Making a Claim
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.
If you, your spouse
, or any of your children
are hospitalized, give the admitting clerk your benefit card.
bill the plan directly. If your hospital does not, send a completed Extended Health Care and Health Spending Account claim form with the hospital’s invoice to Sun Life. They will either pay the hospital directly, if the claim was sent directly from the hospital, or reimburse you, up to the value of semi-private accommodation.
Expense claims must be submitted by paper form.
- Pay the expense and get a receipt,
- complete an Extended Health Care and Health Spending Account claim form, and
- mail the claim and original receipt 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).
- To your NAV CANADA plan
- To your spouse's plan, if a balance remains
- To your spouse's plan
- To your NAV CANADA plan, if a balance remains
- 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)
- 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.
Expense claims must be received by Sun Life no more than 90 days after:
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.