Did You Know?
This article was published before the transition to the new Plan Administrator, Canada Life. If you have any questions, contact the PSHCP Member Contact Centre at 1-855-415-4414 (toll-free anywhere in North America) or 1-431-489-4064 (call collect if you are outside North America).
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:
Eligible virtual services under the PSHCP are:
Maximum Eligible Expense: $300 in a calendar year (Maximum combined amount for the listed practitioners.)
PSHCP reimburses: 80%
Maximum Eligible Expense: $500 in a calendar year
PSHCP reimburses: 80%
Maximum Eligible Expense: $300 in a calendar year
PSHCP reimburses: 80%
Maximum Eligible Expense: $300 in a calendar year
PSHCP reimburses: 80%
Maximum Eligible Expense: Up to $500 and over $1,000 in a calendar year
PSHCP reimburses: 80%
Maximum Eligible Expense: $2,000 in a calendar year (Maximum combined amount for the listed practitioners.)
PSHCP reimburses: 80%
Maximum Eligible Expense: $500 in a calendar year
PSHCP reimburses: 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 prescription 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).