For qualifying members, a Health Care Spending Account (HCSA) is an account through which you may be reimbursed for healthcare and dental expenses up to a predetermined annual credit amount. The Trustees of your Health & Welfare Plan will establish the credits for your benefit level prior to each plan year. These credits may be used to cover expenses not covered by group health plans or to top-up expenses not fully covered by group health plans, including deductibles and co-payment amounts. Also, since annual credits are in the form of before tax dollars, the HCSA is a tax-effective way of paying for your health-related expenses.
How will I know the balance of my HCSA?
To check your current account balance, contact a customer service representative at Canada Life toll-free at 1-877-883-7072. Hours of service are 7 a.m. to 6 p.m. CST for service in English and 7 a.m. to 5 p.m. CST for service in French.
You and your dependents are eligible for HCSA credits through your Benefits Plan if you are covered for basic healthcare benefits under your or your spouse’s group health plan. In addition to the dependents eligible for coverage under your basic health plan, HCSA benefits are extended to any other person for whom you are entitled to claim a medical expense tax credit under the Income Tax Act (Canada).
Your HCSA coverage terminates when your basic healthcare coverage terminates or when your Trustees discontinue the plan.
Your dependents’ HCSA coverage terminates when your coverage terminates or when they no longer qualify, whichever is earlier.
Coverage is provided for those expenses:
Please refer to the Canada Revenue Agency website for information on medical expenses that qualify for the medical expense tax credit under the Income Tax Act (Canada). For additional information on covered expenses, contact a customer service representative at Canada Life toll-free at 1-877-883-7072.
Benefits will be paid for 100% of covered expenses that are incurred while you and your dependents are covered, up to a maximum annual payment equal to the credits in your HCSA. Dental expenses, other than orthodontic expenses, are considered to be incurred when treatment is completed. Orthodontic expenses are considered to be incurred on a periodic basis throughout the course of treatment. All other expenses are considered to be incurred when you or your dependent receives the service or supply.
Credits are available for covered expenses incurred in a plan year. Any remaining credits will be carried forward for covered expenses incurred in the following plan year. If they are not used for expenses incurred in that plan year, they are automatically forfeited.
The maximum annual payment available under your account will consist of the amount of the credit directed to it for the plan year plus any unused amount from the previous year.
No benefits are paid for:
How to Make a Claim
You have the option of submitting a claim by using the Health SolutionsPlus card, or by using the Health SolutionsPlus claim form. Claims for paramedical services, visioncare and dentalcare expenses incurred in Canada may also be submitted online.
The Health SolutionsPlus card is made available to you for use for covered expenses in accordance with the terms and conditions set out in your cardholder agreement.
You may submit a claim against the HCSA plan first, or you may choose to first submit it to a government plan or another private insurance plan under which you or any eligible dependents are covered. If other plans have paid first, you may submit a claim for any remaining balance of the expense to the HCSA plan online or by using the Health SolutionsPlus claim form.
If you use the Health SolutionsPlus card:
If you choose to use your Health SolutionsPlus card to pay for an expense, the amount will be drawn from the credits in your account whether or not coverage is available for the expense under another plan. However, if the expense would have been partially or completely covered under the basic plan sponsored by your plan administrator, you should submit a claim for the expense to the basic plan.
The amount that would have been paid under the basic plan may be credited back to your account and paid instead under the basic plan if:
Using the Health SolutionsPlus card:
Using the Health SolutionsPlus claim form:
If you elect to use the claim form, use form M445D(HSPT) for dental claims, and form M635D(HSPT) for all other claims.
Claim submission deadlines:
Claims against the HCSA must be submitted to the Canada Life Benefit Payment Office before the earliest of the following: