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Use this form to authorize a claim for health care, vision or dental expenses if you're a group contract holder. Not what you're looking for? Find the forms you need. If you have coverage through your employer or plan sponsor, use these forms to make a medical expenses claim.
Get info on average processing times, the appeal process, when you’ll get status updates for your claim, and how you’ll receive payment. Find the right form to make a claim, manage benefits, submit a request, etc. Start by choosing how your got your coverage.
Forms. to see if the drugs you’ve been prescribed are covered. If they are, you can request pre-approval for reimbursement by completing the applicable form (s). Find PSHCP prior authorization, drug coverage requests, claims and other forms.
If your doctor decides the brand name drug is medically necessary, they must complete a Request for brand name drug coverage form found at canadalife.com. If the request is approved, you’ll be reimbursed the cost of the brand name drug according to the terms of your benefits plan.
Create your PSHCP Member Services account through My Canada Life at Work TM and have access to online claims submission and history, direct deposit for your claim reimbursements, the ability to find a provider and more. Register for or sign in to your PSHCP Member Services account.
Healthcare Expenses Statement. INSTRUCTIONS. 1. Complete page 1 and 2 of this form in full. 2. Attach receipts for all services and retain copies for your files as original receipts will not be returned. 3. Send to the appropriate Benefit Payment Office for your plan. See PART 10.
To submit a health care or dental expense, you can: Use your pay-direct card at providers that direct bill Canada Life. (card example shown below): Submit the claim online through: GroupNet for Plan Members. Submit a claim by email or mail to Canada Life using a claim form: Health Claim Form. Dental Claim Form.
