Making a Claim

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​Making a Claim


Submitting a Claim

Select the type of benefit from the list below (to return to this page click your browser`s back button):
Health Practitioner
Hearing Aids
Hospital and Ambulance
Life Insurance
Medical Supplies and Services
Preferred Pharmacy Network
Prescription Drugs
​​Travel
Vision

In provinces with a program to cover expenses also covered under the NAV CANADA Health Care Plan (for example, prescription drugs, artificial limbs and other assistive devices, dental services, etc.), first, submit your claim to the province. Then, submit any eligible expenses remaining under the Health Care Plan.
Coordination of Benefits

If you and your spouse are covered by more than one Benefit Plan, you may be able to claim up to 100% of eligible expenses, depending on what is eligible under your spouse’s plan. You can also coordinate benefits if you and your spouse are both covered under the NAV CANADA Health Care Plan and both have family coverage.

Always submit expenses first to the plan that covers you as a full-time or part-time employee (if, for example, you are covered under another plan as a spouse or retiree).

​For expenses incurred by...
​Submit your claim...
​You
  1. ​To your NAV CANADA plan
  2. To your spouse's plan, if a balance remains
Your Spouse
  1. ​​To your spouse's plan
  2. To your NAV CANADA plan, if a balance remains
​Your Children
  1. To the plan of the parent whose birthday falls earlier in the year (if both parents have the same birth date, to the plan of the parent whose surname begins with the first letter in the alphabet)
  2. To the plan of the other parent, if a balance remains
If you are separated or divorced and are claiming for your children

Claims must be processed in the same order as if you have shared custody of your children. As long as you are the legal parent of the child, you can process his or her claims. 

Claims must be submitted first to the plan of the parent with primary custody, then, to the plan of the other parent, if a balance remains.


Claims Submission Deadlines 

Health Care Plan
Expense claims must be received by Sun Life no more than 90 days after:
  • the end of the year in which the expense is incurred, or
  • termination of coverage.

Checking Health Claims Status

Call the Sun Life toll-free customer service number, and select the option “Medical and Dental Claims Information”, Monday through Friday 7 am to 8 pm, Eastern Standard Time, at 1-800-361-6212.

Alternatively, go online to the Sun Life Member Services web site at www.mysunlife.ca/navcanada using your Access ID and PIN. You can get an Access ID and PIN number by calling Sun Life at the above number.

 
Published on February 01, 2016