# Public Service Health Care Plan PSHCP [Merged]



## ab136 (12 Mar 2005)

As a new member, how does the Cf medical plan work for family members?  What is the cost and are pre-existing medications covered?


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## Loadmaster (12 Mar 2005)

Are you Reg or Reserve??

There is a difference between the 2


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## old medic (12 Mar 2005)

You can read up about it on this link. If you don't find any specific answers, feel free to ask again.

*Understanding and Accessing Your Health Care Benefits*

http://www.forces.gc.ca/health/services/engraph/health_info_home_e.asp


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## ab136 (12 Mar 2005)

Waiting for a Reg. call


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## Loadmaster (12 Mar 2005)

Well there you go, all the info you need to start is in the link above.


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## ab136 (12 Mar 2005)

Thanks guys


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## ab136 (12 Mar 2005)

Can't seem to find anything there.  What I am wondering about is a prescription my wife has now...Imitrex. Just wondering if we might be able to "claim" it; it's about $15 per pill and it's very affective at relieving migraines.


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## Loadmaster (12 Mar 2005)

I'm not sure if they will cover that specifically but in your post you mention that you are waiting for a Reg call. This medical and dental plan do not come into effect until 2-3 months after the application is received.  Have you got the booklets yet from your OR?


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## Michael OLeary (12 Mar 2005)

CFAO 56-21 -- GROUP SURGICAL-MEDICAL INSURANCE PLAN

http://www.admfincs.forces.gc.ca/admfincs/subjects/cfao/056-21_e.asp



> AUTHORITY
> 
> 1. Regulations governing the Group Surgical-Medical Insurance Plan (GSMIP) *for dependants of members of the Regular Force* were approved by Treasury Board Minute 758836 of 17 Jul 78 as the Public Service Health Insurance Directives (PSHID) effective 1 Sep 78.
> PURPOSE
> ...


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## Loadmaster (12 Mar 2005)

Have you read this??

http://www.forces.gc.ca/health/services/spectrum_of_care/engraph/supp_health_care_e.asp?Lev1=1&Lev2=5&Lev3=8#a


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## ab136 (13 Mar 2005)

So from what I have read, and correct me if I am wrong, the CF medical is a Blue Cross plan?


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## Gunner98 (17 Mar 2005)

The CF Medical System uses Blue Cross to assist with the payment for services and supplies to physicians, facilities and suppliers on behalf of CF members.  Blue Cross is not the CF member's insurance provider; they are merely a central agency that the CF uses to pay medical bills.  The CF then pays Blue Cross monthly as bulk claim.  Blue Cross helps track the individual claim back to the home facility responsible for that patient through the billing system.  The providers sign up with Blue Cross for quicker payment.


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## ab136 (18 Mar 2005)

Thanks Gunner98, just what I wanted to know.


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## Gunner98 (18 Mar 2005)

SunLife provides dependent coverage within Canada through the Public Service Health Care Plan, see website:
http://www.tbs-sct.gc.ca/pubs_pol/hrpubs/tb_862/pshcpb-rssfpp_e.asp

Outside Canada info:  http://collection.nlc-bnc.ca/100/201/301/tbs-sct/tb_manual-ef/Pubs_pol/hrpubs/TB_862/CHAP2_3_e.html  or 
http://www.tbs-sct.gc.ca/pubs_pol/hrpubs/TB_862/pshcpb-rssfpp2_e.asp#_Toc81106885


Claims for expenses incurred under the Comprehensive coverage provision
If you incur claims under the Comprehensive coverage provision of the PSHCP, you may send your claims directly to World Access Canada at the following address:

World Access Canada
Public Service Health Care Plan
P.O. Box 880
Waterloo ON N2J 4C3

Plan members living or working in the United States may call World Access toll-free at 1â â€˜800â â€˜363-1835.

Plan members outside Canada in countries other than the United States who are unable to call directly may call the World Access claims line collect at 519â â€˜742â â€˜1691. The claims line is open from 8:30 a.m. to 4:00 p.m. (EST), Monday to Friday.

Emergency travel assistance benefit
The Emergency travel assistance benefit provides emergency medical and general travel assistance to eligible members who travel outside their province/territory of residence.

If emergency assistance is needed, a 24-hour help line is available. Multilingual coordinators can access a worldwide network of professionals who offer help with medical, legal, or other travelâ â€˜related emergencies. Call the 24â â€˜hour toll-free number:

1-800-667-2883 in Canada and the United States, or 
call collect 519-742-1342 in all other countries.


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## ab136 (18 Mar 2005)

Thanks Gunner98, your a wealth of information on my topic.  Thanks again for the PM's


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## Chags (31 May 2005)

Question for y'all..  

I just got married a couple months ago  (wow time really flies) and am just about done all the admin that goes along with it..  I got the Public Service Health Care Plan Card in the mail last week..  now is that the card my wife needs when she goes to the hospital (or dentist) or is there another card..  I've heard of some other card that would have her name on it (and dependents)

Any info would be appreciated


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## wotan (31 May 2005)

Howdy Chags,

  The PSHCP card along with her Provincial Health Care plan card is all that is required.  As you add dependants onto your military records (make sure you add them!), they are automatically covered with PSHCP.

  There is also the CF Dental Care plan, but you aren't issued a card for that.  Simply go to your OR and they can provide you with claim forms and an explanation of benefits.  Most dentists that are familiar with the CFDCP will submit the claim on your behalf and simply bill you the remaining portion, but that is their choice.  They may prefer for you to pay up front and for you to submit the claim.

  There is also a Blue Cross card that is available for your use, but it covers only you on lve while outside Canada.  Basically, the card simply provides a contact number to arrange emergency medical and dental coverage while on lve outside the country, but again, I stress that it covers only you.  If you are taking the family out of the country, I would recommend investing in supplementary Blue Cross or similar coverage.

  Other than that, there are no other plans that I am aware of, however, it may vary from province to province.  However, if you have any doubts, consult your OR staff.  Better to ask and be informed than to be silent and miss out on benefits due to you.  Cheers.


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## aesop081 (31 May 2005)

wotan said:
			
		

> There is also a Blue Cross card that is available for your use, but it covers only you on lve while *outside * Canada.



