YFS Health & Dental Plan

 
 

The York Federation of Students offers a very comprehensive student health and dental plan in all of Canada. The plan covers extended health and dental insurance all at a low cost to you. Most full-time undergraduate students are automatically enrolled in the plan, however students should always check their Student Account Statement to confirm enrollment before seeking undergoing treatments or purchasing services and medications. If you have comparable insurance, you can coordinate your benefits or opt-out for a refund!

For more information about the health and dental plan contact: healthplan@yfs.ca

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Opt Out Schedule

 
 

Opt in/out date and deadlines for 2019/2020:

Fall Deadline: The deadline to opt out or opt in for fall semester is October 18, 2019.

To opt in, we only accept debit, certified cheque, or money order.

Winter Deadline: Students who did NOT enroll in Fall or Full-year courses and began in the Winter are eligible to opt-in/out during the Winter student deadline period January 1, 2020 - February 7, 2020.

Click below for detailed instructions on opting out.

Note: After completing the online opt out, you will receive an e-mail indicating that you completed the opt-out process including an application number. *If you do not receive an e-mail, it means that your application did not go through or was not successful. You will need to contact the Health & Dental Office prior to the deadline to inquire about why you did not receive an application number. Please take a look in your spam folder of the email account you used when completing the online opt-out form.

Keep that e-mail and wait until the November 18 statement. The plan fee will be reimbursed to your student account around two - three weeks after submission. If you have already paid the YFS Health & Dental Plan levy, you can Request a Refund online on the Student Financial Services page. If you have not yet paid the YFS Health & Dental Plan levy the amount will be reversed into your York University Student Account Statement.

This confirmation email does NOT guarantee you a refund. It simply means your application was successfully submitted to the insurance provider for review. If you do not receive a refund 2-3 weeks after you’ve submitted your opt-out application, it is likely your application came back declined and it is the student’s responsibility to get in contact with us to rectify the application. This must be done prior to the deadline date.

 

Your Benefits

 
 

To see a full listing of all your health and dental benefits, download the "My Benefits Plan" booklet

 
 
VISION CARE

$100/24 month based on first paid claim (Prescribed Glasses/Contacts)

EYE EXAM

$65/24 months based on first paid claim (Students who are 19 years or younger must use OHIP)

DENTAL

75 % up to a maximum of $600

 
PRESCRIPTION DRUGS

80 % up to a maximum of $1,000

NON-ORAL/ORAL CONTRACEPTIVES

Includes IUDs, the patch and Nuvaring

PARAMEDICAL SERVICES

The following professional visits below are $25 per visit up to $300 per benefit year.

  • Osteopathy
  • Dietician
  • Naturopathic care (remedies not included)
  • Speech Pathology (medical referral required)

The below services have increased as of last September to $50 per visit up to $600.

  • Physiotherapy
  • Acupuncture
  • Massage Therapy (medical referral required)
  • Psychologist
  • Chiropractic Care
 
ORTHOTICS

100% up to $200/24 month based on first paid claim (when prescribed by your attending physician, podiatrist or chiropodist)

CHIROPODY/PODIATRY (foot care)

$25 a visit, up to $300. Podiatry services are not eligible until the provincial health insurance plan (OHIP) annual maximums have been exhausted.

NOTE: A chiropodist is a specialist in treating minor ailments of the feet, including fitting patients for Orthotics. Chiropodists are not graduate physicians and their activity should be restricted entirely to the treatment of corns, ingrown toenails and other minor foot conditions.

COORDINATION OF BENEFITS

If you are covered for extended health and dental benefits under more than one plan, your benefits under this plan will be coordinated with the other plan so that you may be reimbursed up to 100% of the eligible expense incurred.

Claims must be submitted to the primary payor first. Any unpaid balances should then be submitted to the secondary plan(s).

As a Green Shield plan member, your student plan is always your primary plan. Submit your claims to Green Shield first and if you have a balance remaining, you may submit it to the secondary carrier(s) or benefit plan(s), if applicable, such as a parental plan.

FAQs

 
 
How much does this plan cost?

Full-Time Student Fee: Undergraduate students taking 15 or more credits between fall and winter semesters. $257.52 is charged per individual student for the 2019-2020 benefit year (please note that this is the total cost for 12 months of coverage). This is NOT a monthly rate.

Part-Time Student Fee: Undergraduate students taking 12 or fewer credits between fall and winter semesters. $650.40 is charged per individual student for the 2019-2020 benefit year (please note that this is the total cost for 12 months of coverage). This is NOT a monthly rate.

