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Administration Authority

Plan details

• How the Plan works
  
  
• Key players
  
  • Administration Authority
    
  • Financial management
    
  • Administrator of the PSHCP
    
    
• Joining the Plan
  
  • Who is eligible to join?
    
  • Is membership optional?
    
  • How do I join?
    
  • What do I do if I need a replacement benefit card?
    
  • When does coverage begin?
    
  • Can I change from single to family coverage or vice versa?
    
  • Can I increase or decrease my hospital coverage?
    
  • Can I cancel coverage?
    
  • Where do I call if I have a question about eligibility?
    
    
• Cost
  
  • How do I pay for my part of the cost?
    
  • What happens if the cost changes?
    
  • How do I pay if I'm not getting a paycheque?
    
  • Where do I call if I have a question about my costs?
    
    
• Coverage
  
  • What coverage am I entitled to?
    
  • Do I have to pay a deductible before I can receive benefits?
    
  • Does the Plan pay all my expenses?
    
  • How much does the Plan pay for …
    
  • How can I check whether an expense is covered?
    
  • Where do I call for emergency travel assistance?
    
    
• Claims
  
  • How do I claim eligible expenses?
    
  • What can I do if I disagree with a claims decision made by the Administrator?
    
  • What happens if my spouse also has health care coverage under another plan?
    
  • What is the deadline for submitting claims?
    
  • What is the group policy number?
    
  • Where do I call if I have a question about a claim?
    
    
• What the Plan does not cover
  
• General exclusions and limitations
  
• Drug benefit exclusions and limitations
  
• Vision care benefit exclusions and limitations
  
• Medical practitioner benefit exclusions and limitations
  
• Miscellaneous expense benefit exclusions and limitations
  
• Dental benefit exclusions and limitations
  
• Out-of-province benefit exclusions and limitations
  
• Hospital benefit exclusions and limitations
  
• Comprehensive coverage exclusions and limitations
  
  
• Termination of coverage
  
  • When does my coverage end?
    
  • When does coverage for my dependants end?
    
    
• Other administrative details
  

  • Plan Document
    
  • Plan booklet
    
  • Overpayments
    
  • Pension offices
    
    • Public Service pensioners
      
    • Canadian Forces pensioners
      
    • RCMP pensioners
      
    • Judges Act pensioners