Incorrect.   The blue cross card is there for you when you require medical care and DND facilities are not available *INSIDE * and *OUTSIDE* Canada.   If you are hurt on the weekend and need to go to the hospital/clininc down the street from your house...the blue cross card will cover you.


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## Chags (3 Jun 2005)

Thanks for the info wotan..  thats exactly what I needed to hear..

Chags


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## wotan (6 Jun 2005)

aesop081 said:
			
		

> Incorrect.   The blue cross card is there for you when you require medical care and DND facilities are not available *INSIDE * and *OUTSIDE* Canada.   If you are hurt on the weekend and need to go to the hospital/clininc down the street from your house...the blue cross card will cover you.



Not to start a p*ssing contest, however when I have the temerity to instruct you as to flight ops, then by all means feel free to instruct me on admin.  Form DND-021(B) is based on an agreement between the CF and Atlantic Blue Cross.  You can identify the fact that it is only for outside Canada use by the fact the front of the card carries, in large, red type the following:  EMERGENCY MEDICAL/DENTAL ASSISTANCE OUTSIDE OF CANADA.  

That said, you are correct that CF members, on lve within Canada or requiring after-hours emergency care may attend civilian facilities as directed.  Cheers.


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## aesop081 (6 Jun 2005)

Fair enough, then maybe you will have the temerity to point out where it says "outside canada only" in large red type.........


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## wotan (6 Jun 2005)

If that was the DND-021(B), I certainly would.  What you have is the Blue Cross card, for inside Canada only, that advises you to change the alpha character of your SN from whatever it is to an"M" and use that as your medical number.  The number provided (1-877-MED-DENT [1-877-633-3368]) is good only in Canada.

  The outside Canada DND-021(B) provides two separate numbers, 1-800-563-4444 for requirements in the USA and 1-506-854-2222 (use of collect calling is encouraged) for all other locales.  This card was issued to ORs vice directly to the members, about two years ago.  If you haven't received one, I would certainly encourage you, and anyone else, to get one if you are travelling outside Canada on lve.

  Cheers.


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## buzgo (28 Jul 2005)

After muddling through the PSHCP 'guide' (yeah right.) I see that I am covered for up to $200 for eyeglasses or contact lenses, every 2 years starting on odd years. Now since I am reg force and I already get FREE glasses from DND, does this mean that I can go and get contacts or more glasses and and submit a claim for up to $200? 

I'm not 100% clear on the way the plan actually works, I signed up for it so that my wife has the coverage. I see that there are many things that I am covered for but I don't understand how to get things like massage therapy etc, since AFAIK I can only go to see my doc at NDMC (or go to MIR)...


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## Gunner98 (28 Jul 2005)

No, the $200 is only for your family, not you.  Contact lenses unless specifically prescribed (which is almost never) are not paid for by CF.  Normally, massage therapy is only covered  by Veterans Affairs not by CF, except in a limited fashion for experimental cases.

PSHCP does not apply to soldiers, only their families.


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## Towards_the_gap (29 Apr 2008)

Very important question here. But after completing the paperwork (application) for PSHCP coverage, how long should it take to get the info pack? I ask because I filled out all the paperwork on 09 Dec 2007 when I enrolled (enrollment date 06 Dec) and yet Sunlife is rejecting any claims so far for my pregnant wifes Chiropractor as they 'do not have any record of me', and I have yet to receive a certificate number, or notice any allotments being taken from my pay, which was also screwed up on enrollment. The medical expenses are starting to add up so this is very worrying.

Many thanks,


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## Nfld Sapper (29 Apr 2008)

Maybe talk to the clerks in your OR?


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## exgunnertdo (30 Apr 2008)

Coverage should have started on 1 Jan, based on the info you've provided.

http://www.tbs-sct.gc.ca/pubs_pol/hrpubs/tb_862/pshcpd-drssfp/pshcpd-drssfp04_e.asp


> Unless otherwise stated, coverage will become effective on the first day of the month following receipt of the application by the designated officer if the application is received within 60 days of the applicant becoming eligible.
> 
> Where the application is received more than 60 days after the applicant becomes eligible or after the event requiring an application, the effective date of coverage will be the first day of the fourth month following receipt of the application by the designated officer.



Talk to the OR/Pay and Records.  You should have copies of what you filled out when you applied.


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## Towards_the_gap (30 Apr 2008)

Having spoken with the OR, it seems there is now no record of my application. Which has royally screwed me over, as the 'Public Service Health Care Plan Directive - April 1, 2006' states that if an application is received more than 60 days after initial eligibility, coverage starts from the first day of the fourth month following the application being received. My wife is pregnant, which is therefore making the bills pile right up, and seeing as the CFRC has already screwed up my pay enough (enrolled as skilled-RSBP granted cpl 2, somehow ended up being paid Pte III), this is going to cost alot of money.

What recourse do I have now? My CofC is aware, as is the ROR who are trying to correct this, but I hold little hope. And am understandably VERY pissed off now.


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## exgunnertdo (30 Apr 2008)

Did you get copies of the paperwork?  I think I did when I filled out the application.

We had this problem when we were both still PRes and my husband went on Class C.  OR didn't file the paperwork for PSHC correctly, then I broke my ankle only to discover that Sunlife was incorrectly applying the waiting period.  It took a lot of work, but it was mainly the support of the OR that fixed it.  They knew they screwed up and helped my husband sort it out.  He was in Bosnia, I was in Manitoba and his pay was being administered in Edmonton, so it took a long time to get reimbursed for the expenses.  I feel for you.

If the OR recognizes that it was their screw-up, they can back date the application.  That's what they did in our case.

Good luck!


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## Towards_the_gap (30 Apr 2008)

Regrettably no.....Which reminds me to get copies of absolutely everything next time.

HOWEVER, I have had success both through the OR and more importantly, the CofC. Pay is getting squared away, with a large chunk of backpay to come, and my application is being re-sent (I guess I will have to fill it out again tomorrow), back-dated to my enlistment date, so that I will not have any wait times.

So not much to worry about (until next time!!!)

Thanks for the replies.


