Did You Know?
This article was published before the transition to the new Plan Administrator, Canada Life. If you have any questions, contact the PSHCP Member Contact Centre at 1-855-415-4414 (toll-free anywhere in North America) or 1-431-489-4064 (call collect if you are outside North America).
Under the Public Service Health Care Plan (PSHCP), members and their eligible dependants are covered under the Medical Practitioners Benefit. Many paramedical services are eligible for reimbursement under this benefit, including services from mental health practitioners. In addition to psychologists, the list of eligible practitioners was temporarily extended during the COVID-19 pandemic to include social workers in all areas across the country, psychotherapists and counsellors. The temporary measures, which also allow for virtual services from these practitioners, will remain in effect until otherwise indicated.
The Medical Practitioners Benefit provides reimbursement for eligible expenses that are the reasonable and customary charges. Eligible services must be within the area of expertise of the practitioner and require their specific skills. In addition, the practitioner must be registered, licensed, or certified to practice in the jurisdiction where the services are rendered in accordance with provincial/territorial regulations. At all times, and without exception, under the terms of the PSHCP, a practitioner rendering care to a PSHCP member with supplementary coverage must be registered with a recognized association in Canada.
How to submit your claims for virtual services
PSHCP members must submit their claims for services rendered by a social worker, psychotherapist or counsellor by mail. When submitting a claim for virtual services, members must include all supporting documentation, such as original receipts, bills, invoices, physician or practitioner statements, and/or questionnaires, etc.
Members with Supplementary coverage:
Complete the PSHCP Claim Form and mail it to the address below:
Sun Life Assurance Company of Canada
PO Box 6192, STN CV
Montreal, QC H3C 4R2
Members with Comprehensive coverage
Complete the PSHCP Out-of-Country Claim Form and mail it to the address below:
Allianz Global Assistance
Public Service Health Care Plan
PO Box 880
Waterloo, ON N2J 4C3
Claims for services rendered by other medical practitioners may be sent to Sun Life according to the standard claims submission process. They may be submitted via the Sun Life Plan Member website (www.sunlife.ca/pshcp) or through the my Sun Life Mobile application, or by paper. When submitting a claim electronically, members can enter up to eight different expenses in one transaction. Claims submitted electronically are adjudicated immediately and, if approved, any reimbursement amount is usually deposited directly into the member’s bank account within 24 to 48 hours. However, if the claim requires additional review or information, the processing time will be longer. Members must keep their receipts for 12 months as information may be requested to substantiate services or products that have been claimed.
If you have any questions about virtual services or the eligibility of a mental health practitioner under the PSHCP, contact the PSHCP Call Centre at 1-888-757-7427 (toll-free) or 613-247-5100 (in the National Capital Region).