For Medical Professionals or Billing Agencies only

What is UHIP?

UHIP stands for University Health Insurance Plan. UHIP offers basic health care for eligible international non-residents studying or working at a participating Ontario universities.

The difference between UHIP and OHIP

OHIP provides basic medical health insurance for permanent residents of Ontario and is funded by provincial taxes, whereas UHIP provides similar coverage for international non-residents studying or working at an Ontario university. UHIP is a non-profit plan funded through member premiums. It is similar, though not equivalent, to OHIP.

For example, Unlike OHIP+, UHIP does not provide coverage for prescription drugs to students under age 25.

UHIP Services

The plan provides medical services and supplies that OHIP covers for Ontario residents. These include:

  • In-patient and out-patient hospital services.
  • Physician services.
  • Lab and diagnostic testing.
  • Home care services.
  • Some other specific programs available to an Ontario resident by the Ministry of Health and Long Term Care (for example, Assistive Devices Program (ADP)).

Physician services that need pre-approval (except in an emergency)

  1. Elective in-patient and out-patient surgery (for example, rotator cuff surgery) or treatment (for example, cancer, inpatient/outpatient psychiatric program).
  2. Medically necessary MRIs and CAT scans or referrals to a surgeon don’t need preauthorization.

UHIP reimbursement rate

UHIP reimburses at 125% of the OHIP Schedule of Benefits.

Joining the Sun Life Preferred Provider Network (PPN)

Please email Sun Life at case.mgmt@sunlife.com if you would like to join.

Keep in mind:

  • PPN providers must direct bill Sun Life for UHIP members.
  • The maximum rate of reimbursement is 125% of the OHIP Schedule of Benefits.
  • The clinic name will appear on the Sun Life Preferred Provider Network website.

Checking UHIP eligibility

You can instantly confirm if your patient is eligible by using the Sun Life Eligibility Tool.
UHIP members must show their UHIP card to their health care provider. Please directly bill members who don’t show you their card.
When billing members directly, you must include the following on the receipt or claim form:

  • OHIP code(s).
  • Diagnosis or diagnosis code.
  • Cost of service.

What information is on a UHIP Member ID card?

  • Member ID: You’ll need this for billing.
  • Policy number: You’ll need this for billing.
  • Effective date: start date of UHIP coverage.
  • Termination date: end date of UHIP coverage.
  • Dependant information: lists the eligible dependants covered under UHIP.
Keep in mind:
  • Some universities enroll member and dependants separately on 2 different records.
  • Dependants will be enrolled with a member ID that starts with an alpha prefix of ‘DP’.
  • In these cases, the members and dependants will each have their own UHIP coverage card.
  • You need to see the dependant name on a coverage card to ensure eligibility.
    coverage card

Two ways to submit your bill to UHIP

  1. Complete a claim form
  2. Create an invoice and mail it to Sun Life Financial at:
    Sun Life Assurance Company of Canada
    Claims Department
    PO BOX 2015 STN Waterloo
    Waterloo, ON N2J 0B1
When billing UHIP, you must include the following:
Provider information Service information Claimant/member information
  • Clinic name and address.
  • Payee name and address.
  • Physician’s full name, designation and CSPO Number.
  • Diagnosis or diagnosis code.
  • Date of service.
  • OHIP fee code(s).
  • Cost of service.1
  • Policy # 050150.
  • UHIP member ID.
  • First and last name.
  • Date of birth.

When and how you are reimbursed

Sun Life will mail you a cheque and explanation of benefits within 7 days of receiving the completed UHIP claim form/bill.
If you prefer direct deposit (electronic fund transfer):

Questions about your submitted claim?

Please call 1-855-301-4786 and follow the prompts.
When asked for the member contract number, enter the pound key (#) 3 times to reach a representative.


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Footnotes:
1Cost of service: UHIP reimburses up to a maximum of 125% of the OHIP Schedule of Benefits. For example, the OHIP reimbursement rate for A007 is $33.70. The charge should be $42.13 or less on the UHIP Claim Form or bill.

The information presented on this website summarizes the main aspects of UHIP. Your actual benefits from UHIP will be determined according to the terms and conditions of the insurance contract with the UHIP insurer. No typographical or mechanical error made by a university or any of the parties to the UHIP insurance contract will invalidate insurance otherwise in force, or continue insurance otherwise terminated under the insurance policy's terms and conditions.
UHIP Registered © University Health Insurance Plan - All rights reserved
Sun Life Assurance Company of Canada is the insurer and a member of the Sun Life Financial group of companies