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## Dog (28 Apr 2010)

Is there any way that I will be able to get the PSHCP when I'm overseas. I've been on workup for TF 1-10 since Sept. 2008 (reservist), and have been trying to get health coverage for my family since then, and have not had any success. I've tried calling them directly only to be told that they are unable to give me any assistance, that only my clerk can deal with it. I've pestered the clerk, bothered my chain of command, and even spoke about this issue directly to the CWO of the Army and have yet to see any results, and now that I'm deploying in a few days, I'm out of ideas, and my family is out of luck. 

So, will I be able to get anything done after I hit the ground with regards to this issue? Or should I just try and find alternative coverage? Is there an alternative that anyone here would recommend?


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## George Wallace (28 Apr 2010)

Dog said:
			
		

> Is there any way that I will be able to get the PSHCP when I'm overseas. I've been on workup for TF 1-10 since Sept. 2008 (reservist), and have been trying to get health coverage for my family since then, and have not had any success. I've tried calling them directly only to be told that they are unable to give me any assistance, that only my clerk can deal with it. I've pestered the clerk, bothered my chain of command, and even spoke about this issue directly to the CWO of the Army and have yet to see any results, and now that I'm deploying in a few days, I'm out of ideas, and my family is out of luck.
> 
> So, will I be able to get anything done after I hit the ground with regards to this issue? Or should I just try and find alternative coverage? Is there an alternative that anyone here would recommend?



Your Clerk should be able to set you up.  Either they are totally incompetent, just lazy, figure that you as a Reservist Class C are not entitled, or they are not yet qualified to do the job.  Which ever it is, keep after them.  You should have that done before deploying, and it is part of the RMS clerks job to ensure that you are properly DAG'ed and good to go, seeing as you, the member have brought it to their attention.  Things like this, when dealing with this type of RMS clerk, really peese me off.  It is a tragedy that that Trade has devolved to such a low state.  

Sorry for the little rant.


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## dapaterson (28 Apr 2010)

http://www.admfincs.forces.gc.ca/dcf-dsp/psh-rss/app-dem/index-eng.asp

Two forms to fill out to apply.

Also leave a supply of signed claims forms at home, to be completed and submitted as needed.


Homepage: http://www.admfincs.forces.gc.ca/dcf-dsp/psh-rss/pshcp-rssfp-eng.asp

There are also a variety of useful links on the right hand side of the homepage, with FAQs, forms and info.

Although the page says it's for RMS clerks, the info is applicable to all.

(If you have further Qs feel free to PM me)


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## Dog (28 Apr 2010)

As to the forms, I've already filled the forms out and had them submitted. Twice. They have been seen by PSHCP... but nothing has happened since then. I'm not sure why. Thanks for giving me the information though, it's a site I've never seen.

George, I have been thinking the same things. I'm disappointed in the clerk staff.

I haven't deployed yet, but I do leave very soon. I have one last DAG the day before I go... I'll try to push one last time, and see what happens. 

Thanks to the both of you.


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## PuckChaser (28 Apr 2010)

There's a 3 month cooling off period from the time PSHCP gets the forms, I'm having to go to my SOR to sort out why they think 3 months from 7 Dec 09 extends beyond 20 Mar 10.... If your clerks have a copy of the fax timestamp when it was sent to PSHCP, they can make the date backdated to then, and not have to start your cool down period now. At least, this is what I've been told during a brief conversation with one of my clerks.


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## George Wallace (29 Apr 2010)

You learn the hard way to keep your own 'Shadow File' with copies of everything.  I have kept copies of Fax and Fax Cover Sheets in the past and glad I did, when things were not actioned and I had proof that I had done my part to get things moving, but someone after me in the chain had dropped the ball.  As PuckChaser pointed out, having your copy simplifies the follow up actions you may have to take.


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## Dog (29 Apr 2010)

Well, that's the thing... everyone who I've dealt with WRT this issue knows I've done all the paperwork.... I'm baffled as to what the hang-up is.


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## Jarnhamar (21 Aug 2012)

Currently don't have access to the din.

I have a question from a soldier I'm trying to answer.
He was wonder what the different price packages cost for benefits for his wife and kid and what all are covered in those packages. I know there are 3 different packages but have no idea how much they are a month or whats cowred. 
His wife is paying $60 a month at her work for benefits so he's considering having her covered through the CF to save money.

Can anyone help?


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## Occam (21 Aug 2012)

Are you talking about medical coverage?


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## Jarnhamar (21 Aug 2012)

Yes sorry medical and dental coverage for a wife and child.  Also the name of the company if that makes sense


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## Occam (21 Aug 2012)

For PSHCP...the three different "packages" as you call them are not packages.  There are three different levels of coverage for Hospital room and board charges (semi-private and private rooms).  Level 1 is $60/day, level 2 is $140/day, and level 3 is $220/day.  All three levels include the drug, vision care, and medical practitioners benefits at 80% coverage.  The difference in the premiums for the three levels is ridiculously small, although I don't remember the exact amounts. 

You select the level of coverage you want based on the local "going rate" for semi-private/private rooms in your local hospital.  This presumes, of course, that there are semi-private/private rooms available.  Otherwise, you're paying for a higher level of coverage for nothing, because you'll end up in a ward anyways.

PSHCP is administered by Sun Life Assurance.

Dependents Dental Care Plan is administered by GreatWest Life, and is no charge to the member.


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## Occam (21 Aug 2012)

Looking at my old Pay Statements, Level III coverage for PSHCP was $4.00/month.


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## dapaterson (21 Aug 2012)

The benefits to CF members include deductibles.  He can probably combine benefits - that is, claim under both plans to get 100% reimbursement.  PSHCP has some info on that topic.  Google PSHCP for lots more info - the TBS website has lots.

He and his wife should look at the two plans and figure out whether it's worthwhile to maintain both and combine benefits, or if the money would be less if they just pay the deductible under the CF plans.


As previously stated, the three levels only relate to the maximum hospital room rate that's reimbursed; other than that, the PSHCP coverage is identical at all three levels.


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## Occam (21 Aug 2012)

Here's the PSHCP benefits guide.


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## Jarnhamar (21 Aug 2012)

Perfect. I'll print this and give it to the soldier, thanks everyone.


