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Confusion with new AMS health care plan causes denied coverage

Although the AMS is saving money by switching insurance providers for the AMS Health and Dental Plan, some students were forced to pay extra in the confusion of the switch-over.

This past summer, the AMS/GSS health insurance provider changed from Calgary-based Sun Life Insurance to the local Pacific Blue Cross. The reasoning behind the change was that the new plan would be cheaper, and more convenient for students to file claims.

According to the AMS/GSS health plan website ihaveaplan.ca , the price for the 2010–2011 plan was $223.45, whereas the current plan costs $214.37—a drop in price of $9.08 since last year.

However, during the transition, some students—at least 15-20 at the Shopper’s Drug Mart on campus, said pharmacist Nathan Swartsman—were denied coverage for prescription drugs that were previously covered, despite insistence that the plan is nearly identical.

. “Pacific Blue Cross, like Sun Life, has a ‘generic substitution clause,’ in that if a student goes in to get a brand name drug, it will be reimbursed based on the cheapest equivalent generic drug cost.”

Although she has now been informed that her coverage will continue, PhD student Deirdre Curle was denied coverage when she tried to renew her prescription this September. She requires non-generic Type II diabetes medication.

“When I came to UBC in September 2010 to start my doctoral program, Sun Life agreed to cover my prescriptions, even though they’re not covered by Pharmacare, as long as I provided a form asking for an exception signed by my doctor,” said Curle.

“But when I went in to fill my prescriptions this fall, the pharmacy assistant informed me that my drugs were no longer covered because the AMS decided to switch to Pacific Blue Cross.”

Curle uses a more expensive drug, since generic drugs such as Glucatrol caused negative side effects including slurred speech and tremors.

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Confusion with new AMS health care plan causes denied coverage

This past summer, the AMS/GSS health insurance provider changed from Calgary-based Sun Life Insurance to the local Pacific Blue Cross. The reasoning behind the change was that the new plan would be cheaper, and more convenient for students to file



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Such a center was recommended by the Blue Ribbon Healthcare Committee formed last year. • $408000 more for the new Student Fitness and Wellness Center. It will be used to complete upgrades that were formerly stripped from the plan.



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