News, SSMU, The Tribune Explains

Tribune Explains: SSMU health and dental insurance

If you are an undergraduate student at McGill from Quebec or another province in Canada, you are eligible for health insurance provided through the Students’ Society of McGill University (SSMU). The McGill Tribune looked into 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 that 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 by a primary insurance plan under an employer or family member, SSMU’s insurance can be used as a secondary plan for more extensive coverage. 

The SSMU plan for in-province and other domestic students is optional, but students are enrolled by default for the academic year if they are registered in the fall semester. Should a student decide they want to opt out of the plan, they can withdraw through StudentCare during the change-of-coverage and opt-out period, typically from late August to late September. 

Students entering McGill in the winter semester, however, are not enrolled for the plan by default and must opt in for their winter semester before being automatically enrolled the next fall. For these students, the coverage extends from Jan. 1–Aug. 31 and costs $230. Any student who wishes to add a dependent, such as a child or spouse, to their plan can do so during this period for an extra 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 registered for SSMU’s dental plan. This is because the McGill plan does not cover dental care. 

What does the plan cover? 

SSMU’s health insurance plan covers a vast scope of medical needs outside of those covered by the basic provincial healthcare provided in Canada. The plan covers most dental procedures with a maximum of $750 per person and includes travel insurance, which covers physicians, hospitals, and other emergency services abroad for up to 120 days per trip. As for vision care, the plan provides $75 for eyeglasses 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 collaborates with StudentCare, the SSMU Health and Dental Plan Committee determines what is included or excluded from the health care plan. In a statement to the Tribune, SSMU vice-president (VP) Student Life Hassanatou Koulibaly explained that through StudentCare, SSMU can consult trends in insurance usage, which allows them to see what coverage would best serve the student population.

“Working with StudentCare, we are able to see where most needs are,” Koulibaly wrote. “Over the past year or two, we have seen an increase in mental health consultations and usage of mental health services, and with these trend recommendations [we] are able to address these needs within the plan.” 

How does one file a claim? 

Starting in Fall 2022, all mobile claims should be made through Omni, an app powered directly by Desjardins Insurance. Claims can also be submitted through 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 claims to Desjardins Insurance, which would reimburse students. 

Jordan Marcus, U2 Science, is hopeful about this change. He found the previous process to be unnecessarily bureaucratic. 

“The claim process is self-explanatory from the app,” Marcus said in an interview with the Tribune. “[Before], sometimes I wouldn’t receive the money, and it was very hard to contact someone who could help [due to] multiple layers of obstruction.”  

Marcus explained that after making a claim through the discontinued StudentCare app and not receiving a reimbursement, he had to contact StudentCare, who then had to contact Desjardins for the reimbursement amount, who would later forward it to him. Marcus hopes that by cutting out the middleman, Omni will make claim processing quicker.

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