Faculty and Staff

Supplementary Health Care: Support Staff

The following plan details apply to all eligible support staff.

Reimbursement for claims will be based on the reasonable and customary costs for each type of practitioner. Please contact Sun Life for specific reimbursement levels.

If you require information on a product or service that is not listed below please contact Sun Life Customer Care Centre at 1-800-361-6212 or via email at askus@sunlife.com.  Coverage details can be found by logging into your Sunlife web access and viewing coverage information.

The following services noted with a * below (e.g., Acupuncture/Acupressure, Chiropractor, Naturopath, Physiotherapy, Podiatrist/Chiropodist, and Speech Therapy) incurred after January 1, 2013 have a combined annual maximum of $2500 per year per eligible person. Within the combined annual maximum the amount allowable for each practitioner per insured is $1000 per year.

Service

Coverage

 Accidental Dental
  •  Accidental injury to natural teeth only
  • Services performed within 6 months of accident
Acupuncture/Acupressure (performed by a registered Acupuncutrist) *
  • 100% of reasonable and customary costs included in the combined annual maximum of $2500, to a limit of $1000 per year per covered person 
  • Practitioner registration number must be provided in order for the claim to be considered for reimbursement
Ambulance
  • Professional ambulance services for Medically Necessary transportation in a licensed ground and/or air ambulance to the nearest Hospital able to provide the Medically Necessary services.

Athletic Therapy
  • 100% of reasonable and customary costs included in the practitioners’ combined costs to an annual maximum of $2,500 per year, to a limit of $1,000 per practitioner per year per eligible person
  • Practitioner registration number must be provided in order for the claim to be considered for reimbursement
Chiropractic Treatment *
  • 100% of reasonable and customary costs included in the combined annual maximum of $2500, to a limit of $1000 per year per covered person
  • Practitioner registration number must be provided in order for the claim to be considered for reimbursement
Diagnostic Tests
  • x-rays
  • laboratory tests
Hearing Exam

  •  Exam is covered if hearing aid purchased

 

Home Nursing (R.N., L.P.N. or R.N.A. only)
  • services do not include those of a custodial nature

  • pre-approval by Sun Life required

  • Practitioner registration number must be provided in order for the claim to be considered for reimbursement
Hospital Accommodation
  • semi-private or private room
Naturopath *
  • 100% of reasonable and customary costs included in the combined annual maximum of $2500, to a limit of $1000 per year per covered person
  • Practitioner registration number must be provided in order for the claim to be considered for reimbursement
  • Accepted Practitioner: AANP - Alberta Association of Naturopathic Practitioners
  • Consultation only - NOT remedies
Occupational Therapy
  • $1000 per person per year
Physiotherapy *    
  • 100% of reasonable and customary costs included in the combined annual maximum of $2500, to a limit of $1000 per year per covered person
  • Practitioner registration number must be provided in order for the claim to be considered for reimbursement
Podiatrist/Chiropodist *    
  • 100% of reasonable and customary costs included in the combined annual maximum of $2500, to a limit of $1000 per year per covered person - includes both visits and surgery
  • Practitioner registration number must be provided in order for the claim to be considered for reimbursement
Psycho-Educational Assessments

Access through Homewood Health Inc. (100% coverage)

Assessments are limited to children listed as dependents under the member's Supplementary Health Care plan. (aged 6-16 yrs)

To arrange an assessment, please contact Homewood Health directly at (780) 428-7587.

Psychological Counselling

Access through Homewood Health Inc.

See Employee and Family Assistance Program

Residential Treatment Programs

  • A physician referral is required,
  • Coverage is for inpatient fees associated with a residential treatment program for addictions, eating disorders, mental illness or other injury/illness requiring short term residential treatment.
  • Services must require the specific skills of a licensed health care practitioner and must not be custodial in nature. This coverage includes Government, non-government and  subsidized facilities as long as they are recognized as a treatment facility.
  • The maximum period of time available per disability is 180 consecutive days.
  • programs for alcohol, drug, gambling and other recognized addictions
  • 50% of cost per covered person to a lifetime payable limit of $5000 per person for the specified rehabilitation types combined.
Speech Therapy *
  • 100% of reasonable and customary costs included in the combined annual maximum of $2500, to a limit of $1000 per year per covered person

