Sunlife

How to Check Your Paramedical Coverage on Sun Life

Follow these steps to review your paramedical benefits through Sun Life’s online portal.

1. Access the Sun Life Portal

• Go to the Sun Life sign-in page: https://www.sunnet.sunlife.com/signin/mysunlife/home.wca.
• Enter your Username and Password to log in.
  • Forgot your credentials? Use the “Recover username” or “Reset password” links on the login page.

2. Navigate to Your Coverage Details

• After logging in, look for a section labeled:
  • “Benefits”, “Coverage”, or “My Coverage” (the exact wording may vary).
• Click on “Coverage Summary” or a similar option to view your plan details.

3. Locate Paramedical Coverage

• Under Extended Health Benefits, search for “Paramedical Services” or “Allied Health Professionals”.
• Common covered services include:
  • Physiotherapy
  • Chiropractic care
  • Massage therapy
  • Naturopathy
  • Acupuncture

4. Review Coverage Limits

Check for details such as:

• Annual maximums (e.g., $500 per year).
• Percentage covered (e.g., 80% of costs).
• Per session visit limit(e.g., up to $$80 covered on single visits).

5. Contact Sun Life (If Needed)

If you can’t find your paramedical details online:

• Call: 1-800-361-6212 (Mon–Fri, 8 AM–8 PM ET).
• Email: Use the secure messaging feature in your account.
• Chat: Check for a live chat option on the portal.

Additional Tips

• Check Your Group Benefits Booklet: Your employer may have provided a PDF with coverage specifics.
• Review Claims History: See how much of your paramedical coverage you’ve used under “Claims” or “My Statements”.
• Update Personal Info: Ensure your address and dependents are current to avoid claim issues.

Troubleshooting

• Website Down? Try again later or use the Sun Life mobile app.
• No Paramedical Coverage Listed? Contact your employer’s HR department to confirm if it’s included in your plan.
• Incorrect Information? Report discrepancies to Sun Life immediately.

Step-by-Step Guide to Filing Paramedical Claims with Sun Life

1. Log In to Your Sun Life Account

• Visit the Sun Life portal: https://www.sunnet.sunlife.com/signin/mysunlife/home.wca.
• Enter your Username and Password.
  • Forgot your login details? Use the “Recover username” or “Reset password” links on the login page.

2. Navigate to the Claims Section

• Once logged in, look for:
  • “Submit a Claim”, “Claims Centre”, or “My Claims” (wording may vary).
• Click the option to start a new claim.

3. Select Paramedical Services

• Choose “Extended Health Benefits” or “Paramedical Services” as the claim type.
• Specify the type of service (e.g., physiotherapy, massage therapy, psychology).

4. Fill Out the Claim Form

• Provide details about:
  • Practitioner: Name, license number, and registration details.
  • Service Date: Date(s) of treatment.
  • Cost: Total amount paid (attach a receipt).
  • Patient: Your name or the dependent’s name if claiming for someone else.

5. Attach Required Documents

• Receipts: Must include:
  • Practitioner’s name, credentials, and license number.
  • Date of service.
  • Detailed description of the service (e.g., “60-minute massage therapy session”).
  • Amount paid (marked as “Paid” or “Receipt”).
• Digital Upload: Scan or take a clear photo of the receipt.

6. Submit the Claim

• Review all details for accuracy.
• Click “Submit” or “Send for Processing”.
• Save the confirmation number for tracking.

7. Track Your Claim Status

• Return to the “Claims Centre” to check:
  • Approval progress.
  • Reimbursement amount.
  • Deposit date (if enrolled in direct deposit).
• Claims typically process in 5–10 business days.

Alternative Submission Methods

• Mobile App: Use the Sun Life app to submit claims via your smartphone.
• Mail: Send completed Group Benefits Claim Form + receipts to:
  • Sun Life Assurance Company of Canada  P.O. Box 2015 Stn Waterloo  Waterloo, ON N2J 0A6  

• Fax: 1-888-272-6666 (include your policy/member ID).

Tips for Success

• Submit Promptly: Claims must be filed within 12 months of the service date.
• Keep Copies: Save digital or physical copies of receipts for your records.
• Combine Receipts: If submitting multiple sessions (e.g., 10 physiotherapy appointments), attach a summary receipt with all dates and totals.

FAQ: Sun Life Claims Process

1. What types of claims can I submit through the eClaims portal?

• Currently all paramedical services can be submitted through the eClamins portal or email.

2. How long does Sun Life take to process claims?

• Claims are processed within 5–10 business days after all documents are received

3. Can I upload documents after submitting a claim?

• Yes. The updated portal allows document uploads at any stage, even post-submission

4. What if my claim is denied?

• Resubmit with corrected documentation or contact Advisor Technical Support at PCAID@sunlife.com

5. How do I check my claim’s status?

• Use the portal’s dashboard for real-time updates or wait for email notifications

6. Can I submit claims for dependents?

• Yes. Include their policy details and proof of relationship (e.g., birth certificates) during submission.

7. What if I lose access to my draft claim?

• Drafts expire after 14 days. Ensure you save progress or submit before the deadline

8. Are there fees for using the eClaims portal?

• No. The portal is free for policyholders and advisors.

9. How do I contact Sun Life for support?

• Technical Issues: Email PCAID@sunlife.com.
• General Claims: Email LFCLM@sunlife.com or call 1-800-800-4786‍

Things to Remember Before You Book

1. Plan Coverage: Know Your Limits

Understanding Your Yearly & Per-Session Coverage
Insurance plans have annual limits (e.g., 500/year) )and per−session reimbursement rates (e.g.,$80-$100/session).

• Why it matters: If our clinic’s fee is $120/session and your insurer covers 80/session, you’ll pay $40 out−of−pocket ($120 - $80).
• What to do:
  1. Contact your insurer to ask:
     • “What’s my annual limit for [service]?”
     • “What’s the approved rate per session?”
  2. Check your policy documents for coverage details.

💡 Tip: Always confirm your remaining coverage before booking!

2. Claims: Avoid Payment Surprises

Direct Billing vs. Reimbursement

• Direct billing: We bill your insurer directly. If approved, you only pay your portion (e.g., 20%).
• Reimbursement: If your insurer needs more time to review, you’ll pay upfront, and they’ll refund you later.
  What to do if your claim is pending:
  • Check your insurer’s portal
  • Ask your insurer: “Is there a delay with my claim? When will it be resolved?”

3. Prescriptions/Referrals: Don’t Get Denied

Some Services Need a Doctor’s Referral
What to do:

1. Call your insurer and ask: “Do I need a referral for [service]?”
2. Bring your referral to your appointment.

🚨 No referral? Your claim could be denied!

4. Check Your Coverage: We Can’t Do It For You

How to Verify Your Insurance
For privacy reasons, we can’t check your coverage. Here’s how to do it yourself:

1. Call your insurer using the number on your benefits card. Ask:
   • “Is [service] covered under my plan?”
   • “What’s my per-visit rate?”
2. Log in to your insurer’s portal

5. Cancellations & Rescheduling: Avoid Fees

Please Confirm Coverage Before Booking
We understand that unexpected costs, like insurance not covering 100% of your session, can be frustrating. But last-minute cancellation\rescheduling impacts our ability to serve all clients fairly. To help us accommodate everyone, we kindly ask that any cancellations\rescheduling be made at least 24 hours in advance. Please note that cancellations within 24 hours of the session will incur a fee. To avoid this:

1. Ask your insurer:
   • “Does my plan cover services at this clinic?”
   • “Will I owe anything beyond what insurance pays?”
2. Review our cancellation policy (e.g., 24-hour notice required).