQ)

Initiated by your student association, the FEDS Health & Dental Plan provides students with unique health and dental benefits. The Plan was designed by students for students to provide many important services and cover expenses not covered by basic health-care (i.e. OHIP or UHIP), such as prescription drugs, dental care, travel health coverage, vision care, and more.

Your student associations are pleased to offer this valuable service and we hope that you make the most out of it.
The following are some frequently asked questions (FAQ) to help you better understand the Health & Dental Plan. This FAQ is for general information purposes only. We recommend you contact www.ihaveaplan.ca directly if you have any specific questions about your Plan.

Online: www.ihaveaplan.ca

Toll-free: 1 866 369-8794

In person: Health & Dental Plan Office
Student Life Centre
Room 1121 A

Why a student Health & Dental Plan?

A growing number of important health-care services are not covered by provincial health care. For many students, paying for these services can lead to financial hardship, while others cannot afford them at all. To help students pay for the health services they need, a student health and dental plan has been put in place by your student association. To use the health benefits, you must be covered by provincial health-care coverage (such as OHIP) or the equivalent (such as UHIP for international students). The Plan offers affordable coverage tailored specifically to students and includes travel insurance and vaccinations, which are not typically covered under parental or spousal plans.

Plan members do not incur out-of-pocket costs for vaccinations or contraceptives prescribed and dispensed by UW Health Services.

Who's covered?

All full-time undergraduate students who are taking 3 or more on-campus courses are automatically covered by the FEDS Health & Dental Plan and are charged the Plan fee on their fee statement. This includes International students.

Part-time undergraduate students are not automatically covered by the Plan, but if they are taking at least one on-campus course, they may enrol themselves in the Health and/or Dental Plan during the Change-of-Coverage Period. To enrol, they must pay the FEDS membership fee. If you're not sure of your eligibility, please contact www.ihaveaplan.ca.

How much does the Plan cost?

If you are covered, the cost of the Plan is part of your FEDS administered fees.

For the exact Health and Dental Plan fees, please visit www.ihaveaplan.ca.

What does the Plan cover?

The Plan is a comprehensive package of health and dental benefits including:

• prescription drugs
• travel health coverage
• health practitioners (e.g. chiropractors, physiotherapists, massage therapists, etc.)
• dental checkups and cleanings
• fillings, root canals, oral surgery, and more.

Consult the Plan Booklet available at your student association's office at the beginning of the school year, visit www.ihaveaplan.ca, or go to the Health & Dental Plan Office (SLC 1121A) for more coverage details.

What are the Studentcare Provider Networks?

To offer students even more coverage and to help you get the treatment you need, www.ihaveaplan.ca has set up various networks of health-care professionals. Dental, Vision, Massage Therapy, Physiotherapy, and Chiropractic Network members offer an additional reduction over and above any amount covered by the Health & Dental Plan.

Students can combine their coverage with the Studentcare Network reductions, enabling them to have up to 100% of their health and dental costs covered.

As some practice information may change throughout the year, we recommend you visit the Health-Care Networks section of www.ihaveaplan.ca for an updated list of Network members.

Do I have to see a Network practitioner in order to receive my Health & Dental Plan coverage?

No. The Networks are in place to help students further reduce the overall costs of services, beyond the insured portion of the Health & Dental Plan coverage. You're covered for the insured portion regardless of the health professional you choose. However, by consulting a Studentcare Health-Care Network member, you will get additional coverage.

How do I claim my benefits?

You can download a Pay-Direct Card at www.ihaveaplan.ca or pick one up at the Health & Dental Plan Office and use it for Prescription Drug claims. By presenting the Pay-Direct Card with your valid student ID, you can fill your prescriptions at most Canadian pharmacies and receive 80% off the price cost of prescriptions at the time of purchase. There is a deductible for each prescription, refill, or vaccination of 20% or $15, whichever is less. The Plan also covers the entire dispensing fee, up to $8 per prescription. The pharmacist will be able to process the claim immediately, so you won't have to pay the full amount up front and wait to be reimbursed.

For vision and other health claims (including prescription drugs if you don't use the Pay-Direct Card), you will be responsible for payment when the service is rendered. You can then complete and sign an extended Health-Care Claim Form, attach any necessary receipts and/or documents, and mail them to the insurance company (Sun Life) for reimbursement.

For dental claims, you must complete the claim form with your dentist. Some dental offices can do an electronic submission; in this case, you will only be required to pay for the uninsured portion of the service. Other dental offices will have you pay the full fee for all services and then file the claim for reimbursement. Both you and your dentist must complete the dental claim form.

Claim forms are available at www.ihaveaplan.ca and at the Health & Dental Plan Office. Photocopies of blank claim forms may also be used. Please note that you must attach the original receipt for each expense claimed and keep photocopies for your records.

If I'm covered by the Plan, can I enrol my family?