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## DAA (21 Aug 2012)

CF members are provided with Level III Supplementary coverage which is $4.00 per month.  If your posted OUTCAN, you are enrolled in the Level III Comprehensive Package which costs $4.01 per month.  

See Annex B of Schedule V - http://www.njc-cnm.gc.ca/directive/index.php?sid=87&hl=1&lang=eng

It's not uncommon for a CF member to have coverage for their dependants while their spouse has coverage through their employer and combining the benefit.

Here is the link to the main website - http://www.njc-cnm.gc.ca/directive/index.php?vid=9&lang=eng


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## Jarnhamar (21 Aug 2012)

So basically this guy's wife is paying $60 a month for benefits with her employer and if he has her covered through the CF instead she will be paying $4.00 a month?


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## DAA (21 Aug 2012)

ObedientiaZelum said:
			
		

> So basically this guy's wife is paying $60 a month for benefits with her employer and if he has her covered through the CF instead she will be paying $4.00 a month?



Yup.....He will pay the $4.00 per month and the coverage provided is outlined in the benefits package.  He may wish to review her plan in comparison with ours to make sure they have the coverage they need, especially if there are any unique medical issues.

On a side note, he may want to have a closer look at his most recent pay statement because it is entirely possible that he is already enrolled/paying PSHCP premiums.  This is generally part of the admin process with the OR when you change your marital status or on enrolment.


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## dapaterson (21 Aug 2012)

No.

He would pay $4.00 per month (or whatever the current rate is) for Level III hospital coverage.

However, the PSHCP coverage might be less than hers.  They need to assess whether or not the $720 per year she's paying is more or less than what they'd pay under PSHCP, given the deductibles.


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## Jarnhamar (21 Aug 2012)

Got it. Thanks!


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## Occam (21 Aug 2012)

ObedientiaZelum said:
			
		

> So basically this guy's wife is paying $60 a month for benefits with her employer and if he has her covered through the CF instead she will be paying $4.00 a month?



He'll be paying $4.00 off his pay, correct.

You have to remember that as dapaterson has mentioned, there are some circumstances under which it would be worthwhile for the member to get PSHCP, *and* his spouse to continue paying for her coverage through her own employer.  If you have a dependent who has expensive medication, or requires lots of medical practitioner expenses, then you'd have to crunch the numbers to determine if coordination of benefits makes it worthwhile for the spouse to continue paying the $60/mo through her employer.  There are certainly some families out there that would find this beneficial.

To expand on that:  You submit a drug claim through PSHCP for $100.  They pay for $80 out of that.  Under coordination of benefits, you can submit the remaining $20 under the spouse's coverage.  If your medical expenses are high enough such that the amounts transferred to the spouse's claims exceed $720/year, then it's worthwhile to maintain coverage through both employers.


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## exgunnertdo (21 Aug 2012)

The other thing to consider is that as HER spouse, he can claim under her plan, but not on PSHCP.  There are things that he could claim (contact lenses and prescription sunglasses come to mind) that we can't get through our medical system.  There are probably others, chiropractic, I think?

Another thing to consider is dental - if her plan is both medical and dental, and they have kids who may need braces, he needs to look at that too.  There is often a lengthy wait time for braces if she opts back in later upon discovering someone needs braces (a couple of years).  Our coverage for orthodontics is 50%, and I forget the lifetime max, but it is used up very quickly in today's costs.  Her plan can cover the remaining 50%, and they would get her lifetime maximum too.


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## Neolithium (21 Aug 2012)

Thanks for the links as well everyone, I think I may have to go visit my clerks for clarification because unless I'm really reading my pay stubs wrong it looks like my PSHCP deductions are $112 a month.


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## DAA (21 Aug 2012)

Neolithium said:
			
		

> Thanks for the links as well everyone, I think I may have to go visit my clerks for clarification because unless I'm really reading my pay stubs wrong it looks like my PSHCP deductions are $112 a month.



In Block K of your pay statement under Medical Insurance Plans ------>  http://www.cmp-cpm.forces.gc.ca/dgcb-dgras/ps/pay-sol/dmp-dts/psd-des/doc/dps-des.pdf

One thing I have noticed over the years is people being posted out of BC and the BC Med deductions not being ceased.


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## Occam (21 Aug 2012)

Neolithium said:
			
		

> Thanks for the links as well everyone, I think I may have to go visit my clerks for clarification because unless I'm really reading my pay stubs wrong it looks like my PSHCP deductions are $112 a month.



I think you're reading your pay stubs incorrectly.

If you look at the "Pay Deductions" box, there should be a box there called "Medical Insurance Plans".  You should see an amount in there for PSHCP (in my case, $4.00 for Level III coverage).

Don't look at the "Transaction Details" box, as there may be an amount there called "NON TAXABLE FRINGE BENEFITS MONTHLY/YEARLY", where you'll see an amount for PSHCP.  That's the employer-contributed amount of the premiums.


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## captloadie (22 Aug 2012)

Occam said:
			
		

> To expand on that:  You submit a drug claim through PSHCP for $100.  They pay for $80 out of that.  Under coordination of benefits, you can submit the remaining $20 under the spouse's coverage.  If your medical expenses are high enough such that the amounts transferred to the spouse's claims exceed $720/year, then it's worthwhile to maintain coverage through both employers.



This is true, except that under PSHCP, you have to submit the claims through the spouse's plan first, then submit a claim for the remainder. Of the remainder, you will still likely only get 80% covered. On things like prescriptions and glasses, it is not possible to get 100% of the money back (unless the spouse' s plan covers everything).


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## Occam (22 Aug 2012)

captloadie said:
			
		

> This is true, except that under PSHCP, you have to submit the claims through the spouse's plan first, then submit a claim for the remainder.



Ah, I knew there was an order they were submitted in, but I took a 50/50 chance and blew it.  Thanks for the correction.


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## Neolithium (23 Aug 2012)

Occam said:
			
		

> I think you're reading your pay stubs incorrectly.
> 
> If you look at the "Pay Deductions" box, there should be a box there called "Medical Insurance Plans".  You should see an amount in there for PSHCP (in my case, $4.00 for Level III coverage).
> 
> Don't look at the "Transaction Details" box, as there may be an amount there called "NON TAXABLE FRINGE BENEFITS MONTHLY/YEARLY", where you'll see an amount for PSHCP.  That's the employer-contributed amount of the premiums.



