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Submitting a supplemental health and dental claim

Provider Information

Insurance Provider: Manulife

Policy Number: 85210

Customer Service/Claim Inquiries: 1-800-268-6195

Claims Submission

Due to COVID-19, McGill will be extending the deadline for health and dental claim expenses incurred in 2019. All expenses must be received by Manulife no later than June 30th, 2020. Claims received by Manulife after June 30th will not be accepted, even if post-marked before June 30th.

The benefit year is January 1st to December 31st. All claims must be received by our insurer within 90 days of the end of the benefit year- that is, by March 31st. Claims after this date will not be eligible for consideration. 

Submit Online

  • Sign in to the Manulife Plan Member Secure site. Under Group Benefits and Retirement select My Group Benefits.
  • If you are already registered on the Plan Member Secure Site, enter your plan contract number (85210), your member certificate number (McGill ID) and your password.
  • If you are not already registered, scroll down to 'Get started' and follow the instructions.
  • You will need to keep your receipts for at least one year. 
  • For questions about the online claims submission process, contact Manulife directly at 1-800-268-6195.

Mobile App

Download the Manulife Mobile on the App Store, or on Google Play.

By downloading the app, you will be able to:

  • Submit claims from your smartphone.
  • View your most recent claims.
  • Explore claim details.

Visit your favourite app store to download it now and enjoy the convenience of managing your benefits on the go.

Paper Claims

Paper submissions can be made by mail or in person. Download and print a Health Claim Form or Dental Claim Form.

Be sure to include:

  • The plan member certificate number (your McGill ID number).
  • The name and date of birth of claimant.
  • The total amount submitted.
  • Referral or prescription from the treating physician were necessary (consult the Supplemental Health Plan as to whether the service you incurred requires a referral/doctor's prescription).
  • Attach the original receipt(s) and keep a copy for your personal records, then sign, date and forward the completed form directly to Manulife.

Claims can be mailed to the following addresses:

Health claims

Group Claims Department
PO Box 2580, STN B
Montreal, Qc H3B 5C6

Dental claims

Group Claims Department
PO Box 5000, STN B
Montreal, Qc H3B 4B5

At the Pharmacy/Direct Billing

At the Pharmacy

Payment for drug expenses will be processed through the Deferred Drug Card Program.

You will be required to pay for the cost of the medication up front, at which time your pharmacist will submit an electronic claim directly to Manulife for processing. You will automatically receive payment by direct deposit (into the bank account McGill has on file) for the total amount covered by the McGill Supplemental Health Plan. There is no need to submit a paper claim, or update your bank account with Manulife.

Direct Billing

Health care providers, such as physiotherapists and chiropractors, can submit plan member claims directly to Manulife at the point of care. In many instances, plan members will only have to pay the amount not covered by the plan for approved claims. For more information, speak to your health care provider.

Additional Information 

Benefits Card

You can print a personalized benefit/travel card for you and the eligible dependents covered under your McGill Supplemental Health Plan from Manulife's Plan Member Secure Site. You must be under 65 to do so.

  • Once on the Plan Member Secure Site, select Login/Register. 
  • If you are not already registered, click on "Registration" and follow the instructions on the Manulife website.

When paying for your medication, present your benefit card to your pharmacist, dentist, or health professional service provider, who will submit an electronic claim directly to Manulife for processing. You will automatically receive payment for the total amount covered by the McGill Supplemental Health Plan—there is no need to submit a paper claim. 

What's on the card

  • The benefit card includes the Manulife group plan number 85210, your certificate number and the Manulife customer service phone number.
  • The reverse side of the card includes emergency telephone numbers to use in case of a medical emergency while travelling, as well as the emergency travel assistance plan number.

Family Coverage and Coordinating Payments

Family Coverage and Coordinating Payments

If both you and your spouse have health and/or dental coverage through your respective employers, you can claim payment for health and dental expenses under both plans.

To coordinate payment, you will need to follow the following steps:

  • If you have incurred the expense: You must submit your claim through the McGill plan first. If there is an unpaid portion remaining, your spouse can submit a claim for this amount through his/her plan.
  • If your spouse has incurred the expense: Your spouse must submit his/her claim through his/her plan first. Any unpaid portion may be claimed through your McGill plan, provided you have family coverage.
  • If your child has incurred the expense and you both have family coverage: The claim must be submitted first to the plan of the parent whose birthday falls earlier in the year. Any unpaid portion can then be submitted under the other spouse's plan as the secondary payer.
  • For information regarding coordination of benefit scenarios, please consult the Canadian Life and Health Association's brochure.

