Public Service Health Care Plan PSHCP [Merged]

[ab136]

As a new member, how does the Cf medical plan work for family members?  What is the cost and are pre-existing medications covered?

 

[Loadmaster]

Are you Reg or Reserve??

There is a difference between the 2

 

[old medic]

You can read up about it on this link. If you don't find any specific answers, feel free to ask again.

Understanding and Accessing Your Health Care Benefits

http://www.forces.gc.ca/health/services/engraph/health_info_home_e.asp

 

[ab136]

Waiting for a Reg. call

 

[Loadmaster]

Well there you go, all the info you need to start is in the link above.

 

[ab136]

Thanks guys

 

[ab136]

Can't seem to find anything there.  What I am wondering about is a prescription my wife has now...Imitrex. Just wondering if we might be able to "claim" it; it's about $15 per pill and it's very affective at relieving migraines.

 

[Loadmaster]

I'm not sure if they will cover that specifically but in your post you mention that you are waiting for a Reg call. This medical and dental plan do not come into effect until 2-3 months after the application is received.  Have you got the booklets yet from your OR?

 

[Michael OLeary]

CFAO 56-21 -- GROUP SURGICAL-MEDICAL INSURANCE PLAN

http://www.admfincs.forces.gc.ca/admfincs/subjects/cfao/056-21_e.asp

AUTHORITY

1. Regulations governing the Group Surgical-Medical Insurance Plan (GSMIP) for dependants of members of the Regular Force were approved by Treasury Board Minute 758836 of 17 Jul 78 as the Public Service Health Insurance Directives (PSHID) effective 1 Sep 78.
PURPOSE

2. This order described the benefits available under GSMIP and details the administrative procedures required to effect participation by dependants. It should be read in conjunction with 56-35, Hospital and Health Insurance Plans Within Canada, and 56-27, Hospital Insurance (Outside Canada) Plan.

 

[Loadmaster]

Have you read this??

http://www.forces.gc.ca/health/services/spectrum_of_care/engraph/supp_health_care_e.asp?Lev1=1&Lev2=5&Lev3=8#a

 

[ab136]

So from what I have read, and correct me if I am wrong, the CF medical is a Blue Cross plan?

 

[Gunner98]

The CF Medical System uses Blue Cross to assist with the payment for services and supplies to physicians, facilities and suppliers on behalf of CF members.  Blue Cross is not the CF member's insurance provider; they are merely a central agency that the CF uses to pay medical bills.  The CF then pays Blue Cross monthly as bulk claim.  Blue Cross helps track the individual claim back to the home facility responsible for that patient through the billing system.  The providers sign up with Blue Cross for quicker payment.

 

[ab136]

Thanks Gunner98, just what I wanted to know.

 

[Gunner98]

SunLife provides dependent coverage within Canada through the Public Service Health Care Plan, see website:
http://www.tbs-sct.gc.ca/pubs_pol/hrpubs/tb_862/pshcpb-rssfpp_e.asp

Outside Canada info:  http://collection.nlc-bnc.ca/100/201/301/tbs-sct/tb_manual-ef/Pubs_pol/hrpubs/TB_862/CHAP2_3_e.html  or
http://www.tbs-sct.gc.ca/pubs_pol/hrpubs/TB_862/pshcpb-rssfpp2_e.asp#_Toc81106885


Claims for expenses incurred under the Comprehensive coverage provision
If you incur claims under the Comprehensive coverage provision of the PSHCP, you may send your claims directly to World Access Canada at the following address:

World Access Canada
Public Service Health Care Plan
P.O. Box 880
Waterloo ON N2J 4C3

Plan members living or working in the United States may call World Access toll-free at 1â ‘800â ‘363-1835.

Plan members outside Canada in countries other than the United States who are unable to call directly may call the World Access claims line collect at 519â ‘742â ‘1691. The claims line is open from 8:30 a.m. to 4:00 p.m. (EST), Monday to Friday.

Emergency travel assistance benefit
The Emergency travel assistance benefit provides emergency medical and general travel assistance to eligible members who travel outside their province/territory of residence.

If emergency assistance is needed, a 24-hour help line is available. Multilingual coordinators can access a worldwide network of professionals who offer help with medical, legal, or other travelâ ‘related emergencies. Call the 24â ‘hour toll-free number:

1-800-667-2883 in Canada and the United States, or
call collect 519-742-1342 in all other countries.

 

[ab136]

Thanks Gunner98, your a wealth of information on my topic.  Thanks again for the PM's

 

[Chags]

Question for y'all.. 

I just got married a couple months ago  (wow time really flies) and am just about done all the admin that goes along with it..  I got the Public Service Health Care Plan Card in the mail last week..  now is that the card my wife needs when she goes to the hospital (or dentist) or is there another card..  I've heard of some other card that would have her name on it (and dependents)

Any info would be appreciated

 

[wotan]

Howdy Chags,

  The PSHCP card along with her Provincial Health Care plan card is all that is required.  As you add dependants onto your military records (make sure you add them!), they are automatically covered with PSHCP.

  There is also the CF Dental Care plan, but you aren't issued a card for that.  Simply go to your OR and they can provide you with claim forms and an explanation of benefits.  Most dentists that are familiar with the CFDCP will submit the claim on your behalf and simply bill you the remaining portion, but that is their choice.  They may prefer for you to pay up front and for you to submit the claim.

  There is also a Blue Cross card that is available for your use, but it covers only you on lve while outside Canada.  Basically, the card simply provides a contact number to arrange emergency medical and dental coverage while on lve outside the country, but again, I stress that it covers only you.  If you are taking the family out of the country, I would recommend investing in supplementary Blue Cross or similar coverage.

  Other than that, there are no other plans that I am aware of, however, it may vary from province to province.  However, if you have any doubts, consult your OR staff.  Better to ask and be informed than to be silent and miss out on benefits due to you.  Cheers.

 

[aesop081]

  There is also a Blue Cross card that is available for your use, but it covers only you on lve while outside Canada.  

Incorrect.   The blue cross card is there for you when you require medical care and DND facilities are not available INSIDE and OUTSIDE Canada.   If you are hurt on the weekend and need to go to the hospital/clininc down the street from your house...the blue cross card will cover you.

 

[Chags]

Thanks for the info wotan..  thats exactly what I needed to hear..

Chags

 

[wotan]

Incorrect.   The blue cross card is there for you when you require medical care and DND facilities are not available INSIDE and OUTSIDE Canada.   If you are hurt on the weekend and need to go to the hospital/clininc down the street from your house...the blue cross card will cover you.

Not to start a p*ssing contest, however when I have the temerity to instruct you as to flight ops, then by all means feel free to instruct me on admin.  Form DND-021(B) is based on an agreement between the CF and Atlantic Blue Cross.  You can identify the fact that it is only for outside Canada use by the fact the front of the card carries, in large, red type the following:  EMERGENCY MEDICAL/DENTAL ASSISTANCE OUTSIDE OF CANADA. 

That said, you are correct that CF members, on lve within Canada or requiring after-hours emergency care may attend civilian facilities as directed.  Cheers.