Thank you kindly for the correction.  I was way off in how I was reading it and your info helped clear it up nicely.


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## 63 Delta (28 Mar 2013)

I was just told by someone that they had their PSHCP premium's claimed as medical expense. In the army, doesnt the army pay for the PSHCP? And if they pay, how can we deduct it...


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## my72jeep (28 Mar 2013)

some of us pay our own premium's


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## 63 Delta (28 Mar 2013)

Im talking specifically Regular Force members. In class that wasnt already evident.


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## PMedMoe (28 Mar 2013)

If I understand what you're asking, then yes, the CF pays that for you.  I _believe_ you can change the coverage, but the extra cost is yours.  Claiming insurance as a medical expense?  Not sure that's allowed.....


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## 63 Delta (28 Mar 2013)

https://turbotax.community.turbotaxonline.ca/post/show_full/cVG2aitH8r4ANUeJfaad02

This is the reference Ive found.


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## PMedMoe (28 Mar 2013)

I wouldn't consider an online forum much of a reference.  

Here's a better one: http://www.cra-arc.gc.ca/E/pub/tp/it339r2/it339r2-e.txt

And "Your total expenses must be more than either 3% of your net income or $2,024, whichever is less."  http://support.intuit.ca/turbotax/en-ca/iq/Medical-Expenses/INF15068.html


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## 63 Delta (28 Mar 2013)

Didnt consider it as definitive reference, just a signal flare. Ill look into that one thanks! 

Everyone is filing taxes right now; figured this must have wrung a bell with someone. I know I didnt claim it.


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## dapaterson (28 Mar 2013)

Employer-paid premiums are not claimable unless they are included in your taxable income.  

However, I believe premiums paid by an individual are claimable as medical expenses, provided the total medical expenses exceed the minimum thresholds.  For CF members, basic PSHCP premiums are employer-paid and not included in your taxable income.  If you opt for the top level of coverage, it's about $10 or so per month.


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## 63 Delta (28 Mar 2013)

Awesome. Thats the answer I thought it was and thats what I was looking for. Appreciate the help guys!


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## Eye In The Sky (28 Mar 2013)

$4 I believe is what I pay for the top up and IIRC the top up is specifically for the Lvl 3 hospital stage coverage "stuff".  Private room, belly dancers, etc.


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## PMedMoe (28 Mar 2013)

I think _if_ that's your _only_ medical expense, you're not going to see a difference if you claim it (if you're above the amounts quoted) on your taxes.   :dunno:


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## my72jeep (28 Mar 2013)

Eye In The Sky said:
			
		

> $4 I believe is what I pay for the top up and IIRC the top up is specifically for the Lvl 3 hospital stage coverage "stuff".  Private room, belly dancers, etc.


I pay $132 a month for 3 for level 3 care. Still dosen't get me a Semi Pvt in Toronto, but does in Wawa. but I am a Class A CIC. so I f I get that right I can claim it?


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## Old EO Tech (1 Apr 2013)

my72jeep said:
			
		

> I pay $132 a month for 3 for level 3 care. Still dosen't get me a Semi Pvt in Toronto, but does in Wawa. but I am a Class A CIC. so I f I get that right I can claim it?



Yes I would certainly say you can claim that fully as a medical expense.  But I believe the last time I tried claiming medical expenses, you only get 17% of it in the end of the calculations.   But every little bit helps though.


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## bigcletus (2 Apr 2013)

I was recently hospitalized, 5 surgeries over 2.5 years.  On one of my visits, my wonderful nurse told me a story.  She's married to a Fed gov't employee who has PSHCP.   I had inquired about getting a semi-private room, using my wife's insurance.  She told me that all hospitals, at least in NB, only "issue" S-P and private rooms based on medical need.  They do not keep rooms open waiting for better paying guests.  She also suggested I lower my PSHCP to the basic level as its a waste of money to pay more.  Now I can't speak to other provinces, but I suspect its probably similar.


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## my72jeep (2 Apr 2013)

bigcletus said:
			
		

> I was recently hospitalized, 5 surgeries over 2.5 years.  On one of my visits, my wonderful nurse told me a story.  She's married to a Fed gov't employee who has PSHCP.   I had inquired about getting a semi-private room, using my wife's insurance.  She told me that all hospitals, at least in NB, only "issue" S-P and private rooms based on medical need.  They do not keep rooms open waiting for better paying guests.  She also suggested I lower my PSHCP to the basic level as its a waste of money to pay more.  Now I can't speak to other provinces, but I suspect its probably similar.


Mount Sini will go out of its way to put you in a semi $450/day or a Pvt $500/day Or if your in a pvt due to medical reasons and not paying for it, they will move you out with in an hour of your statis change. but first some one from accounting will visit to see if you want to fork over the money to keep it.
I pay the extra $10 a month for level 3 as it payes up to $375/400 day so the remander on my Visa for a pvt is not so bad, done the ward thing never again.


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## McG (24 Mar 2014)

With all those "other" boxes available at the bottom of the T4, it would be nice if PSHCP premium payments were presented as Box 85.


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## Transporter (24 Mar 2014)

Your total expenses still have to exceed the minimum threshold of either 3% of your net income or $2,024, whichever is less. So, based on the numbers being tossed around above, isn't it a moot point?


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## McG (24 Mar 2014)

By itself, yes.  Added with other medical expenses, maybe not.


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## Crispy Bacon (25 Mar 2014)

Canada Revenue Agency - medical expenses

As well:

http://www.cra-arc.gc.ca/tx/ndvdls/tpcs/ncm-tx/rtrn/cmpltng/ddctns/lns300-350/330/ntllwbl-eng.html



> *Which medical expenses are not eligible?*
> 
> There are a number of expenses that are commonly claimed as medical expenses in error. The expenses you cannot claim include the following:
> 
> ...


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## McG (25 Mar 2014)

Crispy Bacon said:
			
		

> As well:
> 
> http://www.cra-arc.gc.ca/tx/ndvdls/tpcs/ncm-tx/rtrn/cmpltng/ddctns/lns300-350/330/ntllwbl-eng.html


What is your point?


