Health and Dental Plan Frequently Asked Questions (FAQs) – Graduate Student Association (GSA), University of Waterloo

By: Graduate Student Association  09-12-2011
Keywords: General Information, Health Coverage, Graduate Students

Health and Dental Plan Frequently Asked Questions (FAQs) – Graduate Student Association (GSA), University of Waterloo

The Federation of Students (FEDS) and the Graduate Student Association (GSA) implemented the FEDS and the GSA Dental Plans in September 2005. The Student Supplementary Health Plan, previously under the administration of the University of Waterloo, is now under the administration of the FEDS and the GSA.

The newly combined FEDS/GSA Health & Dental Plans came into effect Sept. 1, 2006 and provides increased dental coverage for graduate students and new vision care coverage for undergraduate students, compared to the previous plan. In addition, the Plan covers many important services not covered by basic health care (i.e. OHIP or UHIP), such as prescription drugs, travel health coverage, dental benefits, and more.

Your student associations are pleased to offer this valuable service and we hope 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 directly if you have any specific questions about your Plan.

Toll-free: 1 866 369-8794

On-campus Health and Dental Office: SLC 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 Health & Dental Plan is uniquely designed for you, providing a comprehensive package of health and dental benefits to fill the gaps left by provincial health care and a parent or spouse’s plan.

Who’s covered?

All full-time graduate students are automatically covered by the FEDS/GSA Health & Dental Plan and are charged the Plan fee on their fee statement. This includes International students. Effective January 2007, part-time graduate students are also automatically covered by both the Health and Dental Plans.

How much does the Plan cost?

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.)
  • Gardasil vaccination (as of 2007-2008)
  • dental checkups and cleanings
  • fillings, root canals, oral surgery, and more.

What are the Studentcare Networks?

To offer students even more coverage and to help you get the treatment you need, has set up networks of health-care professionals. Dental, Vision, 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.

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 Network member, you will get additional coverage.

What is the Blackout Period?

Claims processing is delayed during the first two months of the Fall Term while waits for complete enrolment lists, after opt outs and enrolments have been processed. During this time, you may submit claims, but reimbursement cheques will only be mailed once the Blackout Period ends. Practitioners and pharmacists can’t accept Pay Direct or assignment of benefits during the Blackout Period. Returning eligible students who were covered in a previous term will not experience a Blackout Period during the following term. All other students will have a Blackout Period during the first two months of the first term in which they enroll. For example, only new Fall Term students will experience a Blackout Period in 2007’s Fall Term.

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

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 enroll your spouse and/or dependents in the Health & Dental Plan.  If you start school in September, the Change-of-Coverage Period is from August 31,2010  – Oct. 1, 2010. The January Change-of-Coverage Period is from Jan. 3 – 21, 2011 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 enroll their spouse/dependents for coverage from Jan. 1 – Aug. 31, 2011. The May Change-of-Coverage Period is from May 3 – 22, 2011 and is only for new Spring Term students (students that were not registered as full-time students in the Fall or Winter Terms) who wish to opt out or enroll their spouse/dependents for coverage from May 1 – Aug. 31, 2011.

If you’re covered by another plan (i.e. parent or spouse’s employee benefit plan) you can combine this plan with the Health & Dental Plan to maximize your overall coverage and eliminate out-of-pocket costs. By doing so, you may be able to claim deductibles or co-payments that you would otherwise have had to pay. Alternately, 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.

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 Health & Dental Plan, will I need to opt out again next year?

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 by mail from or direct deposit if you had set this up.

How much will my refund be?

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.

Is there other financial aid for medical devices which are very expensive?

The coverage available under the Student Supplementary Health Plan should be used to co-ordinate with the government program to offset any remaining cost.

There is a gap period between my graduation and job start date. Is there any other program to keep my coverage until I start my job?

Yes! Discover Continuum. The Next Step in Your Health Care Coverage.

If you are finishing your studies in this term, your GSA Health & Dental Plan coverage will end at the end of this term. As you move on to the next stages of your life, it’s important to have a plan in place that will help you manage out-of-pocket expenses.

Where can I get more information?

Toll-free: 1 866 369-8794
In person: Health & Dental Plan Office – SLC 1121A

Keywords: Dental Plan, Dental Plans, General Information, Graduate Student Association, Graduate Students, Health Coverage, Student Health,

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