Dentist

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Making a Claim


Regular Dental Expenses and Dental Surgery
 
If Your Dentist Submits Electronically
Make sure all your personal information is correct, including plan number 25298 and your member ID number.
 
If Your Dentist Does Not Submit Electronically
You must submit your claim directly to Sun Life either electronically or by paper claim form.
 
E-claims submission is not available for all types of dental claims. Send Sun Life a paper claim form for any of the following types of dental claims: 
  • requests for predeterminations/estimates of coverage on proposed dental work;
  • claims for bridges, crowns or dentures;
  • claims where the dentist gave you x-rays, tooth molds or supporting documentation/correspondence (these need to be submitted with your paper claim);
  • claims where payment is assigned to your dentist (if permitted under your plan);
  • claims as a result of an accident;
  • out of Canada claims; and
  • orthodontic claims: if Sun Life Financial has approved your treatment plan, you can submit your claims online. If your treatment plan has not been submitted to Sun Life, please include it with your claim form and your receipts. 
Mobile
  1. go to Sun Life Mobile,
  2. sign in with your Access ID and password,
  3. click on Submit a Claim,
  4. click on Dental.  
Online
  1. Go to www.mysunlife.ca/navcanada,
  2. sign in with your Access ID and password,
  3. click on My claims,
  4. click on Dental e-claim under the Submit a claim section.
You can get an Access ID and password by calling Sun Life at 1-800-361-6212 or by clicking "Register now" on the sign-in page www.mysunlife.ca/navcanada.
 
Paper Claim Form
  1. Pay the expense and get a receipt,
  2. complete Dental and Health Spending Account Claim Form, and
  3. mail both the claim form and original receipt to Sun Life. 

Accidental Injury
These claims cannot be submitted electronically by your dentist, they must be submitted by paper claim form.
  1. Have your dentist complete the appropriate sections of the Dental and Health Spending Account Claim Form,
  2. make sure that the claim is not sent electronically to the Dental Care Plan,
  3. attach the Dental claim form to an Extended Health Care and Health Spending Account Claim Form, and
  4. send both to Sun Life. 

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 both work for NAV CANADA 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.


Claim Deadlines
  • Orthodontic expense claims must be received by Sun Life no more than 15 months after the date of each monthly visit throughout the treatment period.
  • Other expense claims must be received by Sun Life no more than 15 months after the date of treatment.

Checking Health and Dental 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