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## Alf125 (18 May 2014)

A few comments on the topic:

1. You can claim what you pay in medical insurance premiums but not the employers share. For the regular force the employer covers the full cost of basic coverage so you would only be able to claim anything you pay for extra coverage which currently maxes out at about $5.00/month I believe. Reservists and Pensioners pay a much higher portion of PSHCP depending on level of coverage, family situation and class/duration of service (for reservists) so they would be able to claim these amounts.

2. As noted by others there is a 3% of net income threshold that must be reached before medical expenses are of any benefit on your taxes. For example a single member with $70K in net income would have to exceed $2100 in medical expenses before there would be any tax benefit, unlikely for a single member. However PSHCP has a co-pay and coverage limitations so a married/common law member might reach this level especially if a dependant has significant medical issues.

3. The combined medical expenses for the entire family (spouses/minor children) may be claimed by either partner in married/common law relationships. A single parent with $70K and medical expenses of $1600 would see no tax benefit. However if he/she was married or common law and the partner had $20Kin net income then the lower income partner could claim $1000 (1600 - [3% of 20K]) medical expenses and save $180-$240 on their taxes depending on province of residence.

4. The Harper government is in the process of tripling PSHCP premiums for pensioners. For single level 1 coverage the cost will go from $21.78 to about $65.00 per month. Combined with co-pays and coverage limitations this will put more pensioners over the 3% threshold for medical expenses.

5. Neither pay offices for current members nor PWGSC for pensioners includes health insurance premiums on T4/T4A slips even though the slips have boxes for these entries. CRA will not accept pay/pension statements as proof of the expense. If you wish to claim these amounts you should get a statement from your pay office or PWGSC as applicable stating how much you paid.

6. For retired members who pay premiums for the Pensioners Dental Service Plan (PDSP), these are also claimable as a medical expenses and PWGSC will include on a statement with your PSHCP premiums if you ask for them both.


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## misratah500 (15 May 2015)

Do you guys know if a service for a child like Registered Clinic Counsellor would be covered under Sun Life or whomever we use for coverage? I'm not sure who to contact to look into this.


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## MJP (15 May 2015)

http://www.pshcp.ca/coverage.aspx

All your coverage questions and more.  I would call them, other than one or two small issues I have found their call center pretty decent.

Services of other medical practitioners
To be eligible under the Plan, the services rendered must:

be performed by a practitioner that is registered, licensed or certified—in accordance with provincial/territorial regulations—to practice in the jurisdiction where the services are rendered,
require the skills and qualifications of the practitioner,
be in the area of expertise of that practitioner.
You are encouraged to contact Sun Life prior to incurring expenses to verify that the medical practitioner has the appropriate credentials for their services to be eligible under the Plan.

Eligible expenses
Acupuncture	
Acupuncture treatments performed by a physician.

Chiropractor	
Maximum eligible expense of $500 per calendar year.

Electrologist

(or physician when performing electrolysis treatments)	
Treatment for the permanent removal of excessive hair from exposed areas of the face and neck when the patient suffers from severe emotional trauma as a result of this condition. 

In the case where the services are performed by an electrologist, a prescription is required from a psychiatrist or a psychologist to certify that the patient suffers from severe emotional trauma as a result of this condition. 

The prescription is valid for three years. The maximum eligible expense is $20 per visit.

Massage therapist	
Maximum eligible expense of $300 per calendar year. 

Physician's prescription is required and is valid for one year.

Naturopath	
Maximum eligible expense of $300 per calendar year.

Osteopath	
Maximum eligible expense of $300 per calendar year.

Physiotherapist	
Maximum eligible expense of up to $500 and over $1,000 per calendar year.

Physician's prescription is required and is valid for one year.

Podiatrist / Chiropodist	
Maximum eligible expense of $300 per calendar year.

Psychologist	
Maximum eligible expense of $2,000 per calendar year.

In 2014, the $1,000 top-up will only apply to expenses incurred on or after October 1st.

Physician's prescription is required and is valid for one year.

Social worker	
Only if you live in an isolated post (listed in Appendix A of the National Joint Council’s Isolated Posts and Government Housing Directive) and no psychologist practices in that isolated post.

Physician's prescription is required and is valid for one year.

Speech language pathologist	
Maximum eligible expense of $500 per calendar year.

Physician's prescription is required and is valid for one year.


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## dapaterson (15 May 2015)

Start reading: http://www.pshcp.ca/coverage.aspx


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## misratah500 (25 Jun 2015)

Does anyone know where I can find our dental coverage?


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## RedcapCrusader (25 Jun 2015)

dapaterson said:
			
		

> Start reading: http://www.pshcp.ca/coverage.aspx



This is Dental Coverage for RegF personnel (and select ResF mbrs)

http://www.forces.gc.ca/en/caf-community-health-services-benefits-drug-coverage/comprehensive-dental-care.page

However for benefits for family are through PSHCP as above.


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## Blackadder1916 (25 Jun 2015)

LunchMeat said:
			
		

> However for benefits for family are through PSHCP as above.



While there is a dental benefit under PSHCP, it is only for certain procedures and courses of treatment following accidental injury.  For regular dental services there is a separate and distinct plan - the Dependants' Dental Care Plan (DDCP) http://www.forces.gc.ca/en/caf-community-benefits/dependants-dental-care-plan.page


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## 3VPspecialty (20 May 2016)

Just wanted to hear what everyone thinks about the PSHCP for veterans? How many use it? Do you find it worth the money?


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## George Wallace (20 May 2016)

Is it worth it?  That answer may differ from person to person.  

It is an insurance policy that will give you coverage and refund a percentage of your medical expenses back to you.

A similar insurance policy for Dental (Pensioner' Dental Service Plan - PDSP) is also available.  This is administered by Sun Life, as well.

In some cases, in conjunction with another medical or dental plan held by your spouse, you may get 100% refund.

In the end, participation is up to you.


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## Rifleman62 (20 May 2016)

I would highly recommend it. The health plan covers 80% of the approved fee schedule for prescription drugs for you and your family, etc. The dental plan covers annual checkups for you and your family and other fees (fillings etc) up to $1,500 per year.

