If you are an undergraduate student at McGill from Quebec or another province in Canada, you are eligible for health insurance provided by the Student Association of McGill University (SSMU). The McGill Tribune reviewed SSMU’s health and dental plan, what it includes, how students can submit claims, and whether it can be combined with other private insurance plans.
What is the SSMU Health and Dental Plan?
SSMU offers health and dental insurance for all Canadian students which costs $345. This plan is administered by StudentCare, a health insurance broker for students in Canada, and provided by Desjardins Insurance, which also reimburses students for claims made. Even if a student is covered under a primary insurance plan through an employer or family member, SSMU’s insurance can be used as a secondary plan for more extensive coverage.
The SSMU plan for out-of-province and other domestic students is optional, but students default to enrollment for the academic year if enrolled in the fall semester. If a student decides they want to opt out of the plan, they can opt out through StudentCare during the Coverage Change and Withdrawal Period, typically from late August through late September.
However, students entering McGill in the winter semester are not enrolled in the default plan and must enroll for their winter semester before being automatically enrolled the following fall. For these students, coverage runs from January 1 to August 1. 31 and costs $230. Any student who wishes to add a dependent, such as a child or spouse, to their plan may do so during this period for an additional annual fee of $345 per person.
Although international students are primarily covered by the McGill International Health Insurance Plan, a mandatory plan administered by McGill, they are automatically enrolled in the EMSA Dental Plan. This is because the McGill plan does not cover dental care.
What does the scheme cover?
SSMU’s health insurance plan covers a wide range of medical needs outside of those covered by basic provincial health care provided in Canada. The plan covers most dental procedures with a maximum of $750 per person and includes travel insurance, which covers doctors, hospitals and other emergency services abroad for up to 120 days per trip. As for vision care, the plan provides $75 for glasses or contacts and $150 for laser eye surgery. Other benefits include partial reimbursement for the cost of mental health services and access to virtual healthcare through Dialogue, a telemedicine app.
How does SSMU decide what is included in the plan?
While SSMU works with StudentCare, SSMU’s Health and Dental Plan Committee determines what is included or excluded from the health care plan. In a statement to GrandstandSSMU Vice President (VP) Student Life Hassanatou Koulibaly explained that through StudentCare, the SSMU can view trends in insurance usage, allowing them to see what coverage would be best suited to the student population.
“By working with StudentCare, we are able to see where most needs are,” Koulibaly wrote. “Over the past two years, we have seen an increase in mental health consultations and use of mental health services, and with these trending recommendations [we] are able to meet these needs within the framework of the plan.
How to file a complaint?
Starting fall 2022, all mobile claims must be made through Omni, an application powered directly by Desjardins Insurance. Claims can also be submitted via the Desjardins web portal or by mail.
Previously, students had to submit a copy of their medical receipts and purchases to the StudentCare app. StudentCare, acting as an intermediary, then sent the claims to Desjardins Assurances, which reimbursed the students.
Jordan Marcus, U2 Science, is optimistic about this change. He found the previous process to be unnecessarily bureaucratic.
“The claims process is self-explanatory from the app,” Marcus said in an interview with the Grandstand. “[Before]sometimes I did not receive the money, and it was very difficult to contact someone who could help me [due to] several layers of obstruction.
Marcus explained that after making a claim through the discontinued StudentCare app and not receiving a refund, he had to contact StudentCare, who then had to contact Desjardins for the refund amount, which would later pass it on to him. Marcus hopes that by removing the middleman, Omni will speed up claims processing.