Changes to your Coverage under the PSHCP for Orthotics

May 27, 2020

Your health benefits for orthotics changed on February 1st, 2019.

Since that date, PSHCP coverage for orthotics and repairs to orthotics are subject to a revised reasonable and customary amount of $550 reimbursed at 80% for one pair of orthotics for each eligible dependant, per calendar year. Coverage must be active at the time the expense was incurred and the cost of repairs are eligible only if a pair of orthotics has not been reimbursed the same calendar year.

The PSHCP provides coverage for both off-the-shelf and custom orthotics under the Miscellaneous Expense Benefit of the Plan. To be eligible for reimbursement, a physician, podiatrist or chiropodist must prescribe the orthotics. Prescriptions are valid for three years.

To be eligible for reimbursement, custom orthotics must now be dispensed by one of the following specialists:

•             Podiatrist* 

•             Chiropodist*

•             Pedorthist

•             Orthotist

•             Chiropractor

•             Certified Orthotist (CO) or Technologue professionnel (TP) in Québec

* Orthotics dispensed by a podiatrist or chiropodist do not require a prescription.  

This requirement ensures that your custom orthotics are dispensed by trained specialists with the expertise to design high-quality orthotics that fit you properly. Your claim to Sun Life must indicate the name and credentials of the specialist who dispensed the orthotics.

We encourage members to sign-in to the Plan Member Services website (www.sunlife.ca/pshcp) or the my Sun Life Mobile app and use the Provider Search tool to find an eligible orthotics specialist near you.

If you have questions regarding your coverage for orthotics under the PSHCP, please contact the PSHCP Call Centre at 1-888-757-7427 (toll-free) or 618-247-5100 (in the National Capital Region).