How can I add someone onto my plan?

To add family members onto your coverage, you need to come into the Member Services Office in room 336 First Student Centre to fill out a form and provide proof of your relationship with the dependent. For the purpose of the YFS Health & Dental Plan, dependents are defined as: children - biological, adopted/legal guardian under 24 and in school full-time.

The deadline for the fall semester is October 18, 2020. The deadline for the winter semester is February 7, 2020. You must wait until the beginning of the opt-in window in order to include dependents on the plan.

To add one or more dependent(s)/family, there is an additional amount to be paid on top of the INDIVIDUAL plan fee. Please see the pricing list below.

Full-Time Student Fees (cash/debit only):

  • $257.52 is charged to all students or to individual student who enrols manually.
  • $244.56 to add ONE dependent (note: this is in addition to $257.52 paid as a student)
  • $361.68 to add more than one dependent (note: this is in addition to $257.52 paid as a student)

Part-Time Student Fees (cash/debit only):

  • $650.40 is charged per individual student to enrol as a part-time student.
  • $636.60 to add ONE dependent (note: this is in addition to $650.40 paid as a student)
  • $951.12 to add more than ONE dependent (note: this is in addition to $650.40 paid as a student).

Documentation Required:

For Children:

  • Proof required, e.g. Birth Certificate, Canada Permanent Resident (PR) Card etc.

Spouse (includes common-law and same sex spouse):

  • Proof required, marriage certificate.

Other proof that is acceptable can be:

  • Notice of Assessment (NOA) from Revenue Canada for the previous year(s). 2018, 2017 etc.
  • Copy of Official documentation with both names (common), for example a lease dated three or more years prior to current benefit year 2019-2020 etc.

Important: If it is your first time adding a dependent onto your coverage, you must bring a copy of your documentation as we will retain it on file. Each academic year moving forward you will not have to provide that documentation, unless you are adding a new dependent.

Please note that each dependent receives the same amount of coverage such as same services and products.

Students must enroll their dependents and pay the appropriate fee each year if they wish to include their dependents onto their coverage. All dependents become inactive as of September 1, 2020!

Why is this plan mandatory?

When the health plan was first created, students voted for a mandatory system. The health plan is mandatory because the cost would be too great and the benefit too little. In an opt-out package, insurers are able to spread out the potential risk (i.e. the likelihood that they would have to pay the claim) amongst a large group of people, driving down the cost for everyone.

Who is eligible for coverage?

Full-Time Students:

All undergraduate students who are taking 15.0 credits or more from fall and winter semesters are eligible for the plan.

Part-Time Students:

Undergraduate students taking 12 or fewer credits between fall and winter semesters. Please enrol yourself and your dependants manually in Room 336 of the First Student Centre. Please see Question #2 for rates.

Glendon Students:

For more information, please visit Student Affairs, Glendon Campus at York Hall C114

Students with Dis/Ability:

Registered full-time (12 credits) and recognized by the Office with Disabilities as disabled are not automatically charged and need to enrol manually (prior to Opt-In deadline) at the YFS Health and Dental Plan office, which is located in room 336 of the First Student Centre. Please bring with you your letter of accommodation to complete your enrolment.

Students recognized by the Office with Disabilities as disabled and are enrolled in 15 or more credits between Fall and Winter semesters by August 17, 2019 will be automatically charged the YFS Health and Dental fee.

Graduating Students:

If you currently have less than 15 credits and also ready to graduate; please provide us with a transcript that verifies you have completed over 80 credits. Please come to enrol manually at the YFS Health and Dental Plan office, which is located in room 336 of the First Student Centre.

 
How am I charged for the plan?

Once you are enrolled into 15 or more credits the YFS Health and Dental Plan, the fee (levy or premium) will be automatically charged to your York University Student Account Statement ANNUALLY during the academic year. This will happen either on or between August 16, 2019 and September 16, 2019 for fall students.

For the winter term only, the charges will appear on your student account on December 14, 2019.

WINTER STUDENTS - PLEASE NOTE: Some winter students are not automatically enrolled in the YFS health and Dental Plan in the winter session. If you want to be enrolled and are enrolled in 9.0 or more credits; or you are in a different program like Transitional Year Program, Nursing etc. please come to enrol manually in Room 336 at the First Student Centre. If you have not been charged by December 14, 2019, you will need to manually enroll by February 7, 2020.

SUMMER STUDENTS: There is no enrollment in the summer session.