  • Practitioner registration number must be provided in order for the claim to be considered for reimbursement

Vision Exam See Vision Care 

Product

Coverage

Allergy Test, Supplies and Vaccines 100%
Artificial Limbs / Prosthesis 100%
Birth Control Devices (IUD) 100%
Continuous Glucose Monitoring receivers, sensors and transmitters that are required to operate the Continuous Glucose Monitor receiver

90% of Reasonable and Customary Charges to a maximum of $4,000 per eligible covered person per year for a person who has been diagnosed by a Physician as having Type 1 diabetes

CPAP Monitor (Constant Positive Airway Pressure) $2000 every 5 years
CPAP Replacement Supplies

Once every 12 months

Glucoscan, Glucometer, Supplies 50% of reasonable and customary charge to a $500 maximum per Insured every five (5) years
Glasses, Contacts and Laser Eye Surgery See Vision Care
Hearing Aids and Repairs

$2000 per ear per person every 5 years

Hospital Bed (manual) 100%
Inhalers/Inhalators 100%
Insulin Infusion Pump

50% of Reasonable and Customary Charges to a maximum of $1,000 per eligible covered person per every 5 years

Mammary Prosthesis and Support Garments
  • following cancer treatment or traumatic injury
  • maximum reimbursement of $500 per year per covered person

Orthopaedic Shoes and Orthotic Inserts

2 custom pairs of orthopaedic inserts @ $500 per pair per person every benefit year

Requires:

  • prescription by physician
  • list of raw materials used
  • explanation of casting techniques

1 pair of orthopaedic shoes per person per calendar year

Requires:

  • prescription by physician
  • list of raw materials used
  • explanation of casting techniques
Ostomy Supplies 100%
Oxygen Administration Equipment 100%
Peak Flow Meter (severe asthma) 100%
Prescription Drugs See Prescription Drugs
Respirator 100%
Splints, Trusses, Braces, Crutches and Casts 100% - Brace requires prescription by physician
Tens Unit 50% of reasonable and customary charge to a $500 maximum per Insured every five (5) years
Vaccinations required for out- of country travel 100%
Walker 100%
Wheelchair and Repairs
(purchase or rental)
100%
  • Pre-approval by Sun Life required
Wigs & Hairpieces
  • following cancer treatment or as a result of medical conditions that result in total baldness
  • maximum reimbursement of $600 per year per covered person


Information on this website is only a summary of the Support Staff Supplementary Health Care Plan Policy and not an official description of the plan. If there is a conflict between the plan text and the website, the plan text will prevail.

The Supplementary Health Care Plan covers you and your dependents for eligible expenses including paramedical practitioners, charges for prescription drugs and vision care which are not covered by the Provincial Health Care Insurance Plan. In some instances, the Plan supplements coverage provided under the Provincial Health Care Insurance Plan. Benefits are only payable for expenses which are medically necessary.

The University supplementary health coverage is provided through Sun Life. Claims for reimbursement of expenses are typically submitted in the following two ways:

  1. Completing a paper form or
  2. Online submission of claims through Sun Life Member Services

Visit the Making a Claim page to learn more. Reimbursement of eligible expenses will be based on reasonable and customary charges for the service in the area in which you reside.

Co-ordination of Benefits

There are certain rules that govern the reimbursement of claims when both you and your spouse have benefit coverage with your respective employers. Visit the Co-ordination of Benefits page to learn more.

There are additional considerations when you or your spouse begin coverage under the Alberta Blue Cross Seniors Program. Upon 65th birthday of you or your spouse all medical services must be submitted to Alberta Blue Cross Senior’s program for determination as to whether any portion of the cost will be eligible for reimbursement under their plan. After expenses have been adjudicated by Alberta Blue Cross, you are then in a position to submit any residual amount to Sun Life for reimbursement.

In the case of prescription medication, it may be possible for the pharmacist to electronically submit the claim under both Alberta Blue Cross and your Sun Life plan provided by the University of Alberta. If the pharmacist is unable to submit electronically under both plans it will be necessary to complete an Extended Health Claim Form. Send the completed form along with the receipt from the pharmacy for the portion of the prescription unpaid by Alberta Blue Cross and submit to the Sun Life for reimbursement.