Canada Life-PSHCP

Step-by-Step Guide to Filing Claims with Canada Life-PSHCP

1. Prepare Required Documentation

• Original Receipts: Must include provider name, service date, cost, and patient’s name. Cash register slips or non-personalized invoices are not accepted
• Supporting Documents: Prescriptions, itemized medical statements, or questionnaires (if required)
• Claim Form: Use the appropriate form (e.g., In-Canada Expenses Claim Form for domestic claims)

2. Choose Your Submission Method

Option 1: Electronic Submission (Recommended)

1. Register/Log In:
   • Create a PSHCP Member Services account using your plan number and certificate number (found on your benefit card)
   • Enable direct deposit for faster reimbursement
2. Submit Claim:
   • Navigate to “Submit a Claim” → Select claim type (e.g., health care, vision) → Upload receipts and supporting documents
3. Track Status:
   • Check real-time updates under “Claims History”. Most electronic claims are processed within 24–48 hours

Option 2: Paper Submission

1. Download Forms:
   • Use the In-Canada Expenses Claim Form for domestic claims or Emergency Benefit While Traveling Claim Form for emergencies abroad
2. Mail Documents:
   • Send completed forms and original receipts to:
     Canada Life
     Winnipeg Benefit Payments, PO Box 99451 Station Main, Winnipeg, MB R3C 1E6
     MSH International (for travel claims): PO Box #4903 STN A, Toronto, ON M5W 0B1

Option 3: Pharmacy/Direct Billing

• Use your PSHCP Benefit Card at participating pharmacies for prescription drugs and eligible medical supplies

3. Track and Receive Payment

• Direct Deposit: Reimbursements are deposited into your account within 2–5 business days for approved claims
• Cheques: Issued if direct deposit is not enabled (allow 7–14 days for mail processing)
• Status Updates: Use the portal’s “Claims History” tab or contact the PSHCP Member Contact Centre at 1-855-415-4414

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FAQ: Canada Life-PSHCP Claims Process

1. What is the deadline to submit claims?

Claims must be received by December 31 of the year following the service date. For example, expenses incurred in 2025 must be submitted by December 31, 2026

2. What documents are required for reimbursement?

• Original receipts, prescriptions, and itemized statements from healthcare providers. Non-personalized invoices are not accepted

3. How long does claim processing take?

• Electronic claims: 24–48 hours for approval and payment
• Paper claims: Up to 2–5 business days for initial review, with additional time for mailing

4. Can I coordinate benefits with another insurance plan?

• Yes. Submit to the primary insurer first. If both plans are with Canada Life, coordination is automatic. For secondary claims with other providers, submit Canada Life’s Explanation of Benefits to the secondary insurer

5. What if my claim is denied?

• Resubmit with corrected documentation or appeal by contacting the Federal PSHCP Administration Authority

6. How do I update my preferred first name?

• Log in to your account → Navigate to “Your Profile” → Edit “Preferred First Name”. Updates take 1–2 business days

7. Are travel emergencies covered?

• Yes. Submit emergency claims to MSH International using the Emergency Benefit While Traveling Claim Form

8. How do I check drug coverage?

• Use the Drug Look-Up tool in your portal to verify coverage and prior authorization requirements

9. What is the Day Supply Limit for prescriptions?

• 100 days for most drugs. For extended travel, pharmacists can request up to 200 days without Canada Life approval

10. How do I appeal a decision?

• Submit a written appeal to the Federal PSHCP Administration Authority (PO Box 2245 Station “D,” Ottawa, ON K1P 5W4)

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