Frequently Asked Questions
If you cannot find the answer to your question here, please contact us!
|Full-time, part-time, ESL & non-degree students||Your University will enroll you in UHIP. They will charge the cost to your student accounts.|
|Employee/short-term visitor||You need to complete a UHIP application form. Take your form in person to the UHIP office at the University.|
If your dependants are with you while you study or work in Ontario, they must get UHIP coverage.
- Physically and or mentally challenged.
- Cardiac issue.
- Undergoing cancer treatment.
- Temporomandibular Joint Disorder.
- Corrective jaw surgery.
- Reconstructive surgery.
- Cyst removal.
- Temporomandibular Joint (TMJ) surgery.
- Bone grafting.
If you think you may require dental surgery in hospital, please email firstname.lastname@example.org for preauthorization.
TIP: Also check with your University Plan Administrator since you may have dental coverage from your supplemental health plan at the University.
TIP: access the Preferred Provider Network to find labs and diagnostic centres that accept UHIP.
Keep in mind:
- Physician charges at up to 125% of the Ontario Health Insurance Plan (OHIP) Schedule of Benefits.
- We use same criteria and conditions as OHIP for covering genetic testing. This requires paperwork from a physician or genetics counselor. If your hospital asks for payment upfront, Sun Life will reimburse eligible expenses. Please contact email@example.com if you have any questions about this expense.
- Your newborn baby may be eligible for OHIP, which is the basic provincial insurance in Ontario. The hospital will provide you with forms to apply. It is your responsibility to complete this information as soon as possible. Otherwise, you will receive a bill. Please contact your local ServiceOntario for more details about OHIP.
- If your baby is not eligible for OHIP, add them as a dependent to your UHIP policy as soon as you can. Please contact your University Administrator to purchase UHIP for the baby. Give your baby’s new UHIP member ID to the hospital billing office.
UHIP will cover medically necessary vaccinations up to 125% of the OHIP Schedule of Benefits.
UHIP doesn’t cover the HPV vaccine and the seasonal influenza vaccine (flu shot). However, UHIP will cover the cost of the administration of the vaccine at UHIP rates.
TIP: Your extended health care plan through your University may cover the vaccine cost. Please contact your University for more details.
The conditions for coverage are:
- You have valid UHIP coverage at the time.
- A physican deems the ambulance service is medically necessary.
- Sun Life considers the service reasonable (at Sun Life’s discretion).
- Your ambulance trip starts and ends in Ontario.
TIP: Your extended health care plan through your University may cover the remaining balance of $45.
UHIP doesn’t cover homecare through CCAC (Community Care Access Centre) or the LHIN (Local Health Integration Network).
If you require homecare services, please contact firstname.lastname@example.org.
UHIP uses the same criteria as OHIP (Ontario’s provincial health plan) to determine eligibility for physiotherapy.
If you had an injury/illness that resulted in a hospital admission, you may be eligible for physiotherapy.
If you think you may be eligible based on the description below please contact email@example.com to request a preauthorization.
|Type of injury requiring physiotherapy||Age 19 to 64||Age 18 and under or over age 65|
|Non-complex injury or surgery that did not require in-patient stay (for example, ACL repair, arthroscopy, rotator cuff surgery).||Not eligible for physiotherapy.||Eligible for private physiotherapy. Maximum coverage of $312.|
|Complex injury or surgery or neurological injury that required an overnight stay in hospital (for example, knee or hip replacement or stroke).||Eligible for hospital physiotherapy and private physiotherapy clinic. Maximum coverage of $312.||Eligible for hospital physiotherapy and private physiotherapy clinic. Maximum coverage of $312.|
TIP: Your extended health care plan through your University may offer some coverage for physiotherapy.
- Services not currently provided by OHIP, changes to OHIP will not be adopted unless approved by the UHIP Steering Committee.
- Physician and hospital charges above those set out in the group policy.
- Charges incurred by a covered person for which he/she is entitled to obtain benefits or reimbursement under any other plan, or which would be provided without charge in the absence of coverage.
- Cosmetic surgery, unless such surgery is required as a result of injury caused by an accident that occurred while the covered person’s coverage is in force and would be covered by OHIP.
- Medical examinations and tests required for immigration purposes or by a third party.
- Expenses for traveling time or mileage, or advice given by telephone; court testimony, preparation of records, reports, certificates or communications; group examinations, immunizations or inoculations (other than routine immunizations for children).
- Physicians’ services or examinations for screenings, except those covered by OHIP, surveys or research purposes.
- Laboratory services or clinical pathology, unless specifically included as an eligible expense.
- Acupuncture procedures.
- Eyeglasses, frames or contact lenses.
- Private-duty nursing, except under Homecare (with preauthorization from firstname.lastname@example.org).
- Hospital visits solely for the administration of drugs.
- Drugs, whether prescribed or not (unless administered during a hospital stay), except as set out under the eligible expenses provision of the group policy.
- Dental care services, except as set out under Dental Surgery, when performed in a hospital.
- Transportation and accommodations.
- Hospital visits.
- Physician services.
- Laboratory and diagnostic tests.
- Prescription drugs.
- Dental visits.
- Travel coverage.
Be sure to include:
- The diagnosis or reason for the visit.
- That Sun Life should pay the hospital (under Section 3 on the form).
UHIP provides the same coverage for emergency medical expenses as OHIP (Ontario’s provincial health plan).
A medical emergency is an acute injury or illness. It poses an immediate risk to a person's life or long-term health.
How it works:
- Always make sure to complete a claim form and include the original receipts for your medical expenses.
- Under UHIP, if you need emergency service, you will have to pay the hospital or medical provider directly. Always make sure to complete a claim form and get the original receipts for your medical expenses. You will need to send these documents to Sun Life for reimbursement.
Out of Canada or out of province
UHIP provides minimal out-of country for emergency medical expenses. A medical emergency is an acute injury or illness. It poses an immediate risk to a person's life or long-term health.
This may not be enough to cover your medical expenses (see Emergency Services outside Ontario or Canada).
We strongly recommend you purchase additional private travel insurance1 to cover significant out-of-pocket expenses.
How it works:
- Under UHIP, if you need emergency service, you will have to pay the hospital or medical provider directly.
- Always make sure to complete a claim form and get the original receipts for your medical expenses.
- You will need to send these documents to Sun Life for reimbursement.
1Please note: UHIP does not endorse nor advertise any particular private coverage plan. It is your sole responsibility to research a private coverage plan that is right for you.