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Submitting a benefit claim - Retired members of the public service group insurance benefit plans

From: Treasury Board of Canada Secretariat

If you are retired and a member of the Public Service Health Care Plan (PSHCP) or Pensioners’ Dental Services Plan (PDSP), use the following information to submit a claim for reimbursement.

Frequently asked questions

  • How do you submit a claim for benefits under the Public Service Health Care Plan?

    Electronic

    • In Canada

      When purchasing eligible prescription drugs and certain medical supplies at the pharmacy in Canada, you should present your Public Service Health Care Plan (PSHCP) benefit card. If accepted, your pharmacy will use it to send the cost of your prescription to Canada Life for processing. Once your claim is processed, the amount paid by the Plan will be shown on your pharmacy receipt (i.e. 80%). You pay the 20% co-payment (unless you have coordinated your benefits with another plan).

      In addition, you can present your benefit card to a registered health care provider (e.g. massage therapist, physiotherapist) to have them submit claims electronically on your behalf. Health care providers can visit Telus Health for information on how to register.

      If you have any problems with your PSHCP benefit card, contact Canada Life.

      You can also submit your claims through the Canada Life PSHCP Member Services website or Canada Life’s My Canada Life at WorkTM mobile app, including claims incurred outside of Canada, if not for a medical emergency.

    • Outside of Canada

      Members with Comprehensive coverage or members with Supplementary coverage who have eligible out-of-province Emergency Benefit claims can submit their claims to MSH International on the MSH PSHCP Member Portal.

      Mail

      PSHCP claims can also be submitted by mail using the appropriate completed PSHCP Claim Form for Supplementary Coverage or for Comprehensive Coverage.

      Mail the form to the address indicated on the form along with supporting documentation (original receipts, bills, invoices, physician or practitioner statements, and/or questionnaires, etc.).

    Note: Keep copies of your receipts, your completed claim form, and any other documentation provided. Originals will not be returned.

  • How do you coordinate benefits under the Public Service Health Care Plan?

    If you and your dependent spouse or common-law partner are covered under more than one health care plan, you may coordinate benefits for up to 100% of the actual eligible expenses. In situations where coordination of benefits is allowed, the combined reimbursement from all Plans cannot exceed the expenses incurred.

    Coordination of benefits between two Public Service Health Care Plan (PSHCP) members is allowed.

    To coordinate benefits under the PSHCP you must have Family Coverage and complete positive enrolment to include your spouse/common-law partner. See Getting Married or Reaching Common-Law Status.

    Complete the applicable coordination of benefits section when submitting a PSHCP claim on the Canada Life PSHCP Member Services website, My Canada Life at WorkTM mobile app or a paper claim form.

  • How do you obtain a Public Service Health Care Plan Benefit Card?

    To obtain your Public Service Health Care Plan (PSHCP) benefit card from Canada Life, you must be enrolled in the PSHCP and have completed positive enrolment. For information on how to enrol in the Plan and complete positive enrolment, consult New to the Public Service.

    If you complete your positive enrolment online, you’ll immediately receive a PDF copy of your benefit card, which you can download to your phone or computer for your records. Plan member and dependant benefit cards are accessible any time through the PSHCP Member Services website after you register. 

    Once you have completed positive enrolment and registered for an account on the Canada Life PSHCP Member Services website , you can also access your benefit cards and save them on your mobile wallet using Canada Life’s My Canada Life at WorkTM mobile app.

    If you complete your positive enrolment by paper, you’ll receive a paper benefit card for the plan member only. The benefit card will be mailed to the address you provided on your PSHCP Positive Enrolment Form approximately 4 weeks after Canada Life receives your completed form.  

  • Is there a deadline for submitting a Public Service Health Care Plan claim?

    Under the Public Service Health Care Plan, a claim must be received by Canada Life within 12 months following the calendar year in which the expense was incurred. For example, claims for expenses incurred in 2023 must be received by Canada Life no later than .