Once you receive payment from the first insurance company, submit the claims statement showing amounts considered and paid by the first insurance company online through the insurance carrier's website or Mobile App. 

Who are eligible dependents?

Under most circumstances, the term "child" includes:

  • Your natural or legally adopted child.
  • Your spouse's child if living with you.
  • A child for whom you are the legal guardian and who is wholly dependent on your for support.
  • During the period of probation that precedes adoption, the child you are adopting.
  • Any child described above must be unmarried, less than 21 years of age and wholly dependent on you for support. You must also have custody and control of that child.
  • Your unmarried child under 26 years of age is also eligible, if he or she is wholly dependent on you for support and is a full-time student attending (or on vacation from) an educational institution.
  • A child who is mentally or physically disabled and wholly dependent on your support is also eligible beyond age 21. Proof of the disability must be submitted within 31 days after the child reaches age 21. The form Application for Health/Dental Coverage for Overage Disabled Dependant Child must be completed in part by Human Resources (HR Service Centre) and then by your child's treating physician. Submit the form direcly to Manulife Financial for review. Manulife will send you written confirmation of the results of their review.

For purposes of your benefits plan, your "spouse" is:

  • A person of either sex with whom you have been living in a conjugal relationship for one year. The one-year cohabitation requirement does not apply when you and your spouse have a child together.
  • As defined under the applicable legislation.
  • Only one person at a time can be covered as your spouse under the terms of the program.

NOTE: Under the Quebec Act respecting prescription drug insurance, you and your eligible family members under age 65 must join the McGill Supplemental Health Plan if drug coverage not provided under another group insurance plan.

Additional Information by Claim Type

Benefit Claim Process
Hospital

If the hospital will bill the insurer directly:

  • Advise the admitting clerk that you are covered under plan contract number 85210 with Manulife.
  • Give them your McGill identification number.
  • The hospital will bill Manulife directly.

If the hospital requires that you pay the bill:

  • Obtain the completed hospitalization claim form from the hospital (keep a copy for your personal records).
  • Forward the completed hospital form directly to Manulife with your policy and ID number indicated, or attach the hospital form to a Manulife claim form and forward both directly to Manulife for processing.
Private Duty Nursing

You must submit a pre-determination to Manulife before nursing services can begin; otherwise, your claim could be refused or reimbursed at a lower level. Please refer to Private Duty Nursing Guidelines for more information, and attach all necessary information to a Manulife Supplemental Health claim form.

PDF icon private_duty_nursing_guidelines.pdf

Orthotics and Orthopaedic Shoes

In order to be eligible for payment, your orthotics and/or orthopedic shoes must be:

  • Custom made.
  • Prescribed by a medical general practitioner or specialist, podiatrist or chiropodist, and
  • Supplied by an orthotist, pedorthist, podiatrist or chiropodist.

For each claim and/or pre-determination for orthotics and orthopaedic shoes, you must supply a detailed prescription from the prescribing medical practitioner indicating all of the following:

  • A diagnosis of the condition (symptoms alone will not suffice),
  • A list of symptoms and the chief complaint,
  • A description of the physical findings from the clinical examination,
  • A brief narrative description of the gait abnormality with the diagnosis,

A detailed receipt from the supplier indicating:

  • The provider's qualifications.
  • Confirmation that the orthotics or orthopedic shoes have been custom made.
Opthamologist If your medical claim is for an eye exam performed by an opthamologist who is registered with Medicare, a detailed explanation of the services rendered, as well a separate charges, must be indicated on the receipt.
Emergency medical and out-of-country/province claims For information, see Emergency travel assistance for active faculty staff or for retired employees.
Dental Claims

Pre-determination

  • If the total treatment is expected to cost more than $400, it is recommended that you submit a treatment plan to Manulife before the treatment begins to avoid surprises.

Electronic claims submission by your dentist

  • Some dentists have the ability to submit dental claims electronically to Manulife, in which case no paperwork is required. Simply provide your dentist with your Manulife policy number 85210 and your plan member certificate number (your McGill ID number).

Paper claim submission

  • Before visiting your dentist, obtain a Manulife dental claim form.
  • Complete Part 2 of the form.
  • Have your dentist complete Part 1 of the form.
  • You can assign your benefit payment directly to your dentist by signing in the appropriate box on the form.
  • Otherwise, sign, date and forward the completed form directly to Manulife. The address is provided on the form. Keep a copy for your records.