Please check the status of York University Student Account Statement online on the 16 of each month) to make sure that the charge is posted. It will read like this depending on the date: "20-Aug-2019 Adjustment Health Care & Dental - YFS $257.52". If you do not see this charge please visit the MSO, located in Room 336 at the First Student Centre, prior to the deadline, to request to be manually enrolled.

How can I cancel the plan?

The opt-out deadline is Friday, October 18, 2019.

If you have comparable coverage from your parents or work/other, you can opt out starting September 1, 2019 until October 18, 2019.

Winter Student ONLY opt-out starts on January 1, 2020 until February 7, 2020, please see "opt-out" link above.

After completing the online opt out, you will receive an e-mail confirmation including an application number. If you do not receive an e-mail confirmation, it means that it did not go through or was not successful. In this case, take a look in the spam folder of your email account used to complete the online opt-out form. Keep that e-mail until the November 16 statement or the 16 of each subsequent month “just in case”.

The plan fee will be reimbursed to your student account on or before November 16, 2019 and on or February 16, 2020 for winter students. If you have already paid the YFS Health & Dental Plan levy, you will receive a refund. If you have not yet paid the YFS Health & Dental Plan levy, the amount will be reversed into your York University Student Account Statement. All the opt-outs will be processed every couple of weeks for a refund/reversal into your student account.

For more information, please visit Student Financial Services. It will read like this depending on the date. "16-Sept-2019 Adjustment Health Care – YFS - Reversal -257.52". If a cheque is issued to you, it will read like this depending on the date. "16-Sept-2019 Cheque Issue Refund Cheque -257.52".

Do I need to opt-out every year?

The plan fee is charged every year. Therefore, unless you want to coordinate your benefits, you need to opt-out of the YFS Health & Dental Plan each academic year (August - April).

How do I make a claim?

All electronic/claims submitted to Green Shield require your Green Shield Identification number. Your identification number at Green Shield is: “YFS” + your student number –"00". eg. YFS123456789-00

Most prescription drugs and dental claims are made direct payments to the provider of services, where applicable; e.g. pharmacies or dental offices. If not, please submit an original itemized paid receipt from the service provider with a claim form for reimbursement at our office (106 Student Centre), Keele Campus.

Glendon College Students please submit all original receipts at Student Affairs at Glendon Campus at York Hall C114.

During the school year, you can mail all the claims to our office anytime:

Health Plan Coordinator, York Federation of Students 336 Student Centre, 4700 Keele St., York University, Toronto, ON, M3J 1P3.

Once you have filed a claim, a cheque will be mailed to the address you wrote on your claim form.

GET YOUR MONEY BACK FASTER:

Sign up for direct deposit. Simply register today for "Plan Member Online Services" (using your unique Green Shield Canada Identification Number) which is YFS+STUDENT#-(00) for Direct Deposit.

How to make sure your claim is included in the Health Plan?

This information can be found in the Benefits Booklet or by simply contacting Green Shield Canada directly to receive benefit eligibility information. NOTE: It is your responsibility to ensure you are aware if a service/treatment is covered by the plan prior to receiving the service.

Find answers about reaching your maximum for drug and dental coverage and receive your claim through Direct Deposit.

This information would be available on your electronic statements posted to your secure, personal Plan Member Online profile. Register here. Once registered, an access code will be emailed your email address entered in the Green Shield Canada system. Just register once and you will be connected anywhere and anytime.

 
When does the benefit year start & end?

YFS Health & Dental Plan benefit year always starts on September 1 and ends the following year on August 31 (for example, September 1, 2019 to August 31, 2020).

The pay direct "card-less" for prescription drugs and dental coverage and the booklet including the plan information will be available and activated with all providers on September 1, 2019.

When do we get a benefits card?

The YFS Health and Dental Plan is now card-less. All you need is the information below:

  • Benefit Provider: GREEN SHIELD CANADA
  • Student Plan Member ID: YFS + Student Number -00 (eg. YFS123456789-00)

DENTAL:

  • Group Policy/Plan No: 11111
  • Division/Section No: YFS
  • Employer: York Federation of Students
  • Certificate No/ I.D. No: Your Student Number

What does the plan cover?

For all information regarding what benefits the YFS Health and Dental plan covers, click here.

You need to pay the full amount for all extended health benefits and services/products for example, Osteopathy, Chiropractic Care, Naturopathic care (remedies not included), Physiotherapy, Acupuncture, and Massage Therapy, etc.