  • Where can you obtain information about the status of your Public Service Health Care Plan claim?

    For information about the status of your claim, you can either:

    1. Consult the Canada Life PSHCP Member Services website using your email address and password to log in; or
    2. Consult Canada Life’s My Canada Life at WorkTM mobile app using the same email address and password used to access your account on the Canada Life PSHCP Member Services website; or  
    3. Contact Canada Life.
  • How do you find out why your Public Service Health Care Plan claim was refused?

    If your claim was refused under the Public Service Health Care Plan (PSHCP), you will be advised by an Explanation of Benefits letter (i.e. claim statement) from Canada Life by email or mail, on Canada Life’s My Canada Life at WorkTM mobile app, or on the Canada Life PSHCP Member Services website. On this statement, Canada Life will have provided an explanation of your health claim. If you have further questions contact Canada Life.

    In the event you disagree with a claim decision, you have one year from the date of the PSHCP claim statement to register an appeal. When contacting Canada Life, please have your plan and certificate numbers ready. For information on How to Submit an Appeal, refer to the Federal PSHCP Administration Authority website.

  • How do you submit a claim under the Pensioners' Dental Services Plan?

    Positive enrolment must be completed before any dental claims can be paid.

    Submit a claim online

    Most Canadian dental providers can submit dental claims online to Canada Life on your behalf. Present your Pensioners’ Dental Services Plan (PDSP) benefit card with your plan number and certificate number. Your claims will be processed in real time and your eligible expenses will be reimbursed by direct deposit or by cheque.

    Alternatively, you can submit dental claims online (for services received in Canada or outside Canada) through your PDSP Member Services account or your My Canada Life at Work mobile app. For the mobile app, you must create a PDSP Member Services account first.

    Submit a claim by mail

    To submit a claim using a paper form:

    Follow the instructions on the claim form and complete your sections of the form. Your dental provider must also complete their sections and include their signature or stamp. Mail the completed form to Canada Life along with the original invoices, receipts and any other supporting documents.

    Note: It is your responsibility to keep a copy of your claims, including invoices, receipts or supporting documents for your records.

    To be eligible for reimbursement, Canada Life must receive your claims within 15 months of the date the expenses were incurred.

    If you have any questions regarding the PDSP Member Services website or how to register, contact Canada Life.

  • How do you coordinate benefits under the Pensioners' Dental Services Plan?

    If you and your dependant spouse or common-law partner are covered under more than one dental care plan, you may be eligible to coordinate your benefits for up to 100% of the actual eligible expenses.

    Note: Coordination of benefits between two members of the Pensioners’ Dental Services Plan (PDSP) is not allowed.

    For information on which plan you should claim from first, refer to the Coordination of benefits with other plans of the PDSP member booklet.

  • Is there a deadline for submitting a Pensioners' Dental Services Plan claim?

    Under the Pensioners' Dental Services Plan (PDSP), claims must be submitted within 15 months of the date the expenses have been incurred.

  • Where can you obtain information about the status of your Pensioners' Dental Services Plan claim?

    For information about the status of a submitted Pensioners' Dental Services Plan (PDSP) claim, you can :

  • How do you find out why your Pensioners' Dental Services Plan claim was refused?

    When your claim is processed, you will receive a notification that an explanation of your benefits statement from Canada Life is ready to be reviewed by text, email or mail. You can also sign into your PDSP Member Services account. The explanation of benefits statement provides details on how your claim was processed and the amount reimbursed.

    If you disagree with a claim decision, first try to resolve the issue with Canada Life. Appeals should be submitted to Canada Life in writing or can be submitted online through the PDSP Member Services website.

    If you wish to submit an appeal over the phone, supporting documents (legible originals or copies) or dental information must be sent to Canada Life by mail for review.

    If you are still not satisfied, you can submit an appeal to the PDSP Board. Consult the PDSP Appeal Checklist.