Yes. The Health & Dental Plan gives you the option to enrol your family (spouse and/or dependants) by completing an enrolment process and by paying an additional fee, over and above your fee as a member of your student association. Common law and same-sex couples are eligible. All enrolments must be completed within the Change-of-Coverage Period (see below) and are for a full-year of coverage (for Fall enrolments). Only new Winter Term students may enrol their spouse/dependants during the January Change-of-Coverage Period (Winter coverage is pro-rated for 8 months). Visit www.ihaveaplan.ca for fees and details.

What is the Change-of-Coverage Period?

The Change-of-Coverage Period is the period at the beginning of the Term when you can either opt out or enrol your spouse and/or dependants in the Health & Dental Plan.

If you start school in September, the Change-of-Coverage Period is from Sept. 1 - Oct. 2, 2009. The January Change-of-Coverage Period is from Jan. 4 - 22, 2010 and is only for new Winter Term students (students that were not registered as full-time students in the Fall Term) who wish to opt out or enrol their spouse/dependants for coverage from Jan. 1 - Aug. 31, 2010.

Students who complete their opt out in September, who return as eligible students in 2010-2011, and who still do not wish to have coverage will only have to renew their opt out at www.ihaveaplan.ca in September 2010.

Covered by Another Plan? Weigh the Costs and Benefits.

Your Student Health & Dental Plan May Provide Better Value: A parent or a spouse's employee benefit plan usually requires your family member to pay additional costs to have you covered.

You can combine the FEDS Plan with another plan to maximize your overall coverage-up to 100%-and eliminate out-of-pocket costs.

If you are thinking about a Co-op work term or exchange abroad, you can take advantage of the Plan's travel coverage, which is specifically designed to cover you while away.

Alternatively, if you wish to opt out of the Health & Dental Plan, you can do so during the Change-of-Coverage Period and you will be reimbursed for the Plan fee.

Visit www.ihaveaplan.ca and follow the on-screen instructions for opting out.

Please note that if it is your first time opting out of the health portion of the Plan, you will have to provide proof of other equivalent health coverage. You can opt out of the Dental Plan without submitting proof of coverage. If you request a complete opt out from the FEDS/GSA Health & Dental Plan, but do not provide proof of other equivalent health coverage before the deadline, you will only be opted out of the FEDS/GSA Dental Plan and will remain covered by the FEDS/GSA Health Plan.

If you are experiencing difficulties opting out, please call 1 866 369-8794.

Do I need to opt out of the Health & Dental Plans each term?

No. If you opt out, your opt out is in effect for the whole policy year, from Sept. 1 through Aug. 31 of the following year (or Jan. 1 through Aug. 31 for new Winter Term students who opt out of the Plan in January). All students enrolled in the Fall Term must opt out during the September Change-of-Coverage Period.
If I opt out of the FEDS Health & Dental Plan, will I need to opt out again next year?

Opt outs are valid for the whole policy year, from Sept. 1 through Aug. 31 of the following year (or Jan. 1 - Aug. 31 for new Winter Term students who opt out of the Plan in January). If you return as an eligible student in following years, you'll be automatically re-enrolled in the Health & Dental Plan. Should you wish to opt out again next year, you must renew your opt out directly through www.ihaveaplan.ca during the Change-of-Coverage Period. If you'll be opting out of the Health portion of the Plan again, you won't have to re-submit your proof of other coverage.

If I opt out, how will I get my refund?

You're responsible for paying all university fees within the prescribed deadlines. If you don't pay the FEDS/GSA Plan fee, you may be assessed late fees and interest. We recommend that you pay all university fees even if you are opting out of the FEDS/GSA Health & Dental Plan. After your opt out is completed and shortly after the end of the Change-of-Coverage Period, you will receive a cheque for the amount of the Health and/or Dental Plan mailed to you by www.ihaveaplan.ca.

You will still be assessed the Plan fee in subsequent Academic Terms. However, you will not have to opt out again during this policy year - if you return as an eligible student in 2010-2011 and still do not wish to have coverage, you will have to renew your opt out directly through www.ihaveaplan.ca in September 2010. You will receive a reimbursement cheque each Term that you are assessed the Health & Dental Plan fee for the policy year.

How much will my refund be?

For the exact health and dental plan fees, please visit www.ihaveaplan.ca.

Why do I have to opt out if I don't want coverage? Why can't I just sign up for health and dental insurance on an individual basis?

Individual insurance plans have always been available for purchase. These plans suffer from several drawbacks.

• They're very expensive - up to 5 times the cost of the Health & Dental Plan;
• They discriminate by sex and age;
• They exclude individuals with pre-existing illnesses (people who need a plan the most).

As a result, individual health and dental plans aren't a real solution. Experience shows that only group insurance programs can meet students' health and dental needs at a reasonable cost. A student health and dental plan is a collective investment to ensure a minimum standard of health care for the student body.

Where can I get more information?

For more information, consult the Plan Booklet or visit the Health & Dental Plan office. A complete description of benefits, as well as claim forms, and more detailed information on how to opt out or enrol your spouse/dependants are available at www.ihaveaplan.ca.

Toll-free: 1 866 369-8794

In person: Health & Dental Plan Office
Student Life Centre
Room 1121 A