How to Claim Health Insurance in Canada?

The Canadian Healthcare system is typically very systematic and organized. All the medical expenses are publicly funded, which is shared by all the taxpayers in the nation. So, if you live in Canada, most of your medical expenses will be taken care of by the hospital services within the country. However, that doesn’t mean you don’t need to claim your medical insurance. You don’t need to worry as we will discuss the easy steps to claim your medical insurance without much hassle. Medical Insurance

Understanding how health insurance work in Canada

Any Canadian citizen can apply for public health insurance. This benefit is also applicable to foreign workers on work permits and privileged international students. In most of the provinces, you can avail provincial health insurance coverage anytime. In the case when you settle down from another province, typically you will get access to all the medical insurance privileges. However, in some provinces, it can take a maximum of three months to formulate everything. In the meantime, you can choose any private health insurance company to keep you insured.

Read : How to Claim a Car Accident Insurance in Canada

Any medical insurance typically covers medical expenses like prescriptions, dental & optical services, and other paramedical care. Some companies also provide medical insurance to their employees as an added benefit. However, you must surpass the probationary period to get access to such benefits. Medical Insurance

If you are a Canadian resident, no matter which province you come from or where you settle down, you will get all the facilities that every Canadian resident enjoy. The same applies to medical insurance as well; you are covered with whichever province you came. However, there are some limitations that you must understand. There are some interim costs that you have to bear, and you will not get it back. Such costs include the ambulance transportation fee, emergency dental services, and prescription drugs.

The steps to file claims of your medical insurance

The terms and policies of medical insurance in Canada varies from one province to another. Therefore, you have to check the respective terms and policies of the province you live, or the province you will go next. It is the basic principle that you should remember. Now, we will discuss the steps to understand and claim your insurance.

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  • What you can claim: Probably the most critical question is what you can claim? To answer that, first, you should remember the variable terms and policies of every province in Canada. However, some of the fundamental clauses are more or less the same – the physician services that you will get outside of your residing province, the payment of physician services, the hospital services outside your residing province are a few standard clauses. Please make sure you understand the terms and policies thoroughly. Medical Insurance
  • Fill up the practitioner services form: The next step is to fill up the practitioner or physician services form. Just like understanding the terms and policies of the variable province, you need to fill up this form which varies from one province to another. Please make sure, you carefully fill up the form with accurate information to avoid any future conflict.
  • Keep your documents handy: While you try to claim medical insurance, you must have all the relevant documents handy with you. These documents are apparently, the proof to claim your insurance. The documents include the likes of every payment receipt you ever made for your medical treatment, pathology payment receipts, and the payment receipts of prescribed medicines. Again, read the terms and policies part carefully to know which documents are mandatory. However, it is wise to keep all the documents handy.
  • Submit the completed form: You need to mail the form along with the necessary documents to file a claim of your medical insurance. The mailing address varies from one province to another. So, confirm the address before sending.

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In the case of services outside Canada, the procedure is more or less similar to those who are in the country. However, in that case, the insurance authority will verify some of the documents first before they grant your insurance claim. Here is a list of what they will ascertain:

  • Hospital service information: As the insurance authority will verify your hospital services, you must have all the information ready with you, such as the name and address of the facility you were in, your hospital admission day along with the discharged date. Apart from that, all the laboratory and pathology services required for your treatment.
  • Physician service information: You need to provide all the payment proof related to the physician who treated you. You will also need to have critical details like his name and his specialty, the current CPT billing codes, and every surgery information if applicable.

Read : What is the Canada Pension Plan (CPP) and What are its Features and Benefits?

The conclusion

You may wonder if all these steps are very messy. Believe us; it is not. You will get full support from every institution, and all you need to do is to keep track of every record, receipts, and information associated with the claim.

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