You can deduct both annual premiums off your income tax as well as what Sun Life did not cover (the 20%). Travel benefit for the health plan for 40 days, so if you travel to the USA you have some coverage. 

All the info is on line which I am sure you looked at.


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## George Wallace (20 May 2016)

You can find contact info in this thread:

https://army.ca/forums/threads/91801/post-907154.html#msg907154


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## 3VPspecialty (20 May 2016)

George Wallace said:
			
		

> Is it worth it?  That answer may differ from person to person.
> 
> It is an insurance policy that will give you coverage and refund a percentage of your medical expenses back to you.
> 
> ...



Thanks for the info, do you know if the dental plan is open to all retired members? Or only those receiving a pension??


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## sarahsmom (21 May 2016)

George, is the dental plan not administered by Great West Life, same as for dependents?


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## George Wallace (21 May 2016)

paleomedic said:
			
		

> George, is the dental plan not administered by Great West Life, same as for dependents?



Great West Life is managing the SRSPs.

Sun Life is managing both the Dental and the Health plans for pensioners.


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## ModlrMike (21 May 2016)

I kept PSHCP when I got out. It costs me on average about $1000 per year. Given that I have four of us to cover, and my drugs costs would be $250 per month (at 100%), plus four pairs of glasses every two years... it's worth it to me. It will still be worth it when my kids leave home.


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## observor 69 (21 May 2016)

Lets take an average retired married couple. As they age diabetes, high blood pressure and a few others become quite common.
In Ontario waiting until you are 65 for the provincial drug plan to kick in can get expensive.

The dental plan is also a good idea. Older teeth can go through $1500 per year in a hurry.

IMHO worth every dollar.


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## the 48th regulator (21 May 2016)

Baden Guy said:
			
		

> Lets take an average retired married couple. As they age diabetes, high blood pressure and a few others become quite common.
> In Ontario waiting until you are 65 for the provincial drug plan to kick in can get expensive.
> 
> The dental plan is also a good idea. Older teeth can go through $1500 per year in a hurry.
> ...



I second , and even third and fouth it. Very well said!

A worthwhile plan, and my family uses it.

Tess


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## thevetswife (28 May 2016)

We most certainly get our $ worth having the plan.  You can also use the amount of the premiums towards your medical amount on your tax return.


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## 3VPspecialty (28 May 2016)

I could be wrong here but my only wish is for there to be an added dental plan with the PSHCP. I understand that there is a pensioners dental plan but as a young adult who isn't a pensioner but still a veteran it makes finding dental insurance a pain having to deal with two different insurance companies.


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## Eric Wang (15 Dec 2016)

Can my family receive Canadian forces benefits? or I am the only one who can have them?


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## AmmoTech90 (15 Dec 2016)

Well, they're not going to get a paycheck unless they join up as well.

Want to be a bit clearer?


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## Eric Wang (15 Dec 2016)

AmmoTech90 said:
			
		

> Well, they're not going to get a paycheck unless they join up as well.
> 
> Want to be a bit clearer?



Like (For example) health/dental benefits


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## PuckChaser (15 Dec 2016)

Dependants are covered under Public Service Health Care Plan. Basically 80% coverage for most things, you can Google the coverage. Dental is under Great West Life, roughly 80% for that as well.


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## mariomike (15 Dec 2016)

Eric16 said:
			
		

> Can my family receive Canadian forces benefits?



Note: OP: Regular/ Reserve: Reserve

See also,

Forces.ca

Health and Dental
http://www.forces.gc.ca/en/caf-community-benefits/health-dental.page

Reserve Dental Care Plan 
http://www.forces.gc.ca/en/caf-community-benefits/reserve-dental-care-plan.page

Reserve Dental Care Plan - Frequently Asked Questions
http://www.forces.gc.ca/en/caf-community-benefits/reserve-dental-faq.page

Dependants' Dental Care Plan (DDCP)
http://www.forces.gc.ca/en/caf-community-benefits/dependants-dental-care-plan.page

etc...


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## sailoraye123 (30 Jan 2018)

Hi,

      my wife is civilian and I've been getting pay deductions off my pay for her Medicare, but we haven't been sent a number.. any info? Or how to put a claim in for dental. Eye, or ordinary prescriptions can somebody point me in the right direction


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## kratz (30 Jan 2018)

Your post has been merged with the answers. 

Reply # 1 -perscriptions, ect... and 
Reply # 4 - dental. 

Follow those two insurance plans.


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## Jarnhamar (30 Jan 2018)

Will the CAF pay for a dependent  to be seen and screened for adhd. It's not covered by Ohio and starts at like $1200


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## brihard (30 Jan 2018)

Is the dependent named under the member’s public service health care plan coverage for family?


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## expwor (30 Jan 2018)

I don't know if this helps but here's the PSHCP Member Booklet and what is/isn't covered
http://www.pshcp.ca/media/38813/pshcp-member-booklet-web-en.pdf
I may be making an assumption the health care plan is the same one Public Servants and retirees have
Pages 35-37 summarize benefits
Also here's contact numbers for Sunlife to ask them 1-888-757-7427 (toll free in North America) and 
613-247-5100 in the National Capital Region
Hope it helps 

Tom


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## Jarnhamar (31 Jan 2018)

Brihard yes they are.

Tom thanks ill check the link out.


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## Occam (31 Jan 2018)

It is covered under PSHCP, under the psychologist benefit.  We had our son tested; the testing was done over several months at the end of one calendar year, and the resulting report was also billed separately in the new calendar year, so we didn't run into any problems with the annual claim limit for the psychologist benefit.  Wasn't planned that way, just kind of worked out like that.


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## FlyLikeAnEagle (15 Apr 2018)

So, I just got married and need some advice on a few things. 

1. When i was at CFLRS they had a civvie/staff come in and talk about how SunLife will provide insurance on military spouses and such. Now, will they cover glasses for my new step daughter and how does it work exactly? 

2. When the time is right & I'm done my training, will they fly my wife & step daughter out to my new base (if I leave CFB ESQUIMALT) along with our personal belongings? 

