Temporary Changes to the Medical Practitioners Benefit

June 17, 2020

In response to the physical distancing restrictions imposed during the COVID-19 pandemic and the limited availability of certain medical practitioners, temporary changes to the Public Service Health Care Plan (PSHCP) were implemented in the spring of 2020.  These changes include the following modifications to the Medical Practitioners Benefit. They will remain in effect until non-critical business is authorized to resume or as indicated otherwise.

Accepted Mental Health Practitioners

Social workers in all areas across the country have been temporarily considered eligible since March 24, 2020, and psychotherapists were added to the exception list on April 24, 2020.

Virtual Services Provided by Medical Practitioners

The PSHCP will reimburse eligible expenses that are the reasonable and customary charges for virtual services provided by the medical practitioners listed below. The practitioner must be registered in the province or territory where the member resides.

Medical service providers covered under the PSHCP virtually are:

Practitioner

Maximum Eligible Expense

PSHCP reimburses

Chiropodist or podiatrist

$300 in a calendar year

(Maximum combined amount for the listed practitioners.)

80%

Chiropractor

$500 in a calendar year

80%

Naturopath

$300 in a calendar year

80%

Osteopath

$300 in a calendar year

80%

Physiotherapist

 

Up to $500 and over $1,000 in a calendar year

80%

Psychologist, social worker or psychotherapist

$2,000 in a calendar year

(Maximum combined amount for the listed practitioners.)

80%

Speech language pathologist

$500 in a calendar year

80%

 

Prescription Requirements

The requirement to have a prescription for mental health or physiotherapy services under the PSHCP is temporarily suspended. Additionally, existing prescriptions for medical services that expired on or after March 20, 2020, will continue to be honoured during the COVID-19 pandemic period. When a member or an eligible dependant submits a claim for a medical service during this period, Sun Life will not ask for a new subscription even if their previous prescription has expired.

Claim Submission

Claims for services received virtually must be sent to Sun Life according to the standard claims submission process. Claims may be submitted by paper claim, via the Sun Life Plan Member website, or through the my Sun Life Mobile app. Members are encouraged to keep copies of receipts, completed claim forms and any other documentation. Please note that to be covered for the services of a social worker or a psychotherapist all claims must be sent by mail using a completed PSHCP Claim Form for members with Supplementary Coverage or a PSHCP Claim Form for Out-of-Country Claims for members with Comprehensive Coverage. Please attach all supporting documentation (original receipts, bills, invoices, physician or practitioner statements, and/or questionnaires, etc.) and mail the form to the following address:

Members with Supplementary Coverage:

Sun Life Assurance Company of Canada                       
PO Box 6192, STN CV
Montreal, QC   H3C 4R2

Members with Comprehensive Coverage:

Allianz Global Assistance
Public Service Health Care Plan
P.O. Box 880
Waterloo, ON  N2J 4C3

If you have questions regarding your PSHCP coverage during the COVID-19 pandemic, please contact the PSHCP Call Centre at 1-888-757-7427 (toll-free) or
613-247-5100 (in the National Capital Region).