Dental claims as a result of an accident

  • Submit a pre-determination under the McGill Supplemental Health Plan using a health claim form. Include from your dentist: x-rays, details of treatment, including procedure codes, tooth #, tooth services and fees and details of the accident. Once the estimate is approved, the claim must be mailed and not submitted electronically.
Life Insurance and Accidental Death and Dismemberment Claims Your beneficiary or the executor of your estate should contact the HR Service Centre at 514-398-4747, or by hrhr [at] mcgill.ca (email) as soon as reasonably possible to advise of your death. A representative will help them complete the claims process.
Provincial Plan Replacement Coverage Refer to the the following page for further information.

Direct Deposit/Claims History

This page deals with direct deposit as it pertains to Health and Dental Claims. In order to sign up for - or change your information for - direct deposit of pay, see Change your banking information.

Automatic Registration

McGill provides Manulife with the required information from your employee file (bank info, email) so that you will be automatically registered for direct deposit of your claims payments.

This means that:

  • Your health and dental claims payments will be automatically deposited directly into your McGill payroll designated bank account.  
  • You will receive claim payments faster -in most instances- within 48 hours.
  • Manulife will send you an e-mail advising when your claim has been processed.

Viewing your statements and claims history - Manulife member site

You can view your claim statements on Manulife’s Plan Member Secure Site. The site also allows you to:

  • Quickly view the status of any online submitted claims.
  • Access details of your claims history.
  • Print a Benefits card from anywhere in the world as long as you have internet access
    TO REGISTER
    • Go to Manulife's Plan Member Secure Site
    • Once on the site, click on the 'Sign In' button, under Group Benefits select 'Participant' and then follow the steps provided.
    • Once you have registered, Manulife will send you an activation key to 'activate' your account.
    • With your activation key, follow the instructions on the Manulife website to gain full access to the Plan Member Secure Site and your benefits information.

    *Note: The activation key expires after 90 days. If you have not used your activation key to complete the process of registering for the Manulife Plan Member Secure Site within 90 days of receipt, please contact the Manulife Customer Service Centre directly at 1-800-268-6195 to request a new one.

    If you encounter any problems during this process or do not receive your activation key, contact Manulife directly at 1-800-268-6195.

    IF YOU DON'T REGISTER Your claim payments will still be deposited into your McGill payroll designated bank account and you will receive email notifications when a claim has been paid.  However, you will not be able to view your claim statements nor your claims payment history.  Nor will you have access to the online features: 'eProvider' and 'Online claims submission'.
    PAPER CLAIM STATEMENTS

    You can obtain a paper statement of your claim payments by contacting Manulife at 1-800-268-6195.  Please note that this is not an automatic process and that you will need to contact Manulife each time you wish to receive a paper statement.


    Printed copies of your electronic claim statements from the Manulife website are acceptable for income tax purposes.

    Changing your information

McGill sends the necessary information for direct deposit - including bank and email information - to Manulife via an employee file, and Manulife updates their records according to the information in the McGill employee file.

McGill sends this information once a week. 

CHANGING BANK INFO

For bank information, the information in your file overrides any other bank information on the Manulife Plan Member Secure Site. This means that in order to change your Direct Deposit banking information you will need to change your McGill payroll designated bank information. To do this, log into Workday and go to the pay application. You will find further information here.

If you have already submitted a claim to Manulife and your new banking information has not yet reached Manulife by the time the claim has been processed, Manulife will issue a cheque reimbursement.  The next claim payment will be deposited directly to your new McGill bank account.

CHANGING YOUR EMAIL ADDRESS

If you would like to change your email address for Direct Deposit purposes to one other than that found in your employee file, you can enter your preferred email address on Manulife’s Plan Member Secure Site under the ‘My Profile’ tab.

Unlike bank account information, there are two systems for the input of email address information on Manulife’s records.  As a result, your email address will not be affected by the McGill employee file.

If your service provider is not set up on the Manulife eClaims network

Manulife Provider eClaims service for electronic claims submission, adjudication and reimbursement was developed in partnership with TELUS Health. Your service provider will need to consult the TELUS Health website for information on how to register.

When you leave the university

You have 90 days from the day you terminate employment to submit any outstanding claims for charges incurred prior to your termination date. Manulife's website will no longer be active once you leave the university, therefore all claims must be submitted by mail. If you need to print out a summary of your claims for income tax purposes, you will need to do it before you leave the university.


 

 

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