3. How does the PAternity leave work? I heard its 80% of your wages from one, 75% from another. 

Thanks,
FLAE


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## dapaterson (15 Apr 2018)

Inform your orderly room of your change of marital status, and that you now have dependants.

Your dependants will now be covered by the PSHCP and PSDCP (health care and dental care) plans.

You will be moved once you reach the OFP.

Paternity leave gets you just over 90% of pay; you'll get both EI and a top- up from the CAF.


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## dimsum (8 Mar 2019)

Folks who have dealt with Common Law and PSHCP:

My S/O and I have been CL since Aug, but she has a decent med/dent plan right now so I hadn't looked into switching to PSHCP for her.  Someone told me that if you're outside 3 months of eligibility (Nov in this case) then it's an extra 3 months' wait to start?  Also, I'm assuming this process starts at the OR - I'd like to be prepared so what docs would I need to bring them?  

Thanks!


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## ballz (28 May 2019)

Anyone know whether or not our healthcare covers the rabbies vaccines? They are like $750 if you don't have coverage. I have started travelling abroad for leisure and some places, like SE Asia and Africa, are high risk. Not exactly places I want to get an immune globulin, that's if it's even available. I was backpacking in SE Asia last xmas and it was hard to be comfortable with stray dogs everywhere that are always coming up to tourists to get food and stuff.


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## kratz (28 May 2019)

ballz said:
			
		

> Anyone know whether or not our healthcare covers the rabbies vaccines? They are like $750 if you don't have coverage. I have started travelling abroad for leisure and some places, like SE Asia and Africa, are high risk. Not exactly places I want to get an immune globulin, that's if it's even available. I was backpacking in SE Asia last xmas and it was hard to be comfortable with stray dogs everywhere that are always coming up to tourists to get food and stuff.



PSHCP website drug benefit will cover: 


> Eligible drugs: Reasonable and customary charges up to 80%



When we were planning our trip to Mexico, the pharmacist was willing to submit each vaccination to PSHCP for payment, prior to administering the injection(s). All of our claims were approved. All total, we saved over $1500 worth of travel vaccinations and will not require boosters for 5 to 8 years for most of them. 

So I think rabies could be covered, as it's good for up to 2 years. The best approach is to ask the pharmacist to run it through the system with PSHCP first. 

If you are still serving and PSHCP does not cover a vaccination, you will be directed to your MIR, who may or may not approve the vaccination. or our trip, my wife was not approved and we had to pay the full amount ourselves, as it was not required for her duties. *shrug* Based on what we saved in total, we paid for that one vaccination.

** Edit: to add if you are still in the CAF.


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## kwon (25 Jan 2020)

I have my spouse enrolled under the pshcp. As a serving member am I covered for drugs, vision etc? I know as serving members we have blue cross but can we also use pshcp for drugs for example? Theres a prescription covered by sunlife but not blue cross.


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## dapaterson (25 Jan 2020)

No.  PSHCP is not for CAF members.


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## kwon (25 Jan 2020)

Could I ask blue cross to coordinate benefits since the pshcp (I'm a member but not covered) covers a drug but blue cross does not (reference the CAF drug benefit list)?


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## dapaterson (25 Jan 2020)

No.  Unless you have a spouse with coverage under the PSHCP, it does not cover you.

This suggests you are seeing a physician outside the CAF for medical care who is issuing you prescriptions.  If that is the case, you have the obligation to report those treatments to the CAF medical system.


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## kwon (26 Jan 2020)

dapaterson said:
			
		

> No.  Unless you have a spouse with coverage under the PSHCP, it does not cover you.
> 
> This suggests you are seeing a physician outside the CAF for medical care who is issuing you prescriptions.  If that is the case, you have the obligation to report those treatments to the CAF medical system.



No, CAF referred me to a specialist and he is the one who wrote the script. CAF is aware that I'm seeing the specialist.


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## PuckChaser (26 Jan 2020)

Kwon said:
			
		

> No, CAF referred me to a specialist and he is the one who wrote the script. CAF is aware that I'm seeing the specialist.


Take it to the base pharmacy, it's free.


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## Eye In The Sky (26 Jan 2020)

This isn't a case where you're a Cl A reservist or something is it?


----------



## kwon (26 Jan 2020)

Eye In The Sky said:
			
		

> This isn't a case where you're a Cl A reservist or something is it?



No, not a Class A.


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## ballz (26 Jan 2020)

kratz said:
			
		

> PSHCP website drug benefit will cover:
> When we were planning our trip to Mexico, the pharmacist was willing to submit each vaccination to PSHCP for payment, prior to administering the injection(s). All of our claims were approved. All total, we saved over $1500 worth of travel vaccinations and will not require boosters for 5 to 8 years for most of them.
> 
> So I think rabies could be covered, as it's good for up to 2 years. The best approach is to ask the pharmacist to run it through the system with PSHCP first.
> ...



I didn't realize that the Public Service Healthcare Plan is not actually what the CAF members are covered under until a later post by DAP. I guess I'm young and don't have dependents so its not something I've really looked into very heavily.



			
				dapaterson said:
			
		

> No.  PSHCP is not for CAF members.



As it turns out, the rabies vaccine is fully covered by our CAF healthcare and there's a handy search tool you can use...

http://www.cmp-cpm.forces.gc.ca/hs/en/drug-benefit-list/index.asp


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## ModlrMike (21 May 2021)

Does anyone know where I send my MB Pharmacare deductible form?


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## dimsum (3 Jun 2021)

Does anyone know if the dependent can submit claims online themselves, or do I have to do it?


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## dapaterson (3 Jun 2021)

Believe it's you, as you are the insured individual.  I am Public Service, and submit for my wife for her expenses.


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## sarahsmom (5 Jun 2021)

dimsum said:


> Does anyone know if the dependent can submit claims online themselves, or do I have to do it?


The workaround a lot of spouses have found for the online claims is the member creates an account, and gives the spouse the login and password. Then the spouse can submit all the claims whether the member is home or away. The onus is on the spouse to ensure the member is aware of all the claims submitted in case Sunlife has questions.  Both halves of the couple can also download and install the sunlife app onto their smartphones and use the member's login. (That's what i do at least and it works great for us).


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