  • What online and digital services are available to members of the Public Service Health Care Plan and the Pensioners’ Dental Services Plan?

    Public Service Health Care Plan

    As a member of the Public Service Health Care Plan (PSHCP), you can access your account via the internet or mobile device.

    The following features are available:

    Canada Life PSHCP Member Services website

    • Submit electronic claim.
    • Attach receipts, photo receipts and other supporting documents to claims for expenses such as lab tests, equipment, and medical supplies.
    • Attach documents requested by Canada Life, such as referrals, proofs of payment, estimates and drug forms, to recently completed claims.
    • Track claims that are being processed and view your completed claims.
    • Learn what is covered under the Plan quickly and conveniently.
    • Locate health practitioners using the "provider search" feature.
    • Review drug coverage and claim history for you and your dependants.
    • Explore alternative drugs to discuss with your health practitioner.
    • Access and print your PSHCP benefit card.
    • Coordinate benefits claims between two Canada Life plans or submit the remaining balance of a claim already processed through another insurer.
    • Complete or update your personal account (“positive enrolment”) information.
    • Sign up for direct deposit or update your banking information.
    • Use Two-Step Verification to verify your identity and protect your personal information. Canada Life will text or email you (your choice) with a one-time security code.

    My Canada Life at Work mobile app

    • View your personal account information, including dependant and banking information.
    • Submit electronic claims, coordinate benefits claims between two Canada Life plans, track claims progress and view claims history for you and your dependants.
    • Attach receipts, photo receipts and other supporting documents to claims for expenses such as lab tests, equipment, and medical supplies.
    • Sign up for electronic explanation of benefits statements.
    • View and save your and your dependants PSHCP benefit cards to your mobile wallet.
    • View your health coverage and balances.
    • Enable and sign into your account with Face and Touch ID.

    Pensioners’ Dental Services Plan

    As a member of the Pensioners’ Dental Services Plan (PDSP), you can access your PDSP Member Services account online and through the My Canada Life at Work mobile app.

    Positive enrolment must be completed to create a PDSP Member Services account.

    Your PDSP Member Services account allows you to do the following and more:

    • easily navigate your plan details
    • update positive enrolment
    • submit claims
    • set up direct deposit
    • check coverage balances
    • access your benefit card

    For more information, consult your PDSP member booklet.

    Your My Canada Life at Work mobile app allows you to do the following and more:

    • save your benefit plan card directly to your mobile phone
    • view your plan number and certificate number
    • update positive enrolment information
    • submit claims
    • view your claims history

    If you’re having trouble registering or signing in, contact Canada Life.

  • How do you register for online services?

    Public Service Health Care Plan

    To access your PSHCP online account, you will need a personal email address and password. If you do not already have an account, you can register on the Canada Life PSHCP Member Services website. You will need your plan and certificate numbers to register.

    For security purposes, an email will be sent to you with an activation code to complete the registration process.

    To access the My Canada Life at Work mobile app, you must first have registered to the PSHCP Member Services website. Once registered:

    • d ownload the My Canada Life at Work mobile app for iPhone and Android devices from the App Store or from Google Play.
    • s ign into the app using your username and password for the PSHCP Member Services account.

    You can choose to enable Face or Touch ID to sign into your account faster.

    Pensioners’ Dental Services Plan Member Services website

    Positive enrolment must be completed to create your Pensioners’ Dental Services Plan (PDSP) Member Services account.

    If you already have a Public Service Health Care Plan or a Public Service Dental Care Plan Member Services account with Canada Life, sign into your account using the same email address and password you are currently using or previously used to sign in. If you don’t have an account, you will need to create one through My Canada Life at work.

    You can also download the My Canada Life at Work mobile app from the app store. Positive enrolment must be completed and your PDSP Member Services account must be created to sign into the mobile app. Use the same email address and password you created for the PDSP Member Services website.

Visit Public service pension plan for information on pension.

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