December 31, 2014

Health & Dental Plans

About the APUS Health and Dental Plans

APUS provides affordable health and dental coverage to part-time students across all three campuses of the University. Depending on your registration, the plans provide extended health and dental coverage for up to 12 months, from September 1 to August 31 annually. The plans cover medical expenses that are not covered by provincial or other health insurance. The plans are supplementary to coverage under OHIP (Ontario Health Insurance Plan) or UHIP (University Health Insurance Plan), not a substitute. Through the health and dental plans, we do our best to provide coverage to address our members’ common health needs. Our health and dental plans are provided through Green Shield Canada, the only national not-for-profit insurance provider in Canada.

Click here for more information about OHIP.

Click here more information about UHIP.

 

 Rates and Terms of Coverage

  1. Coverage

Our coverage runs for up to one year (September 1 to August 31) maximum.

  • If you are registered for both the Fall and Winter sessions of the academic year, you are covered from September 1, 2016 to August 31, 2017.
  • If you are registered for solely the Fall session, you are covered from September 1, 2016 to February 28, 2017.
  • If you are registered for solely the Winter session, you are covered from March 1, 2017 to August 31, 2017.

*March 24, 2017 update: For students enrolled in the Winter semester – if you have encountered any difficulties accessing your coverage this month, please note that coverage activation was delayed due to a delay in accessing our membership information for the semester. However, your coverage is now active and you will be able to process claims dating back to March 1, 2017. If you have any questions or concerns, please contact services@apus.ca. 

  1. Rates

All APUS health and dental plan fees are automatically issued through your incidental fees. Please visit ROSI for a detailed summary. Please note that APUS does not currently collect health and dental fees during the summer session. Enrollment in the plan is based on registration in the Fall and Winter sessions only.

The premium rates per session for the 2016-2017 academic year are:

  • Health plan – $54.24
  • Dental plan – $45.25
  • Both Health and Dental plans – $99.49

 

  1. Family/Couple Coverage

APUS members can enroll a spouse/partner and/or children on their plans at the beginning of their first eligible term. All family members enrolled for coverage under this plan must be residents of Canada. The fall opt-in period is September 1-30, 2016.

To opt in your family members, please complete and submit the Family Opt-in Form and plan fees to APUS.

 

  1. Benefits

For complete details about your coverage, please access your Benefits Booklet for 2016-2017.

 

  1. Member Discounts

National Student Health Network Discounts

As members of the Canadian Federation of Students, our members have access to a series of health-related discounts. For details, click  here.

Dental Discount Network

Our insurance provider, Green Shield Canada, has created a network of dental providers who offer discounts to our members. You are not required to use a network dentist, but doing so can save you money. For details, check out the Student Discounts in the Association of Part-time Undergraduate Students’ page on the Green Shield Student Centre website here.

Optical Retailers

In addition, Green Shield has a discount arrangement with a number of optical retailers. For details, check out the Student Discounts in the Association of Part-time Undergraduate Students’ page on the Green Shield Student Centre website here.

 

  1. Claims

To use your APUS health and dental plans, you will need your Green Shield ID Number (or insurance policy number). This number is comprised of “APU”, your student number, and “-00” for the primary plan user (you). For example: APU999111222-00. For additional family members and dependents added on the plan, the suffix may be “-01” or “-02”.

Some health and dental providers may be able to submit claims electronically on your behalf. In this case, provide them with your policy number and they can send a claim to the insurance provider for the amount covered by the plan. You will then only need to pay the remaining balance upfront.

Otherwise, please complete one of the claim submission forms below, and you will be reimbursed appropriately by the insurance provider for amounts covered by the plans.

Claim Forms

Health Claim Submission Form

Dental Claim Submission Form

 

  1. Temporary Inactive Period – Lack of Coverage

If you are in first-year, returning from a leave of absence, or switching from full-time to part-time studies, or if you opted out of the APUS plan in the previous academic year, you will experience a temporary inactive period from September to November.

During this inactive period, our insurance provider processes new member information. Until this period ends, the insurance provider cannot process any claims and you cannot register for an online account. If you incur eligible expenses during this period, please keep the receipts for submission at the end of November. Remember that your coverage is backdated to September 1 of the plan year.

New for 2016-2017: APUS is working with Green Shield Canada to shorten the temporary inactive periods so you can access your coverage sooner. We hope to have coverage active as early as October.

 

  1. Opting In and Opting Out

Opting Out

APUS members may choose to opt out of the APUS coverage. In order to opt-out and receive a refund of your health and dental premiums, you must demonstrate proof of alternative coverage. This includes the name of your insurer and policy number. Students need only to apply for an opt-out refund once per academic year. Once a student leaves the plan, they can only rejoin the following academic year. Opt-out refunds are issued around March every year. Refunds are issued via cheques mailed to the student’s current address on file with ROSI/ACORN. Please ensure your address is up-to-date.

To opt-out of the plan, visit the Green Shield Canada Student Centre webpage here .

Opting In

APUS members who are seniors have the option of opting in to access APUS health and dental coverage. The opt-in period is the same as for opting out of the insurance plans.

To opt in as a senior student, please complete and submit the Senior Opt-in Form and plan fees to APUS. 

To opt in your family members, please complete and submit the Family Opt-in Form and plan fees to APUS.

 

  1. Travel Insurance

The APUS plan includes emergency travel insurance for 60 days. If you are leaving the country, please make sure to review your travel insurance information at the RSA Travel Insurance Inc. website.

Click here for details on the travel coverage.

Click here for the Medical Assistance Card.

 

  1. Questions and Assistance

To reach a Green Shield service representative, call 1-888-711-1119 for more information on specific coverage inquiries, remaining coverage, status of claims, or other queries. You can also visit the Green Shield website.

If you are told by the Green Shield Canada customer representative that you (or a family member) are not covered or you are denied benefits you believe you are eligible for, please contact the APUS Member Services Coordinator at services@apus.ca.

If you do not receive your opt-out refund by April 30, contact the APUS Member Services Coordinator at services@apus.ca

For other queries, contact the APUS Member Services Coordinator at services@apus.ca.

 

  1. Continuation of Benefits after coverage period ends

Graduating? As a recent member of the Canadian Federation of Students, you are eligible for individual extended health and dental benefit coverage through GSC. This benefit of Federation membership will provide access to life-long coverage at a substantially lower price